Chorioretinal scarring and other posterior segment manifestations may account for up to 20% of ocular pathology in survivors of Ebola virus disease (EVD), according to findings published in Ophthalmology. 

Researchers conducted a secondary analysis of baseline data from patients screened for a previous study, the Ebola Virus Persistence in Ocular Tissues (EVICT) study, to examine posterior segment findings due to the risk of Ebola virus (EBOV) persistence in ocular tissues and fluids. 

The study included 250 eyes of 125 EVD survivors from Sierra Leone, West Africa, (median age28 years) who were referred from local eye clinics for vision impairment or cataract evaluation. The results show that chorioretinal scarring was the most prevalent posterior condition (observed in 22 of 220 eyes, 10%). Any type of retinal detachment (RD) was present in 2.4% of eyes (n=6), and 3 different varieties, including tractional, rhegmatogenous, and serous, were observed. In total, 19.2% of eyes examined (n=48) had posterior segment pathology, which was associated with visual acuity (VA) that was significantly worse than those without it (P <.001).

Finally, the participants in this cohort experienced conditions such as RD, persistent vitreous opacities, epiretinal membrane (ERM), and vitreomacular traction, which may improve as a result of surgical intervention. However, the researchers say this may be difficult given the lack of full access to the resources and technology necessary.


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“Importantly, the young age of our cohort has significant implications for quality-of-life years if left untreated,” the study explains. “In a resource-limited setting, challenges to vitreoretinal surgery include the scarcity of subspecialty-trained personnel, retinal equipment, and instrumentation. Vision health systems strengthening is thus needed to avert vision loss due to potentially treatable vitreoretinal disease.” 

The study explains that uveitis was the most common ocular manifestation in survivors of EVD, according to previous research, with a reported prevalence of 13% to 34%, and cataract is the second-most common finding, reported in 10% of patients. However, the present study sought to focus on posterior segment conditions that may require surgical intervention.

Study limitations include its nature of secondary analysis, potential selection bias, and lack of full resources and technology, which may have prevented researchers from detecting some subtle retinal abnormalities. 

Reference

Berry DE, Bavinger JC, Fernandes AF; EVICT Study Investigators. Posterior segment ophthalmic manifestations in Ebola survivors, Sierra Leone. Ophthalmol. Published online  February 6, 2021. doi:10.1016/j.ophtha.2021.02.001.