Bio

Clinical Focus

  • Neurology - Child Neurology
  • Neuro-ophthalmology

Academic Appointments

Professional Education

  • Fellowship: University of Pennsylvania Ophthalmology Fellowships (2015) PA
  • Residency: UCSF Child Neurology Residency (2014) CA
  • Internship: UCSF Pediatric Residency (2011) CA
  • Medical Education: Virginia Commonwealth University School of Medicine Registrar (2009) VA
  • Board Certification: American Board of Psychiatry and Neurology, Neurology - Child Neurology (2015)

Contact

  • Pediatric Ophthalmology Clinic 2452 Watson Ct Ste 1500 Palo Alto, CA 94303
    • Tel: (650) 723-1143
    Fax: (650) 497-7821

Research & Scholarship

Clinical Trials

  • Surgical Idiopathic Intracranial Hypertension Treatment Trial Recruiting

    Randomized trial of adults (?18 years old) with idiopathic intracranial hypertension and moderate to severe visual loss without substantial recent treatment who are randomly assigned to (1) medical therapy, (2) medical therapy plus ONSF, or (3) medical therapy plus VPS. The primary outcome is visual field mean deviation change at first of Month 6 (26 weeks) or time of treatment failure of the eligible eye(s), followed by a continuation study to assess time to treatment failure. The determination of eligible eye(s) is based on meeting the eligibility criteria at baseline.

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  • Efficacy & Safety of RPh201 Treatment in Patients With Previous Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) Not Recruiting

    This study is designed as a double-masked, randomized, placebo-controlled, clinical study to evaluate the efficacy and safety of subcutaneous (SC) administration of RPh201 in participants with previous NAION. All participants enrolled in Cohort A of the study will have a documented history of NAION for at least 12 months and at most, five years prior to enrollment. Participants enrolled in Cohort B of the study will have a documented history of NAION for at least 6 months and at most, three years prior to enrollment.

    Stanford is currently not accepting patients for this trial. For more information, please contact Mariana Nunez, 650-497-7846.

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  • Phase 2/3, Randomized, Double-Masked, Sham-Controlled Trial of QPI-1007 in Subjects With Acute Nonarteritic Anterior Ischemic Optic Neuropathy (NAION) Not Recruiting

    This study will determine the effect of QPI-1007 on visual function in subjects with recent-onset NAION and assess the safety and tolerability of intravitreal injections of QPI-1007 in this population. This study will also evaluate the structural changes in the retina following administration of QPI-1007.

    Stanford is currently not accepting patients for this trial. For more information, please contact Mariana Nunez, 650-497-7846.

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Publications

All Publications

  • Risdiplam treatment has not led to retinal toxicity in patients with spinal muscular atrophy. Annals of clinical and translational neurology Sergott, R. C., Amorelli, G. M., Baranello, G., Barreau, E., Beres, S., Kane, S., Mercuri, E., Orazi, L., SantaMaria, M., Tremolada, G., Santarsiero, D., Waskowska, A., Yashiro, S., Denk, N., Furst-Recktenwald, S., Gerber, M., Gorni, K., Jaber, B., Jacobsen, B., Mueller, L., Nave, S., Scalco, R. S., Marzoli, S. B., FIREFISH, S. 2020

    Abstract

    OBJECTIVE: Evaluation of ophthalmologic safety with focus on retinal safety in patients with spinal muscular atrophy (SMA) treated with risdiplam (EVRYSDI), a survival of motor neuron 2 splicing modifier associated with retinal toxicity in monkeys. Risdiplam was approved recently for the treatment of patients with SMA, aged?2months in the United States, and is currently under Health Authority review in the EU.METHODS: Subjects included patients with SMA aged 2months-60years enrolled in the FIREFISH, SUNFISH, and JEWELFISH clinical trials for risdiplam. Ophthalmologic assessments, including functional assessments (age-appropriate visual acuity and visual field) and imaging (spectral domain optical coherence tomography [SD-OCT], fundus photography, and fundus autofluorescence [FAF]), were conducted at baseline and every 2-6months depending on study and assessment. SD-OCT, FAF, fundus photography, and threshold perimetry were evaluated by an independent, masked reading center. Adverse events (AEs) were reported throughout the study.RESULTS: A total of 245 patients receiving risdiplam were assessed. Comprehensive, high-quality, ophthalmologic monitoring assessing retinal structure and visual function showed no retinal structural or functional changes. In the youngest patients, SD-OCT findings of normal retinal maturation were observed. AEs involving eye disorders were not suggestive of risdiplam-induced toxicity and resolved with ongoing treatment.INTERPRETATION: Extensive ophthalmologic monitoring conducted in studies in patients with SMA confirmed that risdiplam does not induce ophthalmologic toxicity in pediatric or adult patients with SMA at the therapeutic dose. These results suggest that safety ophthalmologic monitoring is not needed in patients receiving risdiplam, as also reflected in the United States Prescribing Information for risdiplam.

