June 2022
Volume 63, Issue 7
Open Access
ARVO Annual Meeting Abstract  |   June 2022
Long-term decrease in intraocular pressure in survivors of Ebola virus disease in the PREVAIL III Study
Author Affiliations & Notes
  • Shwetha Mudalegundi
    Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Robin Ross
    Global Retina Institute, Arizona, United States
  • Jemma Larbelee
    Redemption Hospital, Liberia
  • Fred Amegashie
    Liberian Ministry of Health, Liberia
  • Robert F Dolo
    New Sight Eye Centre, Liberia
  • Catherine Gargu
    Partnership for Research on Ebola Virus in Liberia, Liberia
  • Yassah Sosu
    Partnership for Research on Ebola Virus in Liberia, Liberia
  • Jennie Sackor
    Partnership for Research on Ebola Virus in Liberia, Liberia
  • Precious Z Cooper
    Partnership for Research on Ebola Virus in Liberia, Liberia
  • Augustine Wallace
    Partnership for Research on Ebola Virus in Liberia, Liberia
  • Ruth Nyain
    Partnership for Research on Ebola Virus in Liberia, Liberia
  • Mosoka Fallah
    Partnership for Research on Ebola Virus in Liberia, Liberia
  • Cavan Reilly
    Division of Biostatistics, University of Minnesota Medical School Twin Cities, Minneapolis, Minnesota, United States
  • Rachel Bishop
    Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Allen Eghrari
    Wilmer Eye Institute, Johns Hopkins Medicine, Baltimore, Maryland, United States
  • Footnotes
    Commercial Relationships   Shwetha Mudalegundi None; Robin Ross None; Jemma Larbelee None; Fred Amegashie None; Robert Dolo None; Catherine Gargu None; Yassah Sosu None; Jennie Sackor None; Precious Cooper None; Augustine Wallace None; Ruth Nyain None; Mosoka Fallah None; Cavan Reilly None; Rachel Bishop None; Allen Eghrari None
  • Footnotes
    Support  This study was supported by the National Institute of Allergy and Infectious Diseases, NIH and the Liberian Ministry of Health, and in part by NIH K12 EY015025-10 (AOE), NIH L30 EY024746 (AOE), NIH 5K23 EY024268-02 (SGP), Research to Prevent Blindness Special Scholar Award (AOE) and the American Society of Cataract and Refractive Surgery Foundation Research Grant Award (AOE).
Investigative Ophthalmology & Visual Science June 2022, Vol.63, 3562 – A0449. doi:
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    • Get Citation

      Shwetha Mudalegundi, Robin Ross, Jemma Larbelee, Fred Amegashie, Robert F Dolo, Catherine Gargu, Yassah Sosu, Jennie Sackor, Precious Z Cooper, Augustine Wallace, Ruth Nyain, Mosoka Fallah, Cavan Reilly, Rachel Bishop, Allen Eghrari; Long-term decrease in intraocular pressure in survivors of Ebola virus disease in the PREVAIL III Study. Invest. Ophthalmol. Vis. Sci. 2022;63(7):3562 – A0449.

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

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Abstract

Purpose : Survivors of Ebola virus disease (EVD) experience decreased intraocular pressure (IOP) relative to unaffected close contacts during the first year of convalescence. Whether this effect persists over time, and its relationship to intraocular pathology, is unclear. We sought to determine if IOP remained lower in survivors of EVD over four years of follow-up, and to identify associated risk factors.

Methods : PREVAIL III is a 5-year, longitudinal cohort study of survivors of EVD and their close contacts and is a collaboration between the Liberian Ministry of Health and the United States National Institutes of Health. Participants who enrolled in PREVAIL III at John F. Kennedy Medical Center in Liberia, West Africa from June 2015 to March 2016 underwent comprehensive ophthalmic evaluation annually for 5 consecutive visits. IOP was measured at each visit by a handheld rebound tonometer using sterile tips. Comparisons are made between antibody-positive survivors and antibody-negative close contacts. Among survivors, we tested for associations between IOP and findings on physical examination, optical coherence tomography, or diagnosis of uveitis at baseline.

Results : Of 565 antibody-positive survivors and 644 antibody-negative close contacts enrolled in the study at baseline, the majority of participants returned annually, with 383 (67.8%) and 407 (63.2%) participants, respectively, presenting for the final study visit at a median of 60 months after symptom onset. A sustained, relative decrease in IOP was observed in survivors relative to close contacts, with mean difference of -0.87 mmHg (95% confidence interval -1.24 to -0.51) across all follow-up study visits. This difference remained constant over time (p=0.23 for interaction over time). Among survivors, physical examination findings of vitreous cell, optical coherence tomography findings of vitreous opacities, and eyes with diagnosis of uveitis all demonstrated a significant association with decreased IOP at baseline (p<0.05 for all).

Conclusions : In this study, survivors of EVD experienced a sustained decrease in IOP relative to close contacts over a five-year period following EVD infection. Clinical implications are unknown, but further research is required to elucidate the physiological origin of such changes. The results highlight the importance of considering long-term sequelae of emerging infectious diseases within a population.

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

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