June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Long-Term Outcomes and Histopathology from Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) Study
Author Affiliations & Notes
  • Lucas Kim
    University of Nebraska Stanley M Truhlsen Eye Institute, Omaha, Nebraska, United States
    Mercer University School of Medicine, Macon, Georgia, United States
  • Tolulope Fashina
    University of Nebraska Stanley M Truhlsen Eye Institute, Omaha, Nebraska, United States
  • Jessica Shantha
    University of California San Francisco Department of Medicine, San Francisco, California, United States
  • Xiankun Zeng
    United States Army Medical Research Acquisition Activity, Fort Detrick, Maryland, United States
  • Steven Yeh
    University of Nebraska Stanley M Truhlsen Eye Institute, Omaha, Nebraska, United States
  • Footnotes
    Commercial Relationships   Lucas Kim None; Tolulope Fashina None; Jessica Shantha None; Xiankun Zeng None; Steven Yeh None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 2881 – F0018. doi:
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      Lucas Kim, Tolulope Fashina, Jessica Shantha, Xiankun Zeng, Steven Yeh; Long-Term Outcomes and Histopathology from Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) Study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):2881 – F0018.

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

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Abstract

Purpose : Ebola virus disease (EVD) survivors are at increased risk of uveitis and sequelae including cataract, which can lead to vision disability. Prior work in the EVICT study explored the short-term outcomes of cataract surgery in survivors but the long-term outcomes and the potential for Ebola virus to reside in cataract materials requires further study.

Methods : We performed a long-term analysis on EVD survivors who were enrolled in the EVICT study underwent manual small incision cataract surgery (MSICS). Patients underwent anterior chamber taps for Ebola virus (EBOV) RNA RT-PCR; those who tested negative were eligible for MSICS. Follow-up data on visual acuity (VA) and ocular complications at 3–4-months, 6 months, and 12 months post-surgery were analyzed. Histology and In situ hybridization (ISH) for EBOV RNA were performed on lens and capsular material from MSICS surgery.

Results : Clinical outcomes of 34 EVD survivors who underwent MSICS surgery were analyzed. Median preoperative logMAR (VA) was 2.65 (VA Counting fingers - Hand motions). Post-operatively, median logMAR VA improved to 0.18 at 3-4 months (p < 0.01) but showed slight worsening to 0.48 (p < 0.01) at 6 months and 0.60 (p < 0.01) at 12 months. Nine patients underwent an additional YAG capsulotomy procedure. Ocular adverse events within 1-3 months included recurrent uveitis (n=1, 3%). Adverse events observed at 3-4 months included vitreous opacity (n=3, 8.8%), epiretinal membrane (n=1, 3%) and panuveitis (n=1, 3%). Recurrent uveitis was observed between 6-12 months in 11 patients (32%). Other findings observed included vitreous opacity (n=5, 14.7%), epiretinal membrane (n=1, 3%), tractional retinal detachment (n=1, 3%) band keratopathy (n=1, 3%), Histopathology of cataracts and cataract nuclei (n=7) showed lens fiber vacuolation and morgagnian globules, Anterior capsules (n=2) showed mineralization and thickened capsule. Further ISH analysis of 7 lens samples showed no evidence of EBOV RNA within lens or capsular material.

Conclusions : Twelve month outcomes from the EVICT study showed that cataract surgery is safe and restored vision with no evidence of EBOV RNA within lens or capsular tissues. Secondary cataract, recurrent uveitis and retinal findings were observed although our analysis was limited by patient dropout and sample size. MSCIS surgery in EVD survivors was well-tolerated but patients required ongoing monitoring.

This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.

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