    View details for DOI 10.1002/acn3.51239

    View details for PubMedID 33231373

  • Video Teaching NeuroImages: Atypical abnormal eye movements in PNPO-related Epilepsy. Neurology Pavitt, S., Karamian, A. G., Chattree, G., Klotz, J., Beres, S. 2020

    View details for DOI 10.1212/WNL.0000000000010861

    View details for PubMedID 32913027

  • Cryopyrin-Associated Periodic Syndrome in Neuro-Ophthalmology. Journal of neuro-ophthalmology : the official journal of the North American Neuro-Ophthalmology Society Harish Bindiganavile, S., Beres, S., Bhat, N., Lee, A. G. 2020

    View details for DOI 10.1097/WNO.0000000000001080

    View details for PubMedID 32868579

  • 50 Years Ago in The Journal of Pediatrics: The Cause of Spasmus Nutans and Congenital Nystagmus: Frozen in Time. The Journal of pediatrics Beres, S. 2020; 223: 169

    View details for DOI 10.1016/j.jpeds.2020.02.042

    View details for PubMedID 32711744

  • The Cause of Spasmus Nutans and Congenital Nystagmus: Frozen in Time JOURNAL OF PEDIATRICS Beres, S. 2020; 223: 169-+

    View details for Web of Science ID 000551283500036

  • A Tearfully Painful Darkness. Survey of ophthalmology Leishangthem, L., Beres, S., Moss, H. E., Chen, J. 2020

    Abstract

    A 70-year-old woman presented with new onset of left eye and facial pain. Ophthalmic and neurological examinations, MRI brain, ESR and CRP were unrevealing. A few days later she developed vision loss in her left eye. Exam revealed decreased visual acuity with a relative afferent pupillary defect in the left eye, and a diffuse mild swelling of the left optic nerve head. Repeat MRI showed T2 hyperintensity and enhancement of the intraorbital optic nerve and surrounding tissues with no other intracranial abnormalities. Serum studies showed elevated myelin oligodendrocyte glycoprotein (MOG) IgG titer. She was treated with IV methylprednisolone 1000mg daily for 3 days and was discharged on prolonged prednisone taper with return of vision to baseline.

    View details for DOI 10.1016/j.survophthal.2020.06.002

    View details for PubMedID 32540257

  • Update in Pediatric Pseudotumor Cerebri Syndrome. Seminars in neurology Beres, S. J. 2020

    Abstract

    Pseudotumor cerebri syndrome (PTCS) is a rare condition in children presenting with headache and papilledema from increased intracranial pressure that can cause significant morbidity. This can be idiopathic, also known as idiopathic intracranial hypertension or primary intracranial hypertension, or can be secondary to medications and associated medical conditions. Given the threat to vision, early detection and treatment is needed in all age groups. However, identifying papilledema or pseudopapilledema in children presents unique challenges sometimes as a result of differences between prepubertal and postpubertal children, further elucidating the complex pathophysiology. Management requires brain imaging, lumbar puncture, and frequent eye exams with medical and rarely surgical treatment. Visual outcomes in children are favorable if caught early and management can be prolonged over years. Pediatric PTCS is different from adult PTCS in many ways, and this review will focus on the most updated definitions of the disease, theories of pathophysiology, management, and treatment in the pediatric population.

