Publications by authors named "Meghan Berkenstock"
Article Synopsis
- * Out of 60 patients reviewed, most were middle-aged males from the U.S., with a significant proportion experiencing neurological issues and diabetes as a common health factor.
- * Key eye symptoms included multifocal chorioretinal lesions and inflammation, with many eyes not receiving treatment; the study highlights the importance of considering WNVI in older patients showing eye issues after recent flu-like symptoms.
Purpose: To evaluate the barriers to adherence with immunomodulatory therapy (IMT) for patients with uveitis across multiple regions of the United States.
Methods: A multi-center survey of adult and pediatric patients with ocular inflammatory diseases undergoing treatment with IMT was conducted between September 2021 and August 2022. Participating sites included Johns Hopkins Wilmer Eye Institute, Wong Eye Institute of the University of Texas at Austin, University of Wisconsin-Madison, University of Minnesota, Veterans Affairs Hospital of Minneapolis, and Washington University of St.
The NCCN Guidelines for the Management of Immunotherapy-Related Toxicities are intended to provide oncology practitioners with guidance on how to manage the wide-ranging and potentially fatal toxicities that may occur with cancer immunotherapy. The guidelines address immune-related adverse events related to immune checkpoint inhibitors, CAR T-cell therapies, and lymphocyte engagers (which include T-cell-engaging bispecific antibodies). These NCCN Guidelines Insights highlight recent guideline updates pertaining to the management of emerging toxicities related to cancer immunotherapy.
View Article and Find Full Text PDFPurpose: To analyze the accuracy and thoroughness of three large language models (LLMs) to produce information for providers about immune checkpoint inhibitor ocular toxicities.
Methods: Eight questions were created about the general definition of checkpoint inhibitors, their mechanism of action, ocular toxicities, and toxicity management. All were inputted into ChatGPT 4.
Article Synopsis
- The study evaluated how accurately and thoroughly three large language models (ChatGPT 4.0, Bard, and LLaMA) could generate information on ocular toxicities related to antibody-drug conjugates (ADCs).
- Twenty-two specific questions about two ADCs were tested, with responses rated by ocular toxicity experts using a 6-point scale for accuracy and completeness.
- Results showed that ChatGPT and Bard scored higher in accuracy than LLaMA, while all models demonstrated high completeness, indicating they can effectively handle specialized topics within ophthalmology.
Article Synopsis
- The article reviews antibody-drug conjugates (ADCs) used in treating gynecological cancers and their associated eye-related side effects.
- Recent findings highlight that the ADCs, tisotumab vedotin and mirvetuximab soravtansine, cause various ocular issues such as conjunctivitis and dry eye, primarily due to their targeting mechanisms affecting eye tissue.
- The authors emphasize the importance of teamwork between oncologists and ophthalmologists, along with following specific protocols, to minimize the risk of these eye-related side effects.
Background: Cases of uveitis can necessitate long-term treatment resulting in recurrent follow-up appointments. Analysing the demographic distribution and patient factors influencing treatment and time spent with physicians in this population compared to other subspecialties of ophthalmology using the National Ambulatory Medical Care Survey (NAMCS) has not previously been studied.
Methods: Data were extracted from the NAMCS database, a large, nationally representative survey of office-based specialists, entered between 2012-2016 and 2018.
Purpose: To assess the accuracy and completeness of ChatGPT-generated answers regarding uveitis description, prevention, treatment, and prognosis.
Methods: Thirty-two uveitis-related questions were generated by a uveitis specialist and inputted into ChatGPT 3.5.
Purpose: To describe the clinical course and evaluate treatment of ocular surface changes in patients receiving immune checkpoint inhibitor (ICI) therapy.
Methods: Multiple markers of ocular surface dryness were evaluated in 16 patients on ICI therapy. The Wilcoxon rank-sum test was used to determine the significant change in the initial and final ocular surface indices.
Aim: To describe the effectiveness and side-effect profile of adding difluprednate therapy to patients with anterior scleritis being treated systemically.
Methods: Retrospective chart review. Charts from all patients with anterior scleritis who were treated with topical difluprednate in addition to systemic therapy from 1 January 2018 to 1 January 2020 were reviewed.
Referral to Vision Rehabilitation Services for Uveitis Patients: Referral Criteria and Barriers.
Ocul Immunol Inflamm
September 2024
Purpose: Despite the benefits of vision rehabilitation services (VRS) for uveitis patients, limited literature has examined issues in VRS access within uveitis. We surveyed American Uveitis Society members regarding VRS referral practices, criteria, and barriers.
Methods: Survey responses were collected from November 2022 to January 2023.
