September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Clinical characterization of Ebola-associated eye disease with spectral domain optical coherence tomography
Author Affiliations & Notes
  • Allen O Eghrari
    Ophthalmology, Johns Hopkins University School of Medicine , Baltimore, Maryland, United States
  • Rachel Jessica Bishop
    Ophthalmology, National Eye Institute, Bethesda, Maryland, United States
  • Christopher J. Brady
    Ophthalmology, Johns Hopkins University School of Medicine , Baltimore, Maryland, United States
  • Vincent Ray
    Ophthalmology, California Pacific Medical Center, San Francisco, California, United States
  • Mosoka Fallah
    PREVAIL III, Monrovia, Liberia
  • Denise Cunningham
    Ophthalmology, National Eye Institute, Bethesda, Maryland, United States
  • Cavan S Reilly
    Biostatistics, University of Minnesota, Minneapolis, Minnesota, United States
  • Frederick L Ferris
    Ophthalmology, National Eye Institute, Bethesda, Maryland, United States
  • Jemma Larbelee
    Ophthalmology, Redemption Hospital, Monrovia, Liberia
  • Footnotes
    Commercial Relationships   Allen Eghrari, None; Rachel Bishop, None; Christopher Brady, None; Vincent Ray, None; Mosoka Fallah, None; Denise Cunningham, None; Cavan Reilly, None; Frederick Ferris, None; Jemma Larbelee, None
  • Footnotes
    Support  NIH K12 EY015025-10
Investigative Ophthalmology & Visual Science September 2016, Vol.57, 1668. doi:
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      Allen O Eghrari, Rachel Jessica Bishop, Christopher J. Brady, Vincent Ray, Mosoka Fallah, Denise Cunningham, Cavan S Reilly, Frederick L Ferris, Jemma Larbelee; Clinical characterization of Ebola-associated eye disease with spectral domain optical coherence tomography. Invest. Ophthalmol. Vis. Sci. 2016;57(12):1668.

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      © 2017 Association for Research in Vision and Ophthalmology.

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Abstract

Purpose : Ebola Virus Disease (EVD) is associated with devastating ocular sequelae and vision loss among survivors. Detailed imaging is required to characterize the pathologial changes affecting vision. We describe a broad spectrum of intraocular pathology associated with EVD assessed by optical coherence tomography (OCT).

Methods : The PREVAIL III Ebola Survivor Study (sponsored by the US National Institute for Allergy and Infectious Disease and the Liberian Ministry of Health and Social Welfare) is a 5-year longitudinal study of the medical effects of EVD on survivors. Enrollment of 1500 survivors and up to 5000 controls is planned in Monrovia, Liberia. Spectral domain OCT imaging of the retina and optic nerve (Zeiss Cirrus, +/- Heidelberg Spectralis) was acquired from all participants during initial ophthalmic evaluation.

Results : Three hundred ninety Ebola survivors and 174 age-matched controls underwent comprehensive examination and imaging. Anterior segment OCT of survivors with active uveitis captured corneal edema, keratic precipitates, and shallowing of the anterior chamber associated with pupillary membrane formation. Macula OCT revealed overlying vitreous opacities in one or both eyes of 52% of survivors and 35% of controls (p=0.017). Macular pathology unique to survivors included a retinoschisis-type pattern of macular edema predominantly affecting the inner nuclear layer and multifocal chorioretinal lesions with focal loss of the outer retina. Tractional retinal detachment appeared in severe cases of panuveitis.

Conclusions : Spectral-domain OCT captures pathological changes that characterize EVD-associated eye disease and contribute to vision loss among survivors. Together with clinical examination, these findings expand the known spectrum of pathology associated with EVD. The data support the need for diagnostic and therapeutic capacity building in EVD-affected regions, and highlight the importance of not only short-term, but also long-term followup. Moreover, the findings reframe the approach to Ebola-associated eye disease as requiring both medical and surgical intervention.

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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