Uveitis and Clinical Ocular Immunology Fellowship

OHSU Casey Eye Institute offers a comprehensive one year clinical fellowship in Uveitis and Ocular Inflammation, an AUPO compliant clinical fellowship. Fellows work with experts in orbital and ocular inflammatory diseases including: orbital inflammation, scleritis, anterior, intermediate, posterior or panuveitis, both infectious and non-infectious causes. They are exposed the breadth of management including adult and pediatric patients, systemic and local immunosuppression, including the use of biologics, clinical trial options, as well as surgical options. In addition, fellows are exposed to overlap entities in the medical retinal fields such as inherited retinal diseases and retinal vascular diseases. 

We hope to educate leaders in uveitis by providing in-depth, well-rounded training in ocular inflammatory disease.

History

The uveitis and ocular immunology fellowship at OHSU has been existence since 1998, and it has been participating in the San Francisco matching program since 2007. The following individuals have completed the training program (* indicates SF matched fellow):

Justine Smith, M.B.B.S., Ph.D.: 1998 - 2001
Matthias Becker, M.D., Ph.D.: 1998 - 2000
Daryl Kurz, M.D.: July 2002 - June 2003
Michael Wertheim, M.B.Ch.B.: 2003 - 2005
Lyndell Lim, M.B.B.S.: 2004 - 06
Friederike Mackensen, M.D.: 2004 - 06
Paul Kurz, M.D.: 2005 - 07
Srilakshmi Sharma, M.D.: 2006 - 08
Sirichai Pasadhika, M.D.: 2007 - 08
* Shelly Lee, M.D.: July 2008 - June 2009
Seema Gupta, M.D.: July 2008 - June 2009
Amro Ali, M.D.: July 2009 - June 2011
* Alexandre de Saint Sardos, M.D.: September 2009 - August 2010
* Nicholas Butler, M.D.: July 2010 - June 2011
* Kelly Larkin, M.D.: July 2011 - June 2012
Jeffrey Healey, M.D.: July 2011 - June 2012
* Robert Beardsley, M.D.: July 2012 - June 2013
Phoebe Lin, M.D., PhD: September 2012 - December 2013
* Kristin Biggee, M.D.: July 2013 - June 2014
* Amde Shifera, M.D., PhD: July 2014 - June 2015
* Laura Kopplin, M.D., PhD: July 2015 - June 2016
George Mount, M.D.: July 2015 - June 2016

Duration 

The length of the clinical/research fellowship is one year.  

Prerequisite training/selection criteria

Prerequisite training requirements include an M.D. or equivalent degree and residency training in ophthalmology. Typical U.S. candidates will have completed residency training, but international candidates who have partially completed training and wish to complete research sabbaticals may be considered. Candidates will have an interest in clinical care of patients with inflammatory disease and basic and/or clinical research training in uveitis and ocular immunology. Interest in pursuing a career in academic ophthalmology is preferred, but not required.  

Goals and Objectives for Training

The educational purpose of the training program and intended goals of the training program are to train academically-inclined uveitis and ocular immunology specialists in the clinical management of patients with ocular inflammatory diseases, including uveitis, scleritis, and orbital and ocular surface inflammatory diseases, and to provide exposure to clinical trials in uveitis as well as basic science research for interested/qualified candidates.

Program Certifications

The Uveitis and Ocular Immunology fellowship program at OHSU is approved by the Association of University Professors of Ophthalmology (AUPO) for one position each year. Additional fellows may be accepted outside the auspices of the AUPO accredited position.  

Primary Teaching Faculty 

Eric B. Suhler, M.D., M.P.H. - Fellowship Director, clinical management of uveitis, clinical research, clinical trials
Phoebe Lin, M.D., Ph.D.- clinical and surgical management, clinical and basic research
James T. Rosenbaum, M.D.- clinical management, clinical and basic research

Other affiliated staff with ad hoc teaching relationships with uveitis fellows include:

John Clements, M.D. - cataract and anterior segment surgery
Christina Flaxel, M.D. - retinal consultation/surgery
Tammy Martin, Ph.D. - basic science
Sirichai Pasadhika, M.D .- clinical care/Devers Eye Institute
Steve Planck, Ph.D. - basic science

Facilities

The clinical and research activities of this fellowship are primarily located in the ophthalmology department at OHSU, at  Casey Eye Institute, and in the Biomedical Research Building for basic science research. In addition, fellows attend relevant conferences in rheumatology at OHSU and attend a weekly half-day clinic at Devers Eye Institute/Legacy Hospitals. Qualified and/or interested applicants also participate in clinical activities at the Portland VA Medical Center. 

