Publications by authors named "Grace Levy Clarke"
Vitamin D Supplementation and Remission from Chronic Anterior Uveitis.
Ocul Immunol Inflamm
November 2024
Purpose: Chronic anterior uveitis (CAU) often requires suppressive therapy, which has potential side effects including cataract, ocular hypertension, and increased risk of infection. No remittive therapy is currently available; however, several studies have demonstrated an association between low 25-hydroxy Vitamin D (25OHD) levels and either uveitis incidence or uveitis disease activity. This study investigates the potential of Vitamin D supplementation as a remittive treatment for CAU.
View Article and Find Full Text PDFPurpose: To evaluate the incidence, remission, and relapse of post-surgical cystoid macular edema (PCME) following cataract surgery in inflammatory eye disease.
Methods: A total of 1859 eyes that had no visually significant macular edema prior to cataract surgery while under tertiary uveitis management were included. Standardized retrospective chart review was used to gather clinical data.
Article Synopsis
- A study evaluated the incidence of significant posterior capsule opacification (PCO) and YAG laser capsulotomy among uveitic eyes after cataract surgery, revealing that about 16% of eyes experienced PCO with reduced visual acuity within a year.* -
- Analysis of 1,855 uveitic eyes found that younger patients, those with poorer preoperative vision, and postoperative inflammation were more likely to develop PCO, while younger age and female sex were risk factors for needing YAG laser capsulotomy.* -
- The findings indicate that PCO is common in uveitic patients post-surgery, with 22% of eyes undergoing YAG laser treatment in the same timeframe, emphasizing the need for
Article Synopsis
- The study aimed to analyze the relationship between immunosuppression and overall as well as cancer-specific mortality in patients with noninfectious ocular inflammatory disease.
- Researchers examined data from over 15,000 patients over a median of 10 years and found there were 1970 deaths, with 435 attributed to cancer.
- The results indicated that patients on various immunosuppressants experienced similar mortality rates compared to the general U.S. population, suggesting that these treatments did not significantly increase overall or cancer mortality risk.
Purpose: To estimate the incidence/risk factors for cataract in noninfectious anterior uveitis.
Design: Retrospective multicenter cohort study (6 US tertiary uveitis sites, 1978-2010).
Methods: Data were harvested by trained expert reviewers, using protocol-driven review of experts' charts.
Purpose: To evaluate the long-term visual acuity (VA) outcome of cataract surgery in inflammatory eye disease.
Setting: Tertiary care academic centres.
Design: Multicentre retrospective cohort study.
Article Synopsis
- The study aimed to estimate the incidence of corneal endothelial transplantation (CET) and identify risk factors in patients with noninfectious ocular inflammation using data from a cohort study of adult patients in the U.S.
- A total of 14,264 eyes were analyzed, revealing a 10-year incidence rate of 1.10% for CET, with notable risk factors including older age (over 60), specific types of inflammation (anterior uveitis and scleritis), and prior operations like cataract and tube shunt surgery.
- The findings suggest that while CET is rare among these patients, certain conditions like hypotony and band keratopathy significantly increase the likelihood of requiring the procedure.
Risk of Cataract in Intermediate Uveitis.
Am J Ophthalmol
September 2021
Purpose: To determine the incidence of and predictive factors for cataract in intermediate uveitis.
Design: Retrospective cohort study.
Methods: Patients were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study, in which medical records were reviewed to determine demographic and clinical data of every eye/patient at every visit at 5 participating US tertiary care uveitis centers.
Introduction: We evaluated the associations of clinical and demographic characteristics with visual acuity (VA) with over 5 years in a subspecialty noninfectious uveitis population.
Methods: Retrospective data from 5,530 noninfectious uveitis patients were abstracted by expert reviewers, and contemporaneous associations of VA with demographic and clinical factors were modeled.
Results: Patients were a median of 41 years old, 65% female, and 73% white.
Purpose: This study evaluated the risk and risk factors for exudative retinal detachment (ERD) in ocular inflammatory diseases.
Design: Retrospective cohort study.
Methods: Patients with noninfectious ocular inflammation had been followed longitudinally between 1978 and 2007 at 4 US subspecialty uveitis centers.
