Poor Documentation of Inflammatory Bowel Disease Quality Measures in Academic, Community, and Private Practice.

Background & Aims: Quality measures are used to standardize health care and monitor quality of care. In 2011, the American Gastroenterological Association established quality measures for inflammatory bowel disease (IBD), but there has been limited documentation of compliance from different practice settings.

Methods: We reviewed charts from 367 consecutive patients with IBD seen at academic practices, 217 patients seen at community practices, and 199 patients seen at private practices for compliance with 8 outpatient measures.

Innate immunity in disease.

Cells can innately recognize generic products of viruses, bacteria, fungi, or injured tissue by engagement of pattern recognition receptors. Innate immune cells rapidly respond to this engagement to control commensals, thwart pathogens, and/or prompt repair. Insufficient or excessive activation of the innate immune response results in disease.

Anterior chamber intraocular lens implantation in patients with a history of chronic uveitis: five-year follow-up.

Purpose: To compare the incidence of long-term complications after cataract surgery with primary anterior chamber intraocular lens (AC IOL) implantation in uveitic patients and patients without a history of intraocular inflammation (control group).

Setting: Single-center private practice.

Design: Retrospective clinical study.

Glaucoma and uveitis.

Despite its relative rarity, uveitis is the third leading cause of preventable blindness worldwide. Glaucoma associated with uveitis is one of the most serious complications of intraocular inflammation. We review in detail the epidemiology and pathogenesis of uveitic glaucoma and the safety and efficacy of the current medical and surgical treatment modalities.

Infliximab treatment of patients with birdshot retinochoroidopathy.

Purpose: To report the outcomes of infliximab treatment of birdshot retinochoroidopathy (BSRC) refractory to conventional immunomodulatory therapy.

Design: Retrospective case series.

Participants: Twenty-two refractory birdshot retinochoroidopathy patients (44 eyes) who received infliximab between July 2005 and June 2012 were identified by retrospective chart review.

Profile of local interleukin expression in a cohort of ocular cicatricial pemphigoid patients.

Purpose: We investigated the expression of IL-1, IL-6, IL-12, IL-13, and IL-17 in the conjunctiva of patients with ocular cicatricial pemphigoid (OCP), also labeled as ocular mucous membrane pemphigoid (MMP).

Methods: A retrospective case-control study was done on 5 biopsy-proven OCP subjects and 6 healthy volunteers. Conjunctival specimens were obtained, and the local expression of IL-1, IL-6, IL-12, IL-13, and IL-17 was studied by immunohistochemistry.

Long-term safety and visual outcomes of anterior chamber intraocular lens implantation in patients with a history of chronic uveitis.

Purpose: To compare the visual outcomes and prevalence of long-term complications in patients with quiescent uveitis after phacoemulsification with traditional in-the-bag intraocular lens (IOL) implantation versus primary or secondary anterior chamber (AC) IOL implantation due to inadequate capsule support.

Setting: Single-center private practice.

Design: Retrospective observational cohort study.

Cataract surgery in patients with history of uveitis.

Cataract surgery in patients with uveitis is not as simple as any senile cataract surgery. Recent evidence suggests that useful visual outcome can be achieved in most of the cases if they are handled meticulously. Key factors leading to improved visual outcome are absolute control of preoperative inflammation with diligent use of immunomodulatory drugs, meticulous surgery along with early detection and care of postoperative complications.

Systemic therapy with conventional and novel immunomodulatory agents for ocular inflammatory disease.

Ocular inflammatory disease is the third leading cause of blindness in the United States. In addition to the conventional immunomodulatory agents, which include antimetabolites, alkylating agents, and antibiotics such as cyclosporine, many of which have been used in the treatment of this disease for decades, several new treatment modalities have emerged within the past 10 years. We review in detail the characteristics, safety, and efficacy of the conventional immunomodulators, the more novel agents such as the biologics, and investigational drugs that appear promising in the treatment of ocular inflammatory disease.

The Boston keratoprosthesis type II: the Massachusetts Eye and Ear Infirmary experience.

Purpose: To report the long-term outcomes of Boston keratoprosthesis type II implantation in the management of severe ocular surface disease and corneal blindness through a retrospective interventional case series.

Methods: This retrospective review included medical records of patients who underwent Boston keratoprosthesis type II implantation at the Massachusetts Eye and Ear Infirmary from January 1, 2000 through December 31, 2009. The main outcome measures analyzed were visual acuity, keratoprosthesis retention, and postoperative complications.

Road to remission: a comprehensive review of therapy in uveitis.

Introduction: Although uveitis remains the third leading cause of preventable blindness in the US, the care and management of patients with uveitis and ocular inflammatory disease sit poised to make evolutionary if not revolutionary changes in the years ahead. This review serves to highlight important advances in the pharmacologic options available for the treatment of uveitis and ocular inflammation.

Areas Covered: Advances in steroid therapy (both topical and extended delivery), updates in the clinical safety of systemic immune modulation, and the emerging therapies for uveitis and ocular inflammatory disease are some of the areas covered in this review.

Immunohistochemical differences between normal and chronically inflamed conjunctiva: diagnostic features.

Purpose: There is widespread misinterpretation of normal conjunctival fibrinogen. In differentiating between normal conjunctiva and cicatrizing conjunctivitis, including ocular cicatricial pemphigoid, atopic keratoconjunctivitis, and lichen planus, it is important to properly evaluate and characterize the histologic appearance of the structures seen and not base a diagnosis on just the presence or absence of certain features. One feature of conjunctival histology prone to misinterpretation and misdiagnosis is the presence of subepithelial fibrinogen, particularly when the diagnosis of lichen planus is being considered.

Herpes keratitis in a patient undergoing treatment with topical mitomycin C.

Purpose: To report a case of herpetic keratitis in a patient undergoing mitomycin C therapy for conjunctival squamous cell carcinoma.

Method: Case report.

Results: A 70-year-old man was referred to the Massachusetts Eye Research and Surgery Institution in consultation for a persistent redness in the right eye.

Scleral necrosis in a patient with congenital erythropoietic porphyria.

Purpose: To report on a patient with congenital erythropoietic porphyria who presented with scleral necrosis.

Method: Case report.

Results: A 34-year-old man with a long history of congenital erythropoietic porphyria was referred to us for evaluation of necrotizing scleritis of the right eye.