Clinical and research components

Clinical responsibilities of uveitis fellows include attendance of faculty uveitis clinics all day on Wednesdays (JTR) , Thursdays (EBS) and Friday afternoons (PL), conducting clinics for clinical research participants on Friday mornings at OHSU, as well as Tuesday PMs at Devers/Legacy with JTR. Qualified candidates will also have the opportunity to participate in medical retina clinics on Mondays and/or Saturdays. Ad hoc clinical responsibilities may be assigned for urgent or emergent patients during other times. The incumbent will be expected to carry out a clinical or basic research program during the remaining time during the week under the supervision of the fellowship faculty. Fellows are exposed to a wide range of diagnostic and treatment modalities, including use of ocular echography, standard and ultra-widefield fundus autofluorescence, standard and ultra-widefield fluorescein angiography, indocyanine green angiography, spectral domain optical coherence tomography, and OCT angiography for diagnosis and management of ocular inflammatory conditions. Interface with other disciplines such as world class rheumatology and infectious disease divisions is plentiful, including with the in-house OHSU infusion center. Participation of the fellows in clinical trials as sub-investigators is also integral to the program.

Participant's supervisory and patient care responsibilities

Uveitis fellows are required to supervise and/or teach OHSU residents and medical students, and provide patient care in the settings described above. 

Didactic components and scholarly activities

Uveitis fellows are expected to present at monthly uveitis conferences, participate in biweekly posterior segment conferences, attend weekly rheumatology grand rounds and journal club, and Casey Eye Institute & Devers Grand Rounds. Fellows' scholarly activities include participation in clinical trials, clinical or basic science independent research, and didactic teaching for the residents. Fellows are encouraged to attend national uveitis fellow forums, to present their research at national meetings, and to submit their work into peer-reviewed journals.  

Clinical studies

Clinical trials

Clearside: "PEACHTREE: A Phase 3, Randomized, Masked, Controlled Clinical Trial to Study the Safety and Efficacy of Triamcinolone Acetonide Injectable Suspension (CLS-TA) for the Treatment of Subjects with Macular Edema associated with Non-Infectious Uveitis"

Eyegate: "A Prospective, Multi-Center, Randomized, Double-Masked, Positive Controlled, Phase 3 Clinical Trial Designed to Evaluate the Safety and Efficacy of Iontophoretic Dexamethasone Phosphate Ophthalmic Solution Compared to Prednisolone Acetate Ophthalmic Suspension (1%) in Patients with Non-Infectious Anterior Segment Uveitis"

FAST: "First-line Antimetabolites as Steroid-sparing Treatment (FAST) Uveitis Trial"

pSivida: "PSV-FAI-001: A Phase III, Multi-National, Multi-Center, Randomized, Masked, Controlled, Safety and Efficacy Study of a Fluocinolone Acetonide Intravitreal (FAI) Insert in Subjects with Chronic Non-Infectious Uveitis Affecting the Posterior Segment of the Eye" (closed to enrollment)

Abbvie: "A Multicenter Open-Label Study of the Long-term Safety and Efficacy of the Human Anti-TNF Monoclonal Antibody Adalimumab in Subjects with Non-infectious Intermediate-, Posterior-, or Pan-uveitis" (closed to enrollment)

Abatacept: "A phase I/II trial of Abatacept (Orencia) in the treatment of refractory non-infectious uveitis" (closed to enrollment)

Investigator-initiated studies

OCT angiography studies in uveitis: Investigating the retinal and choroidal circulation in uveitis patients

Gut microbiome studies in uveitis: Investigating the importance of the gut microbial constituents, and its impact on uveitis 

Basic Science Studies

Mechanisms of and novel systemic vs local therapeutics for immune-mediated uveitis using animal models

Contacts

OHSU Casey Eye Institute participates in the matching program sponsored by the AUPO. You may contact them regarding match information at www.SFMATCH.org. For more information, contact the uveitis fellowship program coordinator, Kimberly Ogle, at oglki@ohsu.edu or 503 494-5023.