Steven Yeh, MD

Louise M. Simpson Professor of Ophthalmology

Director, Section of Uveitis and Vasculitis

Biography

Dr. Yeh serves as Dr. Shantha's mentor.  Dr. Yeh's current research focuses on the application of clinical and laboratory diagnostic modalities for infectious and noninfectious uveitis and the use of emerging therapeutics (systemic and local therapy) for the treatment of uveitis. Within infectious uveitis, his research has focused on the clinical and scientific implications underlying eye disease in Ebola virus survivors.

Clinical imaging modalities including fundus autofluorescence (FAF) and high-resolution spectral domain optical coherence tomography (SD-OCT) scanning techniques have increasingly been helpful in identifying subtle anatomic changes, which are unidentifiable by traditional funduscopic examination and fluorescein angiogram techniques. They have previously utilized fundus autofluorescence signals and SD-OCT to identify architectural changes in neurosensory retina, retinal pigment epithelium and the choroid in both infectious and noninfectious uveitis. Within noninfectious uveitis, they have correlated autofluorescent signal abnormalities in the white dot syndromes (e.g. acute posterior multifocal placoid pigment epithliopathy, multiple evanescent white dot syndrome, birdshot retinochoroidopathy) with functional damage. Within the viral retinitides (cytomegalovirus retinitis, varicella zoster retinitis), they have similarly identified patterns of structural damage by SD-OCT and FAF imaging, which has provided insight into the structural alterations resulting from severe viral infection and resultant inflammation; reversal of this structural damage, as well as improving visual function in these conditions are potential areas of future study that are ongoing.  

Laboratory diagnostic investigations include ongoing work on polymerase chain reaction techniques (PCR) for the diagnosis and management of herpetic viral retinitides.  Specifically, they have previously assessed the utility of qualitative and quantitative PCR, as well as ganciclovir-resistance testing in the management of CMV retinitis. This research is ongoing in patients with varicella zoster-associated acute retinal necrosis (ARN) for which they have developed a classification scheme for ARN-related research and established a paradigm for rapid, effective treatment with the potential for visual preservation and improvement.  Prior clinical research has also focused on intravitreal therapeutics for rapid remission induction of ARN and CMV retinitis and maintenance therapy with oral antiviral agents with high vitreous penetration (i.e. valacyclovir and valganciclovir).

Based on work in infectious viral uveitis, they have most recently studied Ebola virus disease (EVD) associated uveitis in the United States and West Africa as a result of the recent outbreak of unprecedented magnitude.  They previously identified persistent live Ebola virus in the ocular fluid of a United States health care worker who developed a severe, sight-threatening panuveitis during EVD convalescence. This led to further studies in Liberia where we identified eye disease in 25% of Ebola survivors. Of these patients with eye disease including uveitis and optic neuropathy, 40% showed severe visual impairment or blindness. Future studies include natural history studies of eye disease and risk factors for uveitis in EVD survivors and an ongoing study evaluating Ebola virus persistence in West African patients anticipating cataract surgery given the health implications and transmission risk to eye care providers.