Graduate Medical Education Financing in the US Department of Veterans Affairs.

Background: The US Department of Veterans Affairs (VA) partners with 250 sponsors of graduate medical education (GME), annually providing $850 million for 11,000 full-time equivalent resident positions that support veteran patient care and provide educational opportunities for trainees from affiliated academic programs. Knowledge of VA GME financing is vital to maintain these partnerships.

Observations: In response to increased scrutiny from several federal oversight bodies, the VA revised its GME reimbursement policy and procedures, including implementing new resident tracking and auditing mechanisms.

Patient Surgical Outcomes When Surgery Residents Are the Primary Surgeon by Intensity of Surgical Attending Supervision in Veterans Affairs Medical Centers.

Objective: Using health records from the Department of Veterans Affairs (VA), the largest healthcare training platform in the United States, we estimated independent associations between the intensity of attending supervision of surgical residents and 30-day postoperation patient outcomes.

Background: Academic leaders do not agree on the level of autonomy from supervision to grant surgery residents to best prepare them to enter independent practice without risking patient outcomes.

Methods: Secondary data came from a national, systematic 1:8 sample of n = 862,425 teaching encounters where residents were listed as primary surgeon at 122 VA medical centers from July 1, 2004, through September 30, 2019.

75 Years of the Historic Partnership Between the VA and Academic Medical Centers.

Background: The US Department of Veterans Affairs (VA) conducts the largest health professions education program in the country in partnership with academic medical, nursing, and associated health programs across the nation. After World War II, the VA was pressed to meet the increasing population of veterans needing health care and faced challenges in recruiting clinicians.

Observations: The passage of 2 legislative actions, the Servicemen's Readjustment Act and Public Law 79-293, and a key policy memorandum set the foundation for the partnership between the VA and academic medical centers that led to improved medical care for veterans and expansion of health professions education for the VA and the nation.

The Role of Screening for Asymptomatic Ocular Inflammation in Sarcoidosis.

Purpose: To determine the utility of routine screening ophthalmic exam in patients with systemic sarcoidosis and no history of uveitis.

Methods: Prospective, single-center, observational study conducted at Northwestern University from October 11, 2012 to October 1, 2020 of new patients with biopsy-proven systemic sarcoidosis and no history of uveitis, referred by medical subspecialists for screening ophthalmic exam.

Results: Forty-nine patients, with mean age of 51 ± 8.

Automated Pupillometry as an Adjunct to Clinical Examination in Patients With Acute Vision Loss.

Background: Despite automated pupillometry's (AP) improved detection of relative afferent pupillary defects (RAPDs) compared with the Swinging Flashlight Test (SFT), AP remains uncommon in clinical practice. This study examined barriers to routine use of AP in evaluation of acute vision loss.

Methods: (1) Ophthalmologists and optometrists' perceptions of AP were captured via electronic survey.

Update on sarcoidosis.

Purpose Of Review: Sarcoidosis is a multisystem inflammatory disease, characterized by the presence of noncaseating granulomas. Ocular inflammation is often the first manifestation of the disease, and uveitis can be the driving force for treatment. The goal of this review was to provide an update on the relationship between ocular and systemic disease, with a particular focus on cardiac sarcoidosis.

Sarcoidosis in the national veteran population: association of ocular inflammation and mortality.

Purpose: To describe the distribution of ocular sarcoidosis in the veteran population and to determine the association between ocular disease and all-cause mortality.

Design: Retrospective review.

Methods: The Veterans Health Administration National Patient Care Database information on medical diagnoses, date of diagnosis, age, race, gender, and Veterans Administration medical center station number for site-specific calculations for fiscal years 2010 through 2012 was collected.

Sarcoidosis: sex-dependent variations in presentation and management.

Sarcoidosis is an inflammatory disease with a wide range of clinical presentations. The manifestations and prognosis in sarcoidosis are dependent upon not only organ involvement but also age and sex. The purpose of this review is to describe the systemic and ocular manifestations of sarcoidosis with a specific focus on sex-dependent difference in presentation and management.

Correlation between clinical signs and optical coherence tomography with enhanced depth imaging findings in patients with birdshot chorioretinopathy.

Importance: Birdshot chorioretinopathy (BCR) is a bilateral posterior uveitis that typically requires aggressive therapy to prevent loss of vision. Clinical signs of disease activity may be subtle and visual acuity is often preserved despite significant loss of visual function. Optical coherence tomography with enhanced depth imaging (OCT-EDI), a new technology that allows visualization of structures posterior to the retinal pigment epithelium, may be a useful tool to monitor disease activity in these patients.

