Ocular inflammatory diseases in ebola survivors

Abstract

Purpose The last Ebola outbreak severely affected West Africa and led to 2543 deaths and 1268 survivors in Guinea, where it began. The survivors faced various symptoms and disorders including ocular pain and erythema, itching, tearing, photophobia and blurry vision. The purpose of our study was to describe uderluing ocular diseases. Methods This is a prospective observational multicenter cohort study initiated in March 2015 which included survivors followed up in the infectious disease ward of Conakry and Nzérekoré. The patients received multidisciplinary medical follow‐up that included an eye examination. Results Systematic examination of 341 survivors highlighted 46 cases of uveitis (13.5%), six episcleritis (1.8%), and three interstitial keratitis (0.9%). Uveitis were more unilateral (78.3%) and anterior (47.8%) and occurred within the 2 months following discharge from the Ebola treatment center. Moreover, relapses were found up to 13 months after healing. Eleven eyes with anterior chamber inflammation presented with cataracts and visual acuity ≤ 5/10. Ten eyes with chorioretinal scars presented decreased visual acuity ≤ 5/10. Among 46 survivors with uveitis, 13 (28%) suffered from visual alteration on at least one eye. Conclusions Nearly 17% of Ebola survivors presented ocular disorders that may be very delayed in some patients. Moreover our study brought out relapses. We were not authorized to take intra‐ocular samples to identify the virus. The mechanism behind these uveitis is probably is an association between a direct cytopathic impact of the virus and an immune reaction to it. The corticosteroid therapy that is actually recommended by WHO can't be used safely during the acute infection but seems to be efficient in survivors. The current issue is to perform safely cataract surgery in survivors.