Visual changes continue to emerge after Ebola virus disease resolves

  • Eghrari AO & al.
  • JAMA Netw Open
  • 04/01/2021

  • Liz Scherer
  • Clinical Essentials
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Takeaway

  • A spectrum of multifaceted intraocular, neuro-ophthalmologic deficits persists in survivors of Ebola virus disease (EVD).

Why this matters

  • Post-EVD care may require intraocular surgery to restore vision.
  • Current imaging data thresholds inadequately address visual changes in EVD survivors.

Key results

  • 564 survivors and 635 close contacts.
  • Mean age, 30.3 years.
  • Mean (standard deviation [SD]) interval between enrollment and eye examination:
    • 100 (SD, 94.0) days among survivors. 
    • 64 (SD, 62.5) days among contacts.
  • 28.9% of survivors and 19.0% of contacts had color vision deficit:
    • OR, 1.6 (95% CI, 1.2-2.1). 
  • Median intraocular pressure:
    • 12.4 (interquartile range [IQR], 10.4-14.5) mmHg for survivors vs
    • 13.5 (11.5-16.0) mmHg among contacts (P<.001>
  • Uveitis detected in 26.4% of survivors and 12.1% of contacts.
    • OR, 2.4 (95% CI, 1.8-3.2).
  • Rate of uveitis features in survivors vs contacts:
    • Intermediate: 34.2% vs 6.5%.
      • OR, 7.8 (P<.001>
    • Decreased median intraocular pressure: 12.00 (IQR, 10.0-14.0) mmHg vs 13.5 (IQR, 11.0-16.2) mmHg (P<.001>
    • Increased median central subfield thickness of macula: 222 (IQR, 210-236) µm vs 212 (IQR, 200-219) µm (P=.02).
  • Optical coherence tomography showed multifocal retinal lesions, disruption of outer retina.

Study design

  • Baseline, cross-sectional study comparing ophthalmic pathology rates among survivors of EVD and their close contacts over 5 years.
  • Funding: National Institute of Allergy and Infectious Diseases; others.

Limitations

  • Narrow time window.
  • Unmasked examiners.