Uveitis Clinical Updates

SCREENING FOR CMV

Studies have highlighted a need for a standardized approach to screening for cytomegalovirus (CMV) retinitis in transplant patients, as there are no national ophthalmic screening guidelines for this vulnerable population.

In collaboration with multidisciplinary care teams at Primary Children’s Hospital and University of Utah Health, the Moran Uveitis Division developed a screening protocol for CMV retinitis in bone marrow and solid organ transplant patients.

The timely, systematic ophthalmic examinations were implemented in Fall 2019 to maximize early disease detection and potential interventions to prevent irreversible vision loss in a disease that is largely asymptomatic in early stages.

—Katherine Hu, MD

COVID-19 AND UVEITIS CARE

There have been no published reports of COVID-19-associated uveitis; however, retinal microvascular changes have been described. Consensus has been evolving as to the optimal management of uveitis patients during the pandemic, especially for those on immunomodulatory therapy (IMT).

While there is concern these patients would be at higher risk of severe SARS-CoV-2 infection, literature from multiple subspecialties with large numbers of patients on IMT has not shown this to be the case.

Recommendations include continuation of IMT in the absence of known infection, use of local rather than systemic steroids when possible for those at very high risk for severe COVID-19, and a multidisciplinary approach to carefully monitor patients who develop active infection necessitating the discontinuation of IMT.

—Marissa B. Larochelle, MD