    View details for DOI 10.1055/s-0040-1708847

    View details for PubMedID 32422670

  • Atypical abnormal eye movements in PNPO-related epilepsy Pavitt, S., Karamian, A., Chattree, G., Klotz, J., Beres, S. LIPPINCOTT WILLIAMS & WILKINS. 2020

    View details for Web of Science ID 000536058002073

  • Steroid-sparing maintenance immunotherapy for MOG-IgG associated disorder. Neurology Chen, J. J., Flanagan, E. P., Bhatti, M. T., Jitprapaikulsan, J., Dubey, D., Lopez Chiriboga, A. S., Fryer, J. P., Weinshenker, B. G., McKeon, A., Tillema, J. M., Lennon, V. A., Lucchinetti, C. F., Kunchok, A., McClelland, C. M., Lee, M. S., Bennett, J. L., Pelak, V. S., Van Stavern, G., Adesina, O. O., Eggenberger, E. R., Acierno, M. D., Wingerchuk, D. M., Lam, B. L., Moss, H., Beres, S., Gilbert, A. L., Shah, V., Armstrong, G., Heidary, G., Cestari, D. M., Stiebel-Kalish, H., Pittock, S. J. 2020

    Abstract

    Myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG) associated disorder (MOGAD) often manifests with recurrent CNS demyelinating attacks. The optimal treatment for reducing relapses is unknown. To help determine the efficacy of long-term immunotherapy in preventing relapse in patients with MOGAD, we conducted a multicenter retrospective study to determine the rate of relapses on various treatments.We determined the frequency of relapses in patients receiving various forms of long-term immunotherapy for MOGAD. Inclusion criteria were history of ?1 CNS demyelinating attacks, MOG-IgG seropositivity, and immunotherapy for ?6 months. Patients were reviewed for CNS demyelinating attacks before and during long-term immunotherapy.Seventy patients were included. The median age at initial CNS demyelinating attack was 29 years (range 3-61 years; 33% <18 years), and 59% were female. The median annualized relapse rate (ARR) before treatment was 1.6. On maintenance immunotherapy, the proportion of patients with relapse was as follows: mycophenolate mofetil 74% (14 of 19; ARR 0.67), rituximab 61% (22 of 36; ARR 0.59), azathioprine 59% (13 of 22; ARR 0.2), and IV immunoglobulin (IVIG) 20% (2 of 10; ARR 0). The overall median ARR on these 4 treatments was 0.3. All 9 patients treated with multiple sclerosis (MS) disease-modifying agents had a breakthrough relapse on treatment (ARR 1.5).This large retrospective multicenter study of patients with MOGAD suggests that maintenance immunotherapy reduces recurrent CNS demyelinating attacks, with the lowest ARR being associated with maintenance IVIG therapy. Traditional MS disease-modifying agents appear to be ineffective. Prospective randomized controlled studies are required to validate these conclusions.

    View details for DOI 10.1212/WNL.0000000000009758

    View details for PubMedID 32554760

  • Anatomic and Thermometric Analysis of Cranial Nerve Palsy after Laser Amygdalohippocampotomy for Mesial Temporal Lobe Epilepsy. Operative neurosurgery (Hagerstown, Md.) Huang, Y., Leung, S. A., Parker, J. J., Ho, A. L., Wintermark, M., Patel, S. H., Pauly, K. B., Kakusa, B. W., Beres, S. J., Henderson, J. M., Grant, G. A., Halpern, C. H. 2019

    Abstract

    BACKGROUND: Laser interstitial thermal therapy (LITT) is a minimally invasive therapy for treating medication-resistant mesial temporal lobe epilepsy. Cranial nerve (CN) palsy has been reported as a procedural complication, but the mechanism of this complication is not understood.OBJECTIVE: To identify the cause of postoperative CN palsy after LITT.METHODS: Four medial temporal lobe epilepsy patients with CN palsy after LITT were identified for comparison with 22 consecutive patients with no palsy. We evaluated individual variation in the distance between CN III and the uncus, and CN IV and the parahippocampal gyrus using preoperative T1- and T2-weighted magnetic resonance (MR) images. Intraoperative MR thermometry was used to estimate temperature changes.RESULTS: CN III (n=2) and CN IV palsies (n=2) were reported. On preoperative imaging, the majority of identified CN III (54%) and CN IV (43%) were located within 1 to 2 mm of the uncus and parahippocampal gyrus tissue border, respectively. Affected CN III and CN IV were more likely to be found<1 mm of the tissue border (PCNIII=.03, PCNIV<.01; chi-squared test). Retrospective assessment of thermal profile during ablation showed higher temperature rise along the mesial temporal lobe tissue border in affected CNs than unaffected CNs after controlling for distance (12.9°C vs 5.8°C; P=.03; 2-sample t-test).CONCLUSION: CN palsy after LITT likely results from direct heating of the respective CN running at extreme proximity to the mesial temporal lobe. Low-temperature thresholds set at the border of the mesial temporal lobe in patients whose CNs are at close proximity may reduce this risk.

