Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) Study: Reverse Transcription-Polymerase Chain Reaction and Cataract Surgery Outcomes of Ebola Survivors in Sierra Leone.
Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) Study: Reverse Transcription-Polymerase Chain Reaction and Cataract Surgery Outcomes of Ebola Survivors in Sierra Leone.
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DOI：
10.1016/j.ebiom.2018.03.020
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发表时间：
2018-04
期刊：
影响因子：
11.1
通讯作者：
Yeh S
中科院分区：
文献类型：
--
作者：
Shantha JG;Mattia JG;Goba A;Barnes KG;Ebrahim FK;Kraft CS;Hayek BR;Hartnett JN;Shaffer JG;Schieffelin JS;Sandi JD;Momoh M;Jalloh S;Grant DS;Dierberg K;Chang J;Mishra S;Chan AK;Fowler R;O'Dempsey T;Kaluma E;Hendricks T;Reiners R;Reiners M;Gess LA;ONeill K;Kamara S;Wurie A;Mansaray M;Acharya NR;Liu WJ;Bavari S;Palacios G;Teshome M;Crozier I;Farmer PE;Uyeki TM;Bausch DG;Garry RF;Vandy MJ;Yeh S
埃博拉病毒病（EVD）幸存者在康复期间面临葡萄膜炎的风险。白内障引起的葡萄膜炎后观察到视力丧失。由于埃博拉病毒（EBOV）可能在埃博拉病毒病幸存者的眼液中持续存在时间未知，因此对埃博拉病毒病幸存者进行视力恢复性白内障手术的安全性和可行性存在疑问。我们对即将接受白内障手术的埃博拉病毒病幸存者和患有活动性葡萄膜炎的患者进行了一项横断面研究，以评估眼液中 EBOV RNA 的持久性以及白内障手术后的视力结果。房水检测结果为 EBOV RNA 阴性的患者有资格进行手动小切口白内障手术 (MSCICS)。我们筛选了 2016 年 6 月至 2017 年 8 月期间的 137 名埃博拉病毒病幸存者进行登记。我们招募了 50 名埃博拉病毒病幸存者； 46 名患有视觉上明显的白内障，1 名患有晶状体半脱位，2 名患有活动性葡萄膜炎，1 名因葡萄膜炎导致眼睛疼痛失明。中位年龄为 24.0 岁（IQR 17-35），35 名患者 (70%) 为女性。 logMAR 视力 (VA) 中位数为 3.0（Snellen VA 手部动作；四分位距，IQR：1.2-3.0，Snellen VA 20/320 – 手部动作）。在第 1 阶段眼液取样中 EVD 诊断后平均 19 个月 (IQR 18-20) 