Ebola-Associated Bilateral Non-Granulomatous Panuveitis with Tractional Retinal Detachment: A Case Report

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.

 

07/20/15

 

07/28/15