Purchase this article with an account.
Steven Yeh, Jessica Shantha, John Mattia, Robert Garry, Matthew Jusu Vandy; Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) Study: Baseline Characteristics and Primary Findings from Ocular Fluid of Ebola Survivors in Sierra Leone. Invest. Ophthalmol. Vis. Sci. 2017;58(8):3609.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
Thousands of West African Ebola virus disease (EVD) survivors are at-risk for sight-threatening uveitis, which has been associated with persistent Ebola virus (EBOV) in the aqueous humor of a U.S. survivor. The EVICT Study aims to determine the prevalence of EBOV persistence in ocular fluids and establish protocols for ocular fluid sampling of EVD survivors.
EVD survivors were prospectively enrolled into EVICT for visually significant cataract requiring surgery or active uveitis. Demographic and medical information, visual acuity (VA), and ophthalmic exam findings were collected. Serologies included HIV, RPR, EBOV IgG/IgM and Lassa Fever (LASV) IgG/IgM. A high-level safety facility and ocular sampling protocols were established via multidisciplinary collaboration between infectious disease and eye care specialists. Aqueous or vitreous humor and conjunctival swabs (pre-, immediate post-, and post-procedure day 1) were collected. Patients were monitored at post procedure day 1, day 7, and monthly.
Twenty-two patients were enrolled into the EVICT Study. Mean age was 30 years (range 12-70) and 15 were female (68%). Mean time from EVD diagnosis was 18 months (range 15-28). Mean VA was 20/1000 (range 20/40-HM). Cataracts were identified in 20 (91%) patients. Two enrollees (9%) had active anterior or intermediate uveitis. Cataracts were attributed to uveitis (18,90%), age (1,5%), and trauma (1,5%). Other structural complications included posterior synechiae (15, 8%), keratic precipitates (5,23%) and chorioretinal scars (5,23%). Serologies showed EBOV IgG positive in 21 (95%) patients, LASV IgG positive in 1 (5%), RPR positive in 1 (5%). LASV IgM, EBOV IgM and HIV were negative in all patients. 21 aqueous humor and 1 vitreous sample tested EBOV-negative by RT-PCR. Pre-, immediate post-, and post-procedure day 1 conjunctival specimens tested EBOV-negative in all 22 patients. Mean VA was stable at 2-months follow-up.
EVD survivors presented with severe VA impairment or blindness largely due to cataracts associated with uveitis. No evidence of EBOV persistence in ocular fluid was identified at approximately 18-months. These findings are relevant to patients anticipating cataract surgery and have public health implications for eye care providers due to the potential risk of EBOV persistence in ocular fluid.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.
This PDF is available to Subscribers Only