Virginia Miraldi Utz, MD
Miraldi Utz is a pediatric ophthalmologist with subspecialty expertise in ocular inflammation, uveitis and inherited genetic disorders of the eye. Uveitis is inflammation involving the uvea of the eye and is either classified as infectious or non-infectious (autoimmune). In non-infectious uveitis (NIU), systemic steroid-sparing immunosuppression is often needed to prevent complications such as cataracts, glaucoma and life-long vision loss. Miraldi Utz’s uveitis research focuses on the clinical outcomes of patients treated with biologic response modifiers (BRMs) for NIU. She was the lead co-author on a retrospective study of clinical outcomes of children with recalcitrant uveitis treated successfully with infliximab therapy published in
Pediatric Rheumatology Online. In this study, infliximab successfully controlled inflammation in 90%, including a majority who failed adalimumab and methotrexate therapy. Corticosteroid burden, glaucoma medication burden and development of complications were significantly reduced. Importantly, children who were incompletely adherent to follow-up visits and treatment were ten times as likely to have uncontrolled uveitis at a given visit. Therefore, in addition to appropriate treatment selection, adherence remains critical for uveitis disease control. Miraldi Utz also works collaboratively with pediatric rheumatologist,
Sheila Angeles-Han, MD, MSc, on several juvenile idiopathic arthritis (JIA) and uveitis research protocols.
The Journal of Ocular Immunology and Inflammation recently published their work, “S100 Proteins, Cytokines, and Chemokines as Tear Biomarkers in Children with Juvenile Idiopathic Arthritis-associated Uveitis” . Researchers collected tears non-invasively using Schirmer strips in children with uveitis and healthy controls. They found a unique inflammatory biomarker profile in children with uveitis. Miraldi Utz serves as the Cincinnati Children's site co-primary investigator for an international, randomized, placebo-controlled Phase III clinical trial, “ADalimumab in Juvenile idiopathic arthritis-associated Uveitis Stopping Trial” (ADJUST). Randomized patients with long-term control of uveitis and joint disease will stop adalimumab verses continuance of the medication. This study will determine whether patients who stop adalimumab remain inflammation-free and also help to indicate the predictors that indicate long-term disease remission. Through her clinical care, research and advocacy, she hopes to contribute to the understanding and treatment of ocular inflammation and improved outcomes in children with uveitis.
Michael Yang, MD
Yang has a strong interest in retinopathy of prematurity (ROP), a potentially blinding disorder that affects premature infants. Yang is also involved with the G-ROP (Growth in ROP model development, a multicenter study) which analyzed and elucidated the factors that may be important for the development of severe ROP. Recently published validation studies suggest that a exclusion of a significant percentage of premature infants altogether from eye examinations does not put them at risk for undetected occurrence of severe ROP. In the future, these new findings might become incorporated into national standards with more restrictive guidelines as to which infants need examined for ROP and which do not.
Veeral Shah, MD
Shah is the first pediatric neuro-ophthalmologist to join Cincinnati Children’s
Division of Pediatric Ophthalmology, with a secondary appointment in the
Division of Neurology. With his arrival, he has initiated multiple clinical and academic research endeavors. He recently received an award as a North American Neuro-Ophthalmology Society (NANOS) fellow in April 2020, a status obtained by individuals who have made significant contributions to the field of neuro-ophthalmology. Within the department, he expanded clinical diagnostic testing for complex neuro-ophthalmic and ocular genetic patients by establishing clinical electrophysiology lab within the clinic, testing children with electroretinogram and visual evoked potentials without sedation. Additionally, Shah established an extraocular motor recording (EOM) lab for complex ocular motor diseases and cortical visual impairment patients. In a collaborative effort, he recently completed Bosch-Boonstra-Schaaf optic atrophy syndrome
paper in
American Journal of Medical Genetics, which described the vision phenotype in this genetic disorder. Additionally, Shah and colleagues described a novel diagnosis of “diffuse-type” infantile orbital fibromatosis in the
Journal of Neuro-Ophthalmology, and a case series of rare congenital orbital fibrosis in the
Canadian Journal of Ophthalmology. In a collective effort to address the clinical needs for tertiary care of complex patients with neuroimmune disease, Cincinnati Children’s initiated the development of a novel, state-of-the-art, patient-centered multidisciplinary center for children, adolescent and young adults with neuroinflammatory conditions. Presently, Shah is the director of this pediatric neuroimmunology clinic set to start in 2021. Shah, along with a number of neurologists and neuro-ophthalmologists, recently published the largest retrospective
multicenter study of patients with MOG-IgG associated disorder describing maintenance immunotherapy the prevents the recurrence of CNS demyelinating disease in
AAN Neurology Journal.
Kelsey Carriere, OD, FAAO
Carriere is a pediatric optometrist and contact lens provider. Her research interests include myopia progression, myopia management, and contact lenses. Her current studies include a retrospective analysis of myopia progression including the rate of progression as it relates to median household income, as there may be influences of socioeconomic status that may affect the outcome. Carriere is also recruiting for a pilot study on the use of soft contact lenses for patients with accommodative esotropia. The design of this study is to see if children who require bifocal eye glasses to control their accommodative esotropia can be fit in multifocal contact lenses and achieve the same ocular alignment. Her future goals include designing prospective studies that utilize multifocal contact lenses and/or low-dose atropine eye drops to better manage myopia progression in our practice.