An update on ocular complications of Ebola virus disease

• Type of Material: Article
• Authors: Jessica Shantha, Emory University; Ian Crozier, World Health Organization; Steven Yeh, Emory University
• Language: English
• Date: 2017-11-01
• Publisher: Lippincott, Williams & Wilkins
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2017 Wolters Kluwer Health, Inc. All rights reserved.
• Final Published Version (URL): http://dx.doi.org/10.1097/ICU.0000000000000426
• Title of Journal or Parent Work: Current Opinion in Ophthalmology
• ISSN: 1040-8738
• Volume: 28
• Issue: 6
• Start Page: 600
• End Page: 606
• Grant/Funding Information: S.Y. has received consulting fees from Santen, Inc., AGTC and Clearside Biomedical.; J.G.S. has received consulting fees from Santen, Inc.; Grant funding is also provided by Santen Pharmaceutical Co., Alcon Research Foundation, Heed Ophthalmic Fellowship Foundation and the Bayer Global Ophthalmology Awards Program.; This work was supported by a National Institutes of Health Core Grant P30EY006360 to the Emory Eye Center and an unrestricted grant from the Research to Prevent Blindness to the Emory Eye Center/ Emory University School of Medicine.; S.Y. has received grant funding from Alcon Research Institute.
• Keywords: Life Sciences & Biomedicine; Science & Technology; SEQUELAE; Ebola virus; uveitis; Ophthalmology; Ebola virus persistence; SURVIVORS; KIKWIT; GUINEA; MANIFESTATIONS; SIERRA-LEONE; PERSISTENCE; CONGO
• Research Categories: Health Sciences, Public Health; Health Sciences, Opthamology

Abstract

Purpose of review This review provides a summary of our current understanding of the ophthalmic manifestations of Ebola virus disease (EVD), pathogenesis, treatment options and directions for future study. The individual, public health and global health implications of eye disease in EVD survivors are discussed. Recent findings The West Africa EVD outbreak was of unprecedented magnitude, leading to the largest survivor cohort since the first documented EVD outbreak in 1976. Because of the magnitude of the recent outbreak, thousands of survivors are at-risk of systemic and ophthalmic sequelae termed the 'post Ebola virus disease syndrome'. Uveitis is the most common finding during EVD convalescence and may lead to severe vision impairment or blindness in 40% of affected individuals. Ocular complications leading to vision loss include cataract, retinal scarring, optic neuropathy, hypotony and phthisis bulbi. The pathogenesis of eye disease in EVD survivors likely involves Ebola virus persistence, severe inflammation and tissue edema, which present as acute, rapidly progressive disease or chronic, smoldering disease. Further studies into disease pathogenesis including mechanisms of viral persistence may provide guidance into therapies for uveitis secondary to EVD. Summary Uveitis is the most common ophthalmic finding in EVD survivors and can lead to vision loss. Further studies into the clinical manifestations and mechanisms of disease are needed to improve therapies for EVD survivors who often have limited access to ophthalmic medical and surgical care.