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- Title
Characterization of Ebola Virus–Associated Eye Disease.
- Authors
Eghrari, Allen O.; Bishop, Rachel J.; Ross, Robin D.; Davis, Bionca; Larbelee, Jemma; Amegashie, Fred; Dolo, Robert F.; Prakalapakorn, S. Grace; Gaisie, Catherine; Gargu, Catherine; Sosu, Yassah; Sackor, Jennie; Cooper, Precious Z.; Wallace, Augustine; Nyain, Ruth; Gray, Maima; Kamara, Famatta; Burkholder, Bryn; Brady, Christopher J.; Ray, Vincent
- Abstract
This cross-sectional analysis of compares rates of ocular sequelae in antibody-positive survivors of Ebola virus disease and antibody-negative close contacts. Key Points: Question: Do survivors of Ebola virus disease have more eye problems than the general population? Findings: In this cross-sectional study of 564 Ebola virus antibody–positive survivors and 635 antibody-negative close contacts, survivors had higher rates of uveitis, decreased intraocular pressure, impairment of color vision, and decreased accommodative tone. Biomicroscopic examination and optical coherence tomography revealed retinal scars and macular edema in survivors. Meaning: The findings suggest that Ebola virus disease is associated with development of a spectrum of changes throughout the visual pathway that may persist after acute infection. Importance: Survivors of Ebola virus disease (EVD) may experience ocular sequelae. Comparison with antibody-negative individuals from the local population is required to characterize the disease. Objective: To assess features of ophthalmic disease specific to EVD. Design, Setting, and Participants: This baseline cross-sectional analysis of survivors of EVD and their close contacts was conducted within PREVAIL III, a 5-year, longitudinal cohort study. Participants who enrolled at John F. Kennedy Medical Center in Liberia, West Africa from June 2015 to March 2016 were included in this analysis. Close contacts were defined as household members or sex partners of survivors of EVD. Data were analyzed from July 2016 to July 2020. Exposures: All participants, both survivors and close contacts, underwent testing of IgG antibody levels against Ebola virus surface glycoprotein. Main Outcomes and Measures: Ocular symptoms, anterior and posterior ophthalmologic examination findings, and optical coherence tomography images were compared between antibody-positive survivors and antibody-negative close contacts. Results: A total of 564 antibody-positive survivors (320 [56.7%] female; mean [SD] age, 30.3 [14.0] years) and 635 antibody-negative close contacts (347 [54.6%] female; mean [SD] age, 25.8 [15.5] years) were enrolled in this study. Survivors were more likely to demonstrate color vision deficit (28.9% vs 19.0%, odds ratio [OR], 1.6; 95% CI, 1.2-2.1) and lower intraocular pressure (12.4 vs 13.5 mm Hg; mean difference, −1.2 mm Hg; 95% CI, −1.6 to −0.8 mm Hg) compared with close contacts. Dilated fundus examination revealed a higher percentage of vitreous cells (7.8% vs 0.5%; OR, 16.6; 95% CI, 5.0-55.2) and macular scars (4.6% vs 1.6%; OR, 2.8; 95% CI, 1.4-5.5) in survivors than in close contacts. Uveitis was present in 26.4% of survivors and 12.1% of close contacts (OR, 2.4; 95% CI, 1.8-3.2). Among all participants with uveitis, survivors were more likely than close contacts to have intermediate uveitis (34.2% vs 6.5% of all cases; OR, 7.8; 95% CI, 3.1-19.7) and had thicker mean central subfield thickness on optical coherence tomography (222 vs 212 μm; mean difference, 14.4 μm; 95% CI, 1.9-26.9 μm). Conclusions and Relevance: In this cross-sectional study, survivors of EVD had a distinct spectrum of ocular and neuro-ophthalmologic findings compared with close contacts that potentially require medical and surgical treatment.
- Subjects
CONFIDENCE intervals; IMMUNOGLOBULINS; UVEITIS; OPTICAL coherence tomography; CROSS-sectional method; DATA analysis software; DESCRIPTIVE statistics; EBOLA virus; VIRAL eye infections
- Publication
JAMA Network Open, 2021, Vol 4, Issue 1, pe2032216
- ISSN
2574-3805
- Publication type
Article
- DOI
10.1001/jamanetworkopen.2020.32216