Factors associated with uveitis among Ebola survivors in the PREVAIL III study

Abstract

Purpose : Survivors of Ebola virus disease frequently experience intraocular inflammation in the months following systemic infection. Little is known regarding the factors associated with uveitis in a comprehensive population of survivors.

Methods : The PREVAIL III study is the only study of Ebola survivors with enrollment of close contacts and serology confirmation of disease. All survivors were referred for comprehensive ophthalmic evaluation including slit-lamp biomicroscopy, dilated indirect ophthalmoscopy and optical coherence tomography imaging of the macula and optic nerve. Demographic information was collected at the time of enrollment. Uveitis, active or inactive, was diagnosed based on the presence of keratic precipitates, anterior chamber cell, posterior synechiae, vitreous cell or signs of retinal inflammation.

Results : A total of 789 serology-confirmed Ebola survivors underwent baseline eye examination. Uveitis was diagnosed in 68 participants. Increased time spent in the Ebola treatment unit was associated with presence of uveitis (19 vs. 15 days, p=0.002). Younger age was marginally associated with the presence of uveitis (p=0.05). The presence at baseline of HIV (p=0.80) or syphilis (p=0.48) was not associated with uveitis among survivors, nor was the presence of antibody level (p=0.66) or at least one positive semen result (p=0.16).

Conclusions : In this largest sample of Ebola survivors to date, the time spent in the Ebola unit, perhaps associated with severity of disease, was associated with long-term risk of uveitis. However, uveitis does not appear to correlate with a more robust antibody response or with viral persistence in testes. The public health ramifications of these findings will be discussed.

This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.