Volume 23, Number 7—July 2017
Research
Novel Retinal Lesion in Ebola Survivors, Sierra Leone, 2016
Figure 1

Figure 1. Prevalence of retinal scar lesion types in a case–control study of ocular signs in Ebola virus disease survivors, Sierra Leone, 2016. Type 1, uniform pigmented lesion; type 2, uniform pigmented lesion with gray halo; type 3, uniform pigmented lesion with lacunae; type 4, pigmented lesion with deep surrounding atrophy; type 5, previously described lesion attributed to Ebola (8); type 6, angulated lesions (peripapillary and/or peripheral); type 7, indistinct small pigmented lesions; type 8, irregularly pigmented vascular projection lesion; type 9, pigmented curvilinear peripheral bands; type 10, optic disc projection to macula lesion. Error bars indicate 97.5% CI. Asterisk indicates statistical significance (p<0.01) based on Fisher exact statistic value (2.7 × 105).
References
- WHO. Ebola situation report 30th March 2016 [cited 2016 Jul 5]. http://apps.who.int/ebola/current-situation/ebola-situation-report-30-march-2016
- Scott JT, Sesay FR, Massaquoi TA, Idriss BR, Sahr F, Semple MG. Post-Ebola Syndrome, Sierra Leone. Emerg Infect Dis. 2016;22:641–6. DOIPubMedGoogle Scholar
- Kibadi K, Mupapa K, Kuvula K, Massamba M, Ndaberey D, Muyembe-Tamfum JJ, et al. Late ophthalmologic manifestations in survivors of the 1995 Ebola virus epidemic in Kikwit, Democratic Republic of the Congo. J Infect Dis. 1999;179(Suppl 1):S13–4. DOIPubMedGoogle Scholar
- Mattia JG, Vandy MJ, Chang JC, Platt DE, Dierberg K, Bausch DG, et al. Early clinical sequelae of Ebola virus disease in Sierra Leone: a cross-sectional study. Lancet Infect Dis. 2016;16:331–8. DOIPubMedGoogle Scholar
- Bishop R, Eghrari A, Brady C, Ray V, Reilly C, Ferris F, et al. Expanding the spectrum of Ebola-associated eye disease: a summary of ocular findings in a large cohort of Ebola survivors. Invest Ophthalmol Vis Sci. 2016. ARVO E-abstract 4763 [cited 2016 Jul 5]. http://www.arvo.org/webs/am2016/sectionpdf/IM/Session_433.pdf
- Tiffany A, Vetter P, Mattia J, Dayer J-A, Bartsch M, Kasztura M, et al. Ebola virus disease complications as experienced by survivors in Sierra Leone. Clin Infect Dis. 2016;62:1360–6. DOIPubMedGoogle Scholar
- Hereth-Hebert E, Bah MO, Etard JF, Sow MS, Resnikoff S, Fardeau C, et al.; Postebogui Study Group. Ocular complications in survivors of the Ebola outbreak in Guinea. Am J Ophthalmol. 2017;175:114–21. DOIPubMedGoogle Scholar
- Hebert EH, Sow S, Etard Jean-François TA, Msellati P, Taverne B, Barry M, et al. A case series of 11 uveitis in patients who recovered from Ebola in Guinea. Trop Med Int Health. 2015;20(Suppl. 1):435.
- Varkey JB, Shantha JG, Crozier I, Kraft CS, Lyon GM, Mehta AK, et al. Persistence of Ebola virus in ocular fluid during convalescence. N Engl J Med. 2015;372:2423–7. DOIPubMedGoogle Scholar
- Shantha JG, Crozier I, Varkey JB, Kraft CS, Lyon GM III, Mehta AK, et al. Long-term Management of Panuveitis and Iris Heterochromia in an Ebola Survivor. Ophthalmology. 2016;123:2626–2628.e2. DOIPubMedGoogle Scholar
- Chancellor JR, Padmanabhan SP, Greenough TC, Sacra R, Ellison RT III, Madoff LC, et al. Uveitis and systemic inflammatory markers in convalescent phase of Ebola virus disease. Emerg Infect Dis. 2016;22:295–7. DOIPubMedGoogle Scholar
- Shantha JG, Crozier I, Hayek BR, Bruce BB, Gargu C, Brown J, et al. Ophthalmic manifestations and causes of vision impairment in Ebola virus disease survivors in Monrovia, Liberia. Ophthalmology. 2017;124:170–7. DOIPubMedGoogle Scholar
- von Elm E, Altman DG, Egger M, Pocock SJ, Gøtzsche PC, Vandenbroucke JP; STROBE Initiative. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet. 2007;370:1453–7. DOIPubMedGoogle Scholar
- Trusko B, Thorne J, Jabs D, Belfort R, Dick A, Gangaputra S, et al.; Standardization of Uveitis Nomenclature (SUN) Project. The Standardization of Uveitis Nomenclature (SUN) Project. Development of a clinical evidence base utilizing informatics tools and techniques. Methods Inf Med. 2013;52:259–65, S1–6.
