September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Patterns of Ocular Manifestations in Ebola Virus Disease Survivors in the Port Loko, Sierra Leone
Author Affiliations & Notes
  • Matthew Vandy
    Lowell and Ruth Gess Eye Hospital, Freetown, Sierra Leone
  • John Mattia
    Lowell and Ruth Gess Eye Hospital, Freetown, Sierra Leone
  • Joyce Chang
    Partners in Health, Boston, Massachusetts, United States
  • Devin Platt
    Partners in Health, Boston, Massachusetts, United States
  • Yealie Mansaray
    Lunsar Baptist Eye Hospital, Port Loko, Sierra Leone
  • Amadu Kamara
    Lunsar Baptist Eye Hospital, Port Loko, Sierra Leone
  • Ruxandra Pinto
    University of Toronto, Toronto, Ontario, Canada
  • Daniel Bausch
    World Health Organization, Geneva, Switzerland
  • Jessica Shantha
    Emory Eye Center, Atlanta, Georgia, United States
  • Steven Yeh
    Emory Eye Center, Atlanta, Georgia, United States
  • Kerry Dierberg
    Partners in Health, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Matthew Vandy, None; John Mattia, None; Joyce Chang, None; Devin Platt, None; Yealie Mansaray, None; Amadu Kamara, None; Ruxandra Pinto, None; Daniel Bausch, None; Jessica Shantha, None; Steven Yeh, None; Kerry Dierberg, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 4145. doi:
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      Matthew Vandy, John Mattia, Joyce Chang, Devin Platt, Yealie Mansaray, Amadu Kamara, Ruxandra Pinto, Daniel Bausch, Jessica Shantha, Steven Yeh, Kerry Dierberg; Patterns of Ocular Manifestations in Ebola Virus Disease Survivors in the Port Loko, Sierra Leone. Invest. Ophthalmol. Vis. Sci. 2016;57(12):4145.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Purpose : The Ebola virus disease (EVD) outbreak in Sierra Leone infected at least 14,122 people and just over half of them survived. We describe the distribution of ocular findings, and their association with visual impairment, in a representative sample of EVD survivors in Port Loko District, Sierra Leone.

Methods : We examined baseline clinical data on the first 277 patients (March 7 to April 24, 2015) from a retrospective clinical cohort of 661 EVD survivors residing in the district. We examined univariate associations between demographic, Ebola viral load at the time of acute EVD diagnosis, ocular symptoms, ophthalmic findings , and ocular diagnoses, with visual impairment: logMAR of visual acuity, and WHO classification of normal/mild (20/20-20/25); moderate (20/30-20/200); severe (20/200-20/400); and blindness (20/400 or worse). Ocular findings and diagnoses are examined per eye, while patient-specific features are examined per patient using the eye with the worst visual acuity.

Results : Of 266 patients with visual acuity data, 139 (52%) had normal or mild visual impairment; 101 (38%) had moderate visual impairment, 3 (1.1%) had severely impaired vision, 23 (9%) had at least one blind eye. Structural complications include: cataract (Npatients=21; 7.6%), posterior synechiae (Npatients=15; 5.4%), vitreous opacity (Npatients=22; 7.9%). Of the 532 eyes with visual acuity data, the following diagnoses were most common: uveitis (Neyes=62; 11.7%), uncorrected refractive error (Neyes=52; 9.8%), conjunctivitis (Neyes=50; 9.4%), cataract (Neyes=31; 5.8%). Uveitis, cataract, and uncorrected refractive error were associated with decreased visual acuity when compared to eyes without these findings (Table, P < 0.001). Increasing age was associated with worsening visual acuity (Spearman coefficient +0.30, p <0.001). Ebola viral load at the time of acute EVD diagnosis were not associated with worsening logMAR visual acuity (p>0.05). The presence of blurry vision, light sensitivity, or itchy eye was 88.0% sensitive and 50.7% specific for a diagnosis of uveitis.

Conclusions : Uveitis and conjunctivitis are the most common ocular manifestation in EVD survivors. Given the considerable risk of poor visual outcomes including blindness in patients with untreated uveitis, emphasis should be placed on timely ophthalmic evaluations in EVD survivor care with a focus on uveitis care delivery.

This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.

 

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