September 2016
Volume 57, Issue 12
Open Access
ARVO Annual Meeting Abstract  |   September 2016
Ophthalmic Manifestations of Ebola Virus Disease Survivors in Monrovia, Liberia
Author Affiliations & Notes
  • Jessica Shantha
    Ophthalmology, Emory University, Atlanta, Georgia, United States
    Hawaii Macula and Retina Institute , Honolulu, Hawaii, United States
  • Ian Crozier
    Infectious Diseases Institute, Kampala, Uganda
  • Brent Hayek
    Ophthalmology, Emory University, Atlanta, Georgia, United States
  • Beau B Bruce
    Ophthalmology, Emory University, Atlanta, Georgia, United States
  • Catherine Gargu
    Ophthalmology , Ministry of Health and Sanitation Liberia , Monrovia, Liberia
  • Jerry Brown
    ELWA Hospital, Monrovia, Liberia
  • John Fankhauser
    ELWA Hospital, Monrovia, Liberia
  • Steven Yeh
    Ophthalmology, Emory University, Atlanta, Georgia, United States
  • Footnotes
    Commercial Relationships   Jessica Shantha, None; Ian Crozier, None; Brent Hayek, None; Beau Bruce, None; Catherine Gargu, None; Jerry Brown, None; John Fankhauser , None; Steven Yeh, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science September 2016, Vol.57, No Pagination Specified. doi:
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      Jessica Shantha, Ian Crozier, Brent Hayek, Beau B Bruce, Catherine Gargu, Jerry Brown, John Fankhauser, Steven Yeh; Ophthalmic Manifestations of Ebola Virus Disease Survivors in Monrovia, Liberia. Invest. Ophthalmol. Vis. Sci. 201657(12):.

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

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Purpose : The current West African Ebola virus disease (EVD) outbreak is the largest in history with over 28,000 cases. Liberia has been subject to 10,666 cases of EVD and 4,806 deaths. Thousands of EVD survivors are at-risk for the “Post Ebola Syndrome”, which includes arthralgias, fatigue, and uveitis. Herein, we report the ophthalmic manifestations observed in a Liberian cohort of EVD survivors.

Methods : An eye clinic was established in partnership with the Emory Eye Center and the ELWA Hospital in Liberia to urgently assess eye disease in symptomatic EVD survivors. A retrospective study was performed and data collected included demographics, medical history including days hospitalized in an Ebola Treatment Unit (ETU) as a surrogate for EVD severity. Ophthalmic symptoms, diagnoses, visual acuities, and exam findings were recorded.

Results : Ninety-six EVD survivors were examined. Twenty-seven eyes of 21 patients (21.87%) developed EVD-associated uveitis and 4 patients (4.16%) were diagnosed with an optic neuropathy. The most common ophthalmic symptoms were blurred vision (81%), photophobia (62%), and pain (52%). Other post Ebola symptoms observed in patients with uveitis included joint pain (76%), hair loss (38%), fatigue (32%), and hearing loss (10%). These symptoms were comparable in EVD patients with and without uveitis (P>0.05). Visual acuity was normal (20/20-20/25), mildly impaired (20/30 to 20/60), moderately impaired (20/70-20/160), severely impaired (20/200-20/400), or blind (worse than 20/400) in 33.3%, 22.2%, 7.4%, 3.7%, and 33.3% of eyes with uveitis respectively. There was a statistically significant difference in the visual acuities of patients with EVD-associated uveitis versus without uveitis (p<0.0001). Anatomic subtypes of uveitis include anterior in 2 patients, posterior in 13 patients, and panuveitis in 6 patients. Exam findings associated with at least moderate visual impairment included the presence of keratic precipitates (p<0.01), posterior synechiae (p<0.02), and vitritis (p<0.01). The mean number of days in an ETU in EVD patients who developed uveitis (17) was comparable to the number spent by those who did not develop disease (14, P>0.05).

Conclusions : EVD survivors are at risk for uveitis, which may lead to secondary structural complications, visual impairment, and blindness. There is an urgent need to build capacity and mobilize eye care resources for EVD survivors in West Africa.

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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