- Chylack LT Jr, Wolfe JK, Singer DM, Leske MC, Bullimore MA, Bailey IL, et al.; The Longitudinal Study of Cataract Study Group. The Lens Opacities Classification System III. Arch Ophthalmol. 1993;111:831–6. DOIPubMedGoogle Scholar
- Clopper CJ, Pearson ES. The use of confidence or fiducial limits illustrated in the case of the binomial. Biometrika. 1934;26:404–13. DOIGoogle Scholar
- Ahnelt PK, Kolb H, Pflug R. Identification of a subtype of cone photoreceptor, likely to be blue sensitive, in the human retina. J Comp Neurol. 1987;255:18–34. DOIPubMedGoogle Scholar
- Billioux BJ, Smith B, Nath A. Neurological complications of Ebola virus infection. Neurotherapeutics. 2016;13:461–70. DOIPubMedGoogle Scholar
- Pleyer U, Klauß V, Wilking H, Nentwich MM. [Tropical ophthalmology : Intraocular inflammation caused by “new” infectious pathogens and travel-related infections]. Ophthalmologe. 2016;113:35–46. DOIPubMedGoogle Scholar
- Hugh Perry V. The distribution of cones in the primate retina. In: advances in photoreception: proceedings of a symposium on Frontiers of Visual Science. Washington: National Academies Press; 1990. p. 105–16.
- Kuming BS, Kokoris N. Uveal involvement in Marburg virus disease. Br J Ophthalmol. 1977;61:265–6. DOIPubMedGoogle Scholar
- Gear JS, Cassel GA, Gear AJ, Trappler B, Clausen L, Meyers AM, et al. Outbreake of Marburg virus disease in Johannesburg. BMJ. 1975;4:489–93. DOIPubMedGoogle Scholar
- Ronday MJ, Stilma JS, Barbe RF, Kijlstra A, Rothova A. Blindness from uveitis in a hospital population in Sierra Leone. Br J Ophthalmol. 1994;78:690–3. DOIPubMedGoogle Scholar
- Onchocerciasis and its control. Report of a WHO Expert Committee on Onchocerciasis Control. World Health Organ Tech Rep Ser. 1995;852:1–104.PubMedGoogle Scholar
- Whitworth JAG, Gilbert CE, Mabey DM, Maude GH, Morgan D, Taylor DW. Effects of repeated doses of ivermectin on ocular onchocerciasis: community-based trial in Sierra Leone. Lancet. 1991;338:1100–3. DOIPubMedGoogle Scholar
- Rothova A, Van der Lelij A, Stilma JS, Klaassen-Broekema N, Wilson WR, Barbe RF. Ocular involvement in patients with onchocerciasis after repeated treatment with ivermectin. Am J Ophthalmol. 1990;110:6–16. DOIPubMedGoogle Scholar
- Ronday MJ, Stilma JS, Barbe RF, McElroy WJ, Luyendijk L, Kolk AH, et al. Aetiology of uveitis in Sierra Leone, west Africa. Br J Ophthalmol. 1996;80:956–61. DOIPubMedGoogle Scholar
- World Health Organization. HIV/AIDS [cited 2017 Mar 29]. http://www.afro.who.int/en/sierra-leone/health-topics/4958-hivaids.html
- Parpia AS, Ndeffo-Mbah ML, Wenzel NS, Galvani AP. Effects of response to 2014-2015 Ebola outbreak on deaths from malaria, HIV/AIDS, and tuberculosis, West Africa. Emerg Infect Dis. 2016;22:433–41. DOIPubMedGoogle Scholar
- Rutnin U, Schepens CL. Fundus appearance in normal eyes. IV. Retinal breaks and other findings. Am J Ophthalmol. 1967;64:1063–78. DOIPubMedGoogle Scholar
- Diaz RI, Sigler EJ, Randolph JC, Rafieetary MR, Calzada JI. Spectral domain optical coherence tomography characteristics of white-without-pressure. Retina. 2014;34:1020–1. DOIPubMedGoogle Scholar
- Nagpal KC, Goldberg MF, Asdourian G, Goldbaum M, Huamonte F. Dark-without-pressure fundus lesions. Br J Ophthalmol. 1975;59:476–9. DOIPubMedGoogle Scholar