Esther Hereth-Hebert1, Mamadou Oury Bah2, Jean François Etard3, Mamadou Saliou Sow4, Serge Resnikoff5, Christine Fardeau6, Abdoulaye Toure7, Alexis Niouma Ouendeno2, Isaac Ceougna Sagno8, Laura March3, Suzanne Izard3, Pierre Louis Lama2, Moumié Barry4, Eric Delaporte3. 1. IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France. Electronic address: oph.ehereth@gmail.com. 2. CADESSO - Centre d'Application du Diplôme d'Etudes Supérieures Spécialisées en Ophtalmologie, Conakry, Guinea. 3. IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France. 4. Infectious Disease Department, Donka University National Hospital, Conakry, Guinea. 5. Brien Holden Vision Institute, University of New South Wales, Sydney, Australia; Organisation Pour la prévention de la Cécité (OPC), Paris, France. 6. Department of Ophthalmology, Pitié-Salpêtrière Hospital, APHP, Paris, France. 7. IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France; Public Health and Department of Pharmacy, Conakry University, Conakry, Guinea. 8. Department of Ophthalmology, Nzérékoré Regional Hospital, Nzérékoré, Guinea.
Abstract
PURPOSE: The Ebola outbreak of 2013-2016 severely affected West Africa and resulted in 2544 deaths and 1270 survivors in Guinea, the country where it began. This Ebola virus was the Zaire strain of the virus family Filoviridae. In this outbreak the case fatality rate was about 67%. The survivors, declared cured after 2 negative blood polymerase chain reaction (PCR) results, face psychosocial disorders and rheumatic, ear-nose-throat, neurocognitive, and ophthalmologic complications. The goal of this study was to detect and describe ocular complications afflicting these survivors and to observe their occurrence and recurrences. DESIGN: Prospective observational cohort study. METHODS: This prospective observational multicenter cohort study was initiated in March 2015. The cohort study included 341 survivors followed up in the infectious disease ward of Conakry, Forecariah, and Nzérékoré as of May 2016. The patients received multidisciplinary medical follow-up expected to last at least 1 year that included an eye examination as part of complete, free treatment. RESULTS: Systematic examination of 341 patients revealed 46 cases of uveitis (13.5%), 6 cases of episcleritis (1.8%), and 3 cases of interstitial keratitis (0.9%). Uveitis was most frequently unilateral (78.3%) and anterior (47.8%) and occurred within the 2 months after discharge from the Ebola treatment center. Moreover, uveitis relapses were found up to 13 months after the negative PCR result for Ebola in the blood. CONCLUSION: Nearly 1 out of 6 survivors presented ocular disorders after discharge from the Ebola treatment center. An ophthalmologic follow-up for Ebola-infected patients should start, if possible, during the acute phase of the disease and last more than 1 year. Treatment guidelines need to be urgently developed and implemented.
PURPOSE: The Ebola outbreak of 2013-2016 severely affected West Africa and resulted in 2544 deaths and 1270 survivors in Guinea, the country where it began. This Ebola virus was the Zaire strain of the virus family Filoviridae. In this outbreak the case fatality rate was about 67%. The survivors, declared cured after 2 negative blood polymerase chain reaction (PCR) results, face psychosocial disorders and rheumatic, ear-nose-throat, neurocognitive, and ophthalmologic complications. The goal of this study was to detect and describe ocular complications afflicting these survivors and to observe their occurrence and recurrences. DESIGN: Prospective observational cohort study. METHODS: This prospective observational multicenter cohort study was initiated in March 2015. The cohort study included 341 survivors followed up in the infectious disease ward of Conakry, Forecariah, and Nzérékoré as of May 2016. The patients received multidisciplinary medical follow-up expected to last at least 1 year that included an eye examination as part of complete, free treatment. RESULTS: Systematic examination of 341 patients revealed 46 cases of uveitis (13.5%), 6 cases of episcleritis (1.8%), and 3 cases of interstitial keratitis (0.9%). Uveitis was most frequently unilateral (78.3%) and anterior (47.8%) and occurred within the 2 months after discharge from the Ebola treatment center. Moreover, uveitis relapses were found up to 13 months after the negative PCR result for Ebola in the blood. CONCLUSION: Nearly 1 out of 6 survivors presented ocular disorders after discharge from the Ebola treatment center. An ophthalmologic follow-up for Ebola-infectedpatients should start, if possible, during the acute phase of the disease and last more than 1 year. Treatment guidelines need to be urgently developed and implemented.
Authors: Paul J Steptoe; Fayiah Momorie; Alimamy D Fornah; Sahr P Komba; Elizabeth Emsley; Janet T Scott; Simon P Harding; Matthew J Vandy; Foday Sahr; Nicholas A V Beare; Malcolm G Semple Journal: JAMA Ophthalmol Date: 2018-06-01 Impact factor: 7.389
Authors: Shevin T Jacob; Ian Crozier; William A Fischer; Angela Hewlett; Colleen S Kraft; Marc-Antoine de La Vega; Moses J Soka; Victoria Wahl; Anthony Griffiths; Laura Bollinger; Jens H Kuhn Journal: Nat Rev Dis Primers Date: 2020-02-20 Impact factor: 52.329
Authors: Paul J Steptoe; Janet T Scott; Simon P Harding; Nicholas A V Beare; Malcolm G Semple; Matthew J Vandy; Foday Sahr Journal: Am J Ophthalmol Date: 2017-07-29 Impact factor: 5.488