Ophthalmic Manifestations and Causes of Vision Impairment in Ebola Virus Disease Survivors in Monrovia, Liberia
| Autor: | Brent Hayek, Jerry Brown, Jessica G. Shantha, Steven Yeh, John Fankhauser, Ian Crozier, Beau B. Bruce, Catherine Gargu |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Pediatrics medicine.medical_specialty Visual acuity Adolescent genetic structures Cross-sectional study viruses Visual impairment Vision Disorders Visual Acuity Cataract Article Uveitis Optic neuropathy Young Adult 03 medical and health sciences 0302 clinical medicine Risk Factors medicine Humans 030212 general & internal medicine Young adult Child Aged Retrospective Studies business.industry Retrospective cohort study social sciences Hemorrhagic Fever Ebola Length of Stay Middle Aged Liberia medicine.disease humanities Surgery Ophthalmology Cross-Sectional Studies Cohort 030221 ophthalmology & optometry Female medicine.symptom business human activities |
| Zdroj: | Ophthalmology. 124:170-177 |
| ISSN: | 0161-6420 |
| DOI: | 10.1016/j.ophtha.2016.10.011 |
| Popis: | To describe the ocular findings, visual impairment, and association of structural complications of uveitis with visual impairment in a cohort of survivors of Ebola virus disease (EVD) in Monrovia, Liberia.Retrospective, uncontrolled, cross-sectional study.Survivors of EVD who were evaluated in an ophthalmology clinic at Eternal Love Winning Africa (ELWA) Hospital in Monrovia, Liberia.A cohort of EVD survivors who underwent baseline ophthalmic evaluation at ELWA Hospital were retrospectively reviewed for demographic information, length of Ebola treatment unit (ETU) stay, visual acuity (VA), and ophthalmic examination findings. For patients with uveitis, disease activity (active vs. inactive) and grade of inflammation were recorded according to Standardization of Uveitis Nomenclature criteria. The level of VA impairment was categorized according to World Health Organization classification for VA impairment as follows: normal/mild, VA 20/70 or better; moderate, VA 20/70-20/200; severe, VA 20/200-20/400; blindness, VA20/400. Visual acuity, length of ETU stay, and structural complications were compared between EVD survivors with and without uveitis. Structural complications associated with moderate VA impairment or poorer were analyzed.Frequency of ocular complications including uveitis and optic neuropathy in EVD survivors, level of VA impairment in EVD survivors with uveitis, and structural complications associated with VA impairment in EVD survivors.A total of 96 survivors of EVD were examined. A total of 21 patients developed an EVD-associated uveitis, and 3 patients developed an EVD-associated optic neuropathy. Visual acuity was blind (VA20/400) in 38.5% of eyes with uveitis. Anatomic subtypes of uveitis included anterior, posterior, and panuveitis in 2, 13, and 6 patients, respectively. Examination findings associated with at least moderate visual impairment by World Health Organization criteria (VA20/70) included keratic precipitates (P0.002), posterior synechiae (P0.002), vitritis (P0.005), and chorioretinal scars (P0.02).Survivors of EVD are at risk for uveitis, which may lead to secondary structural complications, visual impairment, and blindness. Eye care resources should be mobilized for EVD survivors in West Africa because of the frequency of this spectrum of disease complication and its potential for severe VA impairment and blindness. |
| Databáze: | OpenAIRE |
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