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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

Table

Ophthalmic examination findings in a case–control study of ocular signs in Ebola virus disease survivors, Sierra Leone, 2016*

Finding Survivors
 Controls
No. % (97.5% CI)† No. % (97.5% CI)†
Best eye visual acuity‡
Missing data 3 – 56 –
Normal 59 74.7 (62.1–84.9) 37 75.5 (59.1–87.9)
Near normal 18 22.8 (13.1–35.1) 8 16.3 (6.4–31.6)
Moderate 1 1.3 (0–7.8) 3 6.1 (1–18.6)
Severe 1 1.3 (0–7.8) 0 0 (0–8.6)
Profound 0 0 (0–5.5) 1 2 (0–12.3)
Near total 0 0 (0–5.5) 0 0 (0–8.6)
Total
 0
 0 (0–5.5)
0
 0 (0–8.6)
Intraocular pressure, mmHg
Missing data 35 – 74 –
Hypotonous (<5) 5 10.6 (3–25) 0 0 (0–13.2)
Reduced (6–10) 5 10.6 (3–25) 3 9.7 (1.6–28.2)
Within normal range (11–21) 35 74.5 (57.6–87.3) 26 83.9 (63.8–95.4)
Elevated (22–29) 1 2.1 (0–12.8) 2 6.5 (0.5–23.7)
High (>30)
 1
 2.1 (0–12.8)
0
 0 (0–13.2)
Worst eye cup:disc ratio§
Bilateral ungradable 1 – 0 –
Unilateral ungradable 11 – 8 –
Normal (0.1–0.6) 73 90 (80.1–96.2) 79 75.2 (64.5–84.1)
Moderate (0.7–0.8) 7 8.6 (3.1–18.3) 23 21.9 (13.5–32.3)
Advanced (>0.9)
 1
 1.2 (0–7.6)
3
 2.9 (0.5–9)
Cataract
All cataract 19 23.2 (13.6–35.3) 18 17 (9.7–27)
White cataract 6 7.3 (2.3–16.5) 0 0 (0–4.1)
White cataract with hypotony, IOP <5 mm Hg¶
 4
 80 (23.6–99.7)
NA
 NA
Active anterior uveitis
Missing data 13 – 67 –
Anterior chamber cells present
 5
 7.3 (2–17.4)
4
 10.5 (2.4–27)
Previous anterior uveitis
Missing data 12 – 65 –
Signs of previous anterior uveitis#
 7
 10 (3.6–21)
0
 0 (0–10.4)
Vitreous signs**
Signs suggestive of active or past intermediate uveitis
 8 (9.8)
 9.8 (3.8–19.6)
14
 13.3 (6.9–22.5)
Retinal signs**
Retinal hemorrhages 0 0 (0–5.2) 2 1.9 (0.2–7.5)
Retinal neovascularization 0 0 (0–5.2) 1 1 (0–5.9)
Papilledema 0 0 (0–5.2) 0 0 (0–4.1)
Retinal vasculitis 0 0 (0–5.2) 4 3.8 (0.8–10.4)
Macula hole 0 0 (0–5.2) 1 1 (0–5.9)
Retinal tears 1 1.2 (0–7.5) 1 1 (0–5.9)
Retinal detachment 0 0 (0–5.2) 2 1.9 (0.2–7.5)
Asteriod hyalosis 0 0 (0–5.2) 1 1 (0–5.9)
Myelinated nerve fibers 0 0 (0–5.2) 1 1 (0–5.9)
Benign flecked retina 1 1.2 (0–7.5) 0 0 (0–4.1)
Geographic retinal darkening and variants 16 19.5 (10.7–31.2) 13 12.4 (6.2–21.4)
White without pressure 18 22 (12.6–34) 20 19 (11.2–29.2)

*IOP, intraocular pressure; NA, not available; –, not applicable.
†Calculated by using exact binomial Clopper-Pearson method.
‡Grading based on International Classification of Diseases, Ninth Revision, Clinical Modification (true Snellen fractions).
§When only 1 cup:disc ratio was gradable, only that ratio was used for analysis.
¶Missing data on 2 patients.
#Posterior synechiae and/or pigment on anterior lens capsule, keratic precipitates but no anterior chamber inflammation, or both.
**Graded based on widefield retinal image.

Main Article

Page created: June 19, 2017
Page updated: June 19, 2017
Page reviewed: June 19, 2017
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