TNF inhibition for ophthalmic indications: current status and outlook.

Background: Tumor necrosis factors (TNF) are a group of cytokines that play a role in systemic inflammation, stimulating the acute phase reaction. They are involved in systemic rheumatologic conditions such as rheumatoid arthritis and juvenile idiopathic arthritis, as well as ocular inflammatory conditions in the uveitis spectrum. Several drugs were developed to inhibit the action of TNF, thereby reducing inflammation.

Bilateral simultaneous-onset nongranulomatous acute anterior uveitis: clinical presentation and etiology.

OBJECTIVE To describe the etiology and outcome of patients with simultaneous-onset nongranulomatous bilateral acute anterior uveitis. METHODS The medical records of patients who presented to a single tertiary care center with simultaneous-onset nongranulomatous bilateral acute anterior uveitis between January 1990 and May 2010 were retrospectively reviewed; the clinical presentation, results of diagnostic testing, and outcome data are described. RESULTS A total of 4288 new patients with uveitis were evaluated by the Uveitis Service at the University of Illinois at Chicago Eye and Ear Infirmary between January 1990 and May 2010.

Behçet uveitis in the American midwest.

Purpose: Behçet disease is most common in Asia, the Middle East, and North Africa (Silk Road). The authors compare clinical presentation and course of Behçet uveitis in patients of Silk Road and non-Silk Road descent.

Methods: Retrospective review of patients evaluated at the University of Illinois January 1983-July 2010.

Chronic anterior uveitis in common variable immunodeficiency.

Purpose: To describe patients with uveitis and common variable immunodeficiency (CVID).

Design: Retrospective observational case series.

Methods: Retrospective review of patients with uveitis and CVID, specifically focusing on clinical presentation and treatment.

Posterior syphilitic uveitis: clinical characteristics, co-infection with HIV, response to treatment.

Purpose: To describe the characteristics and clinical course of patients with active posterior syphilitic uveitis evaluated between 1991 and 2009.

Methods: Retrospective chart review.

Results: Thirteen patients with active posterior syphilitic uveitis were identified at a single institution.

Clinical features and diagnostic evaluation of biopsy-proven ocular sarcoidosis.

Objectives: To compare the clinical characteristics of uveitic sarcoidosis in African American and non-African American patients with biopsy-proven sarcoidosis and to determine which diagnostic test results were most often suggestive of sarcoidosis in patients who were ultimately diagnosed as having the disease.

Method: Retrospective review of consecutive patients with biopsy-proven sarcoidosis evaluated by the uveitis service between 1989 and 2009.

Results: A total of 63 patients with uveitic sarcoidosis were identified: 39 (62%) were African American (P <.

Presentation and outcome of patients with punctate inner choroidopathy at a tertiary referral center.

Purpose: To describe the clinical course of patients with punctate inner choroidopathy seen at the University of Illinois, with emphasis on development of choroidal neovascularization (CNV).

Methods: Patients with a diagnosis of punctate inner choroidopathy were identified retrospectively. The diagnosis was made clinically based on findings of multiple, small "punched-out" lesions in the posterior pole without intraocular inflammation.

Etiologies of chronic anterior uveitis at a tertiary referral center over 35 years.

Purpose: To describe the epidemiology of chronic anterior uveitis (CAU) at a tertiary center over 35 years.

Methods: Data regarding etiology of CAU was collected from medical records of patients evaluated between 1973-2007. Relative frequencies of each diagnosis of CAU were calculated.

Optic neuritis associated with adalimumab in the treatment of uveitis.

Background: Tumor necrosis factor (TNF) inhibitors such as adalimumab are increasingly used in the treatment of ocular inflammatory disease refractory to standard therapies. There is evidence that TNF inhibitors are associated with demyelinating neurologic events.

Objective: The authors report a case of optic neuritis and multiple sclerosis developing in association with the use of adalimumab for the treatment of bilateral chronic granulomatous iridocyclitis and multifocal choroiditis.

Pediatric uveitis secondary to probable, presumed, and biopsy-proven sarcoidosis.

Purpose: To describe pediatric patients with uveitis diagnosed as having sarcoidosis.

Methods: Medical records of pediatric patients evaluated between 1987 and 2008 were reviewed to identify those with ocular inflammation in whom a diagnosis of sarcoidosis was considered. A classification system including ocular findings and results of laboratory testing was devised and used to classify likelihood of sarcoidosis.