Purpose: To evaluate the effectiveness of tacrolimus in patients with noninfectious intermediate, posterior, or panuveitis needing a two-immunosuppressive-agent regimen.
Methods: Design: Retrospective cohort study. Setting: Two tertiary-care uveitis practices at academic medical centers.
A Geodemographic Analysis of Travel Time to Uveitis Specialists in the United States.
Ocul Immunol Inflamm
August 2024
Purpose: Travel time to a patient's medical provider represents a significant component of access to care. We examined travel time to the nearest uveitis specialist for the American population and characterize its impact on access to uveitis care.
Design: Observational studies using the American Community Survey and American Census Bureau population estimates.
Article Synopsis
- The study aims to evaluate how effective TNF inhibitors are in treating non-infectious scleritis and achieving symptom relief.
- A retrospective review of patients revealed that 82.2% experienced symptom relief after 6 months, and 76.2% maintained that relief after 12 months, while also reducing their use of corticosteroids significantly.
- Results show TNF inhibitors not only help control scleritis effectively but also allow for a significant reduction in corticosteroid dosage.
Purpose: To study the types of uveitis examined in a hospital serving indigent populations in need of low-cost care.
Methods: A retrospective chart review examined the electronic medical records of all patients with uveitis-related at Drexel Eye Physicians. Data collected included demographics, anatomic location of the uveitis, systemic disease associations, treatment modalities and insurance.
Background And Objectives: Treatment of chronic, noninfectious ocular inflammation includes corticosteroids, disease-modifying antirheumatic medications, and biologics. To mitigate adverse effects associated with the use of these medications, routine laboratory test monitoring is recommended throughout treatment. We evaluated the effectiveness of an alert added to the electronic medical record (EMR) to aid in laboratory test monitoring for patients prescribed these high-risk medications.
View Article and Find Full Text PDFPurpose: To estimate the incidence of scleritis in Lyme disease and report clinical features.
Design: Incidence rate estimate and case series.
Methods: Data were collected from an electronic medical record on patients with scleritis presenting to the Wilmer Eye Institute between January 1, 2012 and December 31, 2020.
Article Synopsis
- Uveitides are over 30 diseases causing inflammation in the eye, often treated with oral corticosteroids and immunosuppressants, complicating clinical trials due to their rarity and diverse characteristics.
- Many trials have faced challenges with efficacy measures, leading to unclear results and difficulties in recruitment due to the need for a specific outcome measure for each disease.
- A promising approach involves using a single outcome focusing on successful corticosteroid sparing (inactive uveitis with low prednisone) to streamline assessment, which is currently being tested in the ADVISE Trial.
Article Synopsis
- The NCCN Guidelines aim to provide guidance for managing immune-related adverse events caused by cancer immunotherapy.
- An interdisciplinary panel of experts in various medical fields collaborates to create these guidelines, addressing a broad spectrum of potential toxicities.
- The excerpt focuses on recommendations for managing CAR T-cell therapy toxicities and offers a review of current evidence; for comprehensive guidelines, visit NCCN.org.
Bilateral anterior and posterior scleritis in a patient with acute myelogenous leukemia.
Am J Ophthalmol Case Rep
June 2022
Purpose: To report a novel case of bilateral anterior and posterior scleritis in a patient with acute myelogenous leukemia (AML).
Observations: A 69-year-old African American man was admitted to the hospital for relapse of AML. After admission, but prior to induction of chemotherapy, the patient developed ocular redness and proptosis.
Aim: To evaluate if there is a difference in the clinical course of primary vitreoretinal lymphoma (PVRL) in vitrectomized versus non-vitrectomized eyes.
Methods: Observational multicenter retrospective case series of patients diagnosed with PVRL between 2007 and 2019, at three tertiary centers. The main outcomes were relapse rates, inflammatory parameters, and best-corrected visual acuities (BCVA).
Purpose: To describe the effectiveness and side effect profile of difluprednate therapy in a series of patients with anterior scleritis.
Design: Retrospective, interventional case series.
Methods: Data collected from all patients with anterior scleritis who used difluprednate as a single treatment agent from January 1, 2018, to January 1, 2020, including demographics, scleritis type, presence of nodules or necrosis, changes in scleritis activity, intraocular pressure (IOP), number of difluprednate drops used, best-corrected visual acuity (BCVA), and lens status.
Immune checkpoint inhibitor associated ocular hypertension (from presumed trabeculitis).
Am J Ophthalmol Case Rep
September 2021
Purpose: Immune checkpoint inhibitors (ICIs) are associated with a range of immune-related adverse ophthalmic events. To date, there are scant reports of ocular hypertension coupled with ICI-associated uveitis. However, in instances of ocular hypertension in the context of only mild uveitic reaction and absence of synechiae, trabeculitis is considered.
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