Ophthalmology   

What would be your RT volumes and dose?

Patient previously trialed two anti-TNFi and Tocilizumab. Avoiding Rituximab due to positive JC virus testing. 

Can nodular scleritis be a presenting manifestation of GCA?

Is the diagnosis of Sjogren's mostly clinical in a patient with a consistent history and physical with positive serologies?

And have you ever seen it occur in isolation without any other manifestations of SLE? 

The patient has no extraocular features of a spondyloarthropathy and is on methotrexate. No active eye disease for past 1 year.

What is your approach to guiding ophthalmologists regarding our clinical suspicion for ocular syphilis and does the quantification of the titer help i...

If so, when do you recommend timing for the cataract surgery? 

Patient is asymptomatic. Labs showed +P-ANCA 1:160. Negative MPO and PR3.

Patient has failed methotrexate and adalimumab. 

Patient failed topical ocular therapies, methotrexate, azathioprine.

Is the approach different from uveitis immunosuppression?

Would increased risks from concurrent intravitreal avastin preclude treatment? Would you recommend a waiting period in between the treatments?

Are there specific features that suggest drug-induced uveitis versus de novo uveitis?

Are IL-17 or IL-23 inhibitors helpful?

Patient was previously well controlled on methotrexate, which was discontinued during cancer treatment.