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Rachel Jessica Bishop, Allen O Eghrari, Christopher Brady, Vincent Ray, Cavan S Reilly, Frederick Ferris, Denise Cunningham, Edward Guizie, Mosoka Fallah; Expanding the spectrum of Ebola-associated eye disease: a summary of ocular findings in a large cohort of Ebola survivors. Invest. Ophthalmol. Vis. Sci. 201657(12):.
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© 2017 Association for Research in Vision and Ophthalmology.
Ocular symptoms are among the leading complaints of survivors of Ebola virus disease (EVD). However, the spectrum of short- and long-term ocular sequelae of EVD has not been fully described. We conducted a natural history eye study of Ebola survivors and control participants, comparing visual function and ocular changes in these groups.
The PREVAIL III Ebola Survivor Study is a 5-year longitudinal study of the medical effects of Ebola Virus Disease (EVD) on survivors in Liberia, sponsored by the National Institute of Allergy and Infectious Diseases at NIH and the Liberian Ministry of Health. The eye sub-study explores ocular pathology and response to treatment in this cohort, conducted in a clinic equipped with state-of-the-art diagnostic ophthalmic equipment. Over 390 Ebola survivors and 174 age-matched controls, who failed vision screening parameters, underwent comprehensive eye evaluation, including slit lamp photography and spectral domain OCT imaging. We compare visual indicators and ocular findings between survivors and controls, and document abnormalities with appropriate imaging modalities.
Signs of uveitis were present in at least 24% of Ebola survivors, including: prominent corneal nerves, anterior chamber cell, posterior synechiae, secondary angle closure and glaucoma, cataract, vitreous opacities, macular edema, epiretinal membranes, retinal lesions, tractional retinal detachment, and phthisis bulbi. Optic nerve changes, such as nerve swelling, were present in 10% of survivors and 5% of controls (p=0.03), with color vision deficits occurring in 39% of survivors vs. 13% of controls (p<0.001).
Ebola-associated eye disease includes a broader range of pathology than previously appreciated, with neuro-ophthalmic changes an important component of eye disease among Ebola survivors. In addition to medical management of ocular complications, our study reveals that a significant fraction of survivors will require surgical intervention, a finding with significant public health implications in a resource-limited environment.
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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