Purpose: To estimate the incidence of medication-free remission of chronic anterior uveitis and identify predictors thereof.
Design: Retrospective cohort study.
Participants: Patients diagnosed with anterior uveitis of longer than 3 months' duration followed up at United States tertiary uveitis care facilities.
: We evaluated visual acuity (VA) over 5 years in a subspecialty noninfectious uveitis population.: Retrospective data from 5,530 noninfectious uveitis patients with anterior, intermediate, posterior or panuveitis were abstracted by expert reviewers. Mean VA was calculated using inverse probability of censoring weighting to account for losses to follow-up.
View Article and Find Full Text PDFPurpose: To compare mycophenolate mofetil (MMF) to methotrexate (MTX) as corticosteroid-sparing therapy for ocular inflammatory diseases.
Design: Retrospective analysis of cohort study data.
Methods: Participants were identified from the Systemic Immunosuppressive Therapy for Eye Diseases Cohort Study.
Purpose: To assess how often non-infectious anterior scleritis remits and identify predictive factors.
Methods: Our retrospective cohort study at four ocular inflammation subspecialty centers collected data for each affected eye/patient at every visit from center inception (1978, 1978, 1984, 2005) until 2010. Remission was defined as inactivity of disease off all suppressive medications at all visits spanning at least three consecutive months or at all visits up to the last visit (to avoid censoring patients stopping follow-up after remission).
Purpose: To describe the risk and risk factors for ocular hypertension (OHT) in adults with noninfectious uveitis.
Design: Retrospective, multicenter, cohort study.
Participants: Patients aged ≥18 years with noninfectious uveitis seen between 1979 and 2007 at 5 tertiary uveitis clinics.
Adalimumab for Ocular Inflammation.
Ocul Immunol Inflamm
June 2017
Purpose: To evaluate adalimumab as an immunomodulatory treatment for non-infectious ocular inflammatory diseases.
Methods: Characteristics of patients treated with adalimumab were abstracted in a standardized chart review. Main outcomes measured were control of inflammation, corticosteroid-sparing effect, and visual acuity.
Purpose: To evaluate the incidence of remission among patients with intermediate uveitis; to identify factors potentially predictive of remission.
Design: Retrospective cohort study.
Methods: Involved eyes of patients with primary noninfectious intermediate uveitis at 4 academic ocular inflammation subspecialty practices, followed sufficiently long to meet the remission outcome definition, were studied retrospectively by standardized chart review data.
Purpose: To evaluate the risk of and risk factors for retinal neovascularization (NV) in cases of uveitis.
Design: Retrospective cohort study.
Participants: Patients with uveitis at 4 US academic ocular inflammation subspecialty practices.
Purpose: To characterize the risk and risk factors for intraocular pressure (IOP) elevation in pediatric noninfectious uveitis.
Design: Multicenter retrospective cohort study.
Participants: Nine hundred sixteen children (1593 eyes) younger than 18 years at presentation with noninfectious uveitis followed up between January 1978 and December 2007 at 5 academic uveitis centers in the United States.
Purpose: To evaluate the benefits and complications of periocular depot corticosteroid injections in patients with ocular inflammatory disorders.
Design: Multicenter, retrospective cohort study.
Participants: A total of 914 patients (1192 eyes) who had received ≥ 1 periocular corticosteroid injection at 5 tertiary uveitis clinics in the United States.
Background: A recent Canadian case-control study reported a 4.5-fold increased risk of retinal detachment (RD) during oral fluoroquinolone use. Of the fluoroquinolone-exposed cases, 83 % were exposed to ciprofloxacin.
View Article and Find Full Text PDFTopic: To provide recommendations for the use of anti-tumor necrosis factor α (TNF-α) biologic agents in patients with ocular inflammatory disorders.
Clinical Relevance: Ocular inflammatory diseases remain a leading cause of vision loss worldwide. Anti-TNF-α agents are used widely in treatment of rheumatologic diseases.
Purpose: To identify factors predictive of remission of inflammation in new-onset anterior uveitis cases treated at tertiary uveitis care facilities.
Design: Retrospective cohort study.
Participants: Patients seeking treatment at participating academic uveitis clinics within 90 days of initial diagnosis of anterior uveitis.