    View details for DOI 10.1093/ons/opz279

    View details for PubMedID 31555820

  • Unilateral retinitis pigmentosa in children JOURNAL OF AAPOS Mercado, C. L., Pham, B. H., Beres, S., Marmor, M. F., Lambert, S. R. 2018; 22 (6): 457?61

    View details for DOI 10.1016/j.jaapos.2018.08.003

    View details for Web of Science ID 000453638000013

  • Pseudotumor Cerebri Syndrome is the Best Term for This Condition PEDIATRIC NEUROLOGY Beres, S. J., Digre, K. B., Friedman, D. I., Liu, G. T. 2018; 87: 9?10

    View details for DOI 10.1016/j.pediatrneurol.2018.08.018

    View details for Web of Science ID 000454972400004

  • Pseudotumor Cerebri Syndrome is the Best Term for This Condition. Pediatric neurology Beres, S. J., Digre, K. B., Friedman, D. I., Liu, G. T. 2018; 87: 9?10

    View details for PubMedID 30501891

  • Unilateral retinitis pigmentosa in children. Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus Mercado, C. L., Pham, B. H., Beres, S., Marmor, M. F., Lambert, S. R. 2018

    Abstract

    BACKGROUND: Retinitis pigmentosa (RP) is a group of rare inherited retinal disorders characterized by diffuse progressive degeneration of the retina that typically presents bilaterally. Unilateral RP has not often been reported in children. We present a series of cases that illustrate discrimination between unilateral and asymmetric disease and between dystrophy and acquired degeneration.METHODS: Four patients (9-15 years of age; 3 females) were referred to our institution for possible unilateral RP based on fundus appearance and unilateral symptoms. All underwent full-field electroretinography (ERG), spectral domain optical coherence tomography (SD-OCT), widefield and color fundus photography, and fundus autofluorescence (FAF) imaging. Genetic testing and a vitamin and essential fatty acids panel were also conducted in 1 patient.RESULTS: Unilateral retinal degeneration was confirmed in 2 patients, whose fellow eyes showed no abnormalities on ERG or imaging. The other 2 patients were found to have highly asymmetric retinal degeneration based on ERG, wide-angle images, and repeated examinations (range, 0.3-9.8 years). Genetic testing and blood testing in 1 unilateral case were negative.CONCLUSIONS: Childhood-onset "unilateral RP" remains a difficult and uncertain diagnosis. ERG testing and longitudinal and widefield fundus examination are necessary to exclude asymmetrical disease. Although unilateral degeneration may exist in some children, its inherited or acquired etiology remains poorly understood.

    View details for PubMedID 30243749

  • Pediatric Pseudotumor Cerebri Syndrome: Diagnosis, Classification, and Underlying Pathophysiology SEMINARS IN PEDIATRIC NEUROLOGY Sheldon, C. A., Paley, G. L., Beres, S. J., McCormack, S. E., Liu, G. T. 2017; 24 (2): 110?15

    Abstract

    Pseudotumor cerebri syndrome (PTCS) is defined by the presence of elevated intracranial pressure in the setting of normal brain parenchyma and cerebrospinal fluid. PTCS can occur in the pediatric and adult populations and, if untreated, may lead to permanent visual loss. In this review, discussion will focus on PTCS in the pediatric population and will outline its distinct epidemiology and key elements of diagnosis, evaluation and management. Finally, although the precise mechanisms are unclear, the underlying pathophysiology will be considered.

    View details for PubMedID 28941525

  • Optic Pathway Gliomas Secondary to Neurofibromatosis Type 1 SEMINARS IN PEDIATRIC NEUROLOGY Beres, S., Avery, R. A. 2017; 24 (2): 92?99

    Abstract

    Children with neurofibromatosis type 1 frequently manifest optic pathway gliomas-low-grade gliomas intrinsic to the visual pathway. This review describes the molecular and genetic mechanisms driving optic pathway gliomas as well as the clinical symptoms of this relatively common genetic condition. Recommendations for clinical management and descriptions of the newest imaging techniques are discussed.

    View details for PubMedID 28941532

  • Optic Pathway Gliomas JOURNAL OF PEDIATRIC NEUROLOGY Beres, S., Avery, R. A. 2017; 15 (1): 15?24

    View details for DOI 10.1055/s-0036-1593742

    View details for Web of Science ID 000395403100004

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