July 2018
Volume 59, Issue 9
Open Access
ARVO Annual Meeting Abstract  |   July 2018
Ebola-Associated Bilateral Non-Granulomatous Panuveitis with Tractional Retinal Detachment: A Case Report
Author Affiliations & Notes
  • Ian Yu Loong Yeung
    National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
    John F. Kennedy Medical Center, Monrovia, Liberia
  • Augustine Wallace
    John F. Kennedy Medical Center, Monrovia, Liberia
  • Allen O Eghrari
    Wilmer Eye Institute, Johns Hopkins University Hospital, Baltimore, Maryland, United States
    John F. Kennedy Medical Center, Monrovia, Liberia
  • Jemma Larbelee
    John F. Kennedy Medical Center, Monrovia, Liberia
  • Edward Guizie
    John F. Kennedy Medical Center, Monrovia, Liberia
  • H Nida Nida Sen
    National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
  • Rachel Bishop
    National Eye Institute, National Institutes of Health, Bethesda, Maryland, United States
    John F. Kennedy Medical Center, Monrovia, Liberia
  • Footnotes
    Commercial Relationships   Ian Yeung, None; Augustine Wallace, None; Allen Eghrari, None; Jemma Larbelee, None; Edward Guizie, None; H Nida Sen, None; Rachel Bishop, None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science July 2018, Vol.59, 4173. doi:
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      Ian Yu Loong Yeung, Augustine Wallace, Allen O Eghrari, Jemma Larbelee, Edward Guizie, H Nida Nida Sen, Rachel Bishop; Ebola-Associated Bilateral Non-Granulomatous Panuveitis with Tractional Retinal Detachment: A Case Report. Invest. Ophthalmol. Vis. Sci. 2018;59(9):4173.

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

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Abstract

Purpose : PREVAIL III is a study of post-Ebola sequelae among Liberian survivors of Ebola Virus Disease (EVD). We would like to describe a Case Report of Ebola-mediated tractional retinal detachment (TRD) which to our knowledge has not been described before. Through this case report, we hope to suggest that the Ebola virus may have a natural affinity for nerve tissue (eg. nerve fibre layer of the inner retina) thus hopefully encouraging further research into Ebola and it's interactions with the retina and neural tissues.

Methods : Case report.

Results : A 15 year-old male presented seven months after discharge from an Ebola Treatment Unit complaining of a 4 month history of blurred vision and photophobia OU. Best-corrected visual acuity (BCVA) was 20/100 OD and 20/50 OS. IOP was normal. Anterior segment findings included band keratopathy, prominent corneal nerves, non-granulomatous keratic precipitates, corneal endothelial pigment, 2+ anterior chamber cells OU and 1+ flare OU. Posterior synechiae and posterior subcapsular cataract were present. Vitreous haze 2+ OU and vitreoretinal adhesions OS were appreciated. Ultrasound B-scan demonstrated an attached retina OD but shallow temporal tractional retinal detachment (TRD) OS. He was started on 40mg of oral prednisone daily and felt subjective improvement. Two months later his BCVA was 20/100 OD and 20/30 OS, with worsening of inflammation (2+ cell and 1+ flare OD, 1+ cell OS). Vitreous cells were trace OD, and 2+ OS. Vitreous haze was 1+ to 2+ OD and trace OS. Fundoscopy revealed retinal infiltrates, vitreous condensation OD and occluded vessels, sheathing, retinal infiltrates and epiretinal membranes OS. SD-OCT showed vitreomacular traction (VMT) OU with an early TRD OD.

Conclusions : We demonstrate a case of Ebola-associated non-granulomatous panuveitis with VMT and TRD, two features not previously described as sequelae of EVD. This case demonstrates Ebola can lead to a broad spectrum of anterior and posterior pathology. We suggest that the Ebola virus may have a natural affinity for nerve tissue (eg. nerve fibre layer of the inner retina) and that it was Ebola-mediated inflammation (ie. uveitis) along the inner retina that led to vitreo-retinal adhesions (VMA) and ultimately a TRD.

This is an abstract that was submitted for the 2018 ARVO Annual Meeting, held in Honolulu, Hawaii, April 29 - May 3, 2018.

 

 

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