Corneal and Conjunctival Findings in a Cohort of Ebola Virus Disease Survivors from the West African Ebola Outbreak

Abstract

Purpose : This post-hoc analysis aims to assess ocular surface disease and visual acuity impact in an EVD survivor cohort from the West African Ebola Outbreak.

Methods : A retrospective assessment of 121 patients, who underwent screening for the Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) study, was performed. Patients were examined at the Lowell and Ruth Gess Kissy Eye Hospital in Freetown, Sierra Leone, and all underwent comprehensive ophthalmic exam. Demographic data including age, sex, and the number of days spent in the Ebola treatment unit (ETU) along with examination data such as visual acuity, and ocular complications were recorded. Descriptive and inferential statistical analyses were performed to assess ocular surface disease and visual acuity impact among EVD survivors in the EVICT study cohort.

Results : A total of 242 eyes (121 patients) were included in this study. The median age was 28.5 ± 16.2 years, and 70% were female. Of 242 eyes, twenty-eight (11.5%) eyes of 15 patients presented with at least one corneal or conjunctival finding. Dry eye, band keratopathy, and corneal scar were respectively most common in 28.6%, 25%, and 21.4% of 28 affected eyes of 15 patients. Corneal edema was found in 14.3%, while Pterygium and epithelial bullae were each found in 7.1% of affected eyes. Median logMAR visual acuity (VA) was 0.18 (Interquartile range [IQR] 0-2); Snellen VA 20/30. Patients without ocular surface disease had better visual acuity compared to patients with ocular surface disease although the difference was not statistically significant (0.82 ± 1.17 vs 1.01 ± 1.29, p=0.4). Median number of days spent in the ETU was 21 ± 18.4 days. Patients without ocular surface disease spent longer time in the ETU compared to patients with ocular surface disease but the difference was also not statistically significant (26.38 ± 19.06 vs 20.75 ± 12.90, p=0.4).

Conclusions : We identified a portion of EVD survivors with corneal and conjunctival disease. Although the presence of ocular surface diseases was not statistically associated with a worse visual acuity outcome, further studies may help to understand the impact of ocular surface disease in EVD survivors. Further studies of ocular surface findings in relation to the length of EVD disease and/or treatment may provide insight into the relationship between the severity of EVD and the occurrence of ocular surface disease.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.