Abstract
Purpose :
Survivors of Ebola virus disease (EVD) frequently experience ophthalmic sequelae, in some cases requiring surgical intervention. Surgical outcomes in this cohort are important to investigate because of the risk of viral persistence and recurrent uveitis. We describe three-month outcomes of the first cases of known anterior segment surgery in Ebola survivors in Liberia.
Methods :
Ophthalmic history and examination data were collected from Ebola survivors who presented to the PREVAIL III eye clinic in Monrovia, Liberia. Participants were specifically asked about surgical history at each visit. Visual acuity, intraocular pressure, and severity of inflammation, if present, were documented on standard data forms. Optical coherence tomography (OCT) was conducted of the anterior segment, optic nerve and macula with the Zeiss Cirrus 5000 spectral domain OCT device.
Results :
To date, three-month follow-up data is available for three surgeries among two survivors. The first, a 26-year-old male with known zonular dehiscence, underwent cataract surgery followed by YAG vitreolysis. Intraocular inflammation reduced from 2+ anterior chamber cell at one week to quiet at 3 months with taper of topical dexamethasone 1%. There was no macular thickening on OCT. The second, a 23-year-old male, underwent laser peripheral iridotomy for iris bombe in the setting of inflammatory pupillary membrane and posterior synechiae. Following a one-month taper of topical prednisolone acetate 1%, at 3 months he had a quiet eye, intraocular pressure of 8mmHg, and patent peripheral iridotomy by OCT.
Conclusions :
In these two cases of intraocular surgery in Ebola survivors in Liberia, inflammation resolved with topical steroids, and without worsening of the disease course. Public health ramifications and further surgical outcomes will be discussed.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.