Skip directly to site content Skip directly to page options Skip directly to A-Z link Skip directly to A-Z link Skip directly to A-Z link
Volume 23, Number 7—July 2017
Research

Novel Retinal Lesion in Ebola Survivors, Sierra Leone, 2016

Paul J. SteptoeComments to Author , Janet T. Scott, Julia M. Baxter, Craig K. Parkes, Rahul Dwivedi, Gabriela Czanner, Matthew J. Vandy, Fayiah Momorie, Alimamy D. Fornah, Patrick Komba, Jade Richards, Foday Sahr, Nicholas A.V. Beare, and Malcolm G. Semple
Author affiliations: University of Liverpool, Liverpool, UK (P.J. Steptoe, J.T. Scott, G. Czanner, N.A.V. Beare, M.G. Semple); Royal Liverpool Hospital, Liverpool (P.J. Steptoe, J.M. Baxter, C.K. Parkes, R. Dwivedi, N.A.V. Beare); National Institute for Health Research Health Protection Research Unit in Emerging and Zoonotic Infections, Liverpool (J.T. Scott, M.G. Semple); Connaught Hospital, Freetown, Sierra Leone (M.J. Vandy); 34th Military Hospital, Freetown (F. Momorie, A.D. Fornah, P. Komba, F. Sahr); Public Health England Laboratory, Makeni, Sierra Leone (J. Richards)

Main Article

Figure 3

Characteristic features of lesions observed in a case–control study of ocular signs in Ebola virus disease survivors, Sierra Leone, 2016. A) Composite scanning laser ophthalmoscope retinal image, left eye. Arrow indicates direction of the optical coherence tomography scan. B) Optical coherence tomography. White, long, dashed line indicates cross-sectional plane; white arrowhead indicates Ebola lesion limited to the retinal layers with an intact retinal pigment epithelium. Magnified 1.5× from ori

Figure 3. Characteristic features of lesions observed in a case–control study of ocular signs in Ebola virus disease survivors, Sierra Leone, 2016. A) Composite scanning laser ophthalmoscope retinal image, left eye. Arrow indicates direction of the optical coherence tomography scan. B) Optical coherence tomography. White, long, dashed line indicates cross-sectional plane; white arrowhead indicates Ebola lesion limited to the retinal layers with an intact retinal pigment epithelium. C) Examples of straight-edged, sharp angulated lesions (magnified 1.5× from panel A). D) Example of tangential section through the human fovea with illustrative highlighting of a triangular photoreceptor matrix corresponding to Ebola lesional shape. Courtesy of Ahnelt et al. (17).

Main Article

References
  1. WHO. Ebola situation report 30th March 2016 [cited 2016 Jul 5]. http://apps.who.int/ebola/current-situation/ebola-situation-report-30-march-2016
  2. 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
  3. 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
  4. 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
  5. 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
  6. 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
  7. 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
  8. 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.
  9. 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
  10. 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
  11. 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
  12. 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
  13. 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
  14. 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.
  15. 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
  16. 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
  17. 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
  18. Billioux  BJ, Smith  B, Nath  A. Neurological complications of Ebola virus infection. Neurotherapeutics. 2016;13:461–70. DOIPubMedGoogle Scholar
  19. 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
  20. 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.
  21. Kuming  BS, Kokoris  N. Uveal involvement in Marburg virus disease. Br J Ophthalmol. 1977;61:265–6. DOIPubMedGoogle Scholar
  22. 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
  23. 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
  24. 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
  25. 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
  26. 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
  27. 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
  28. World Health Organization. HIV/AIDS [cited 2017 Mar 29]. http://www.afro.who.int/en/sierra-leone/health-topics/4958-hivaids.html
  29. 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
  30. Rutnin  U, Schepens  CL. Fundus appearance in normal eyes. IV. Retinal breaks and other findings. Am J Ophthalmol. 1967;64:1063–78. DOIPubMedGoogle Scholar
  31. 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
  32. Nagpal  KC, Goldberg  MF, Asdourian  G, Goldbaum  M, Huamonte  F. Dark-without-pressure fundus lesions. Br J Ophthalmol. 1975;59:476–9. DOIPubMedGoogle Scholar

Main Article

Page created: June 19, 2017
Page updated: June 19, 2017
Page reviewed: June 19, 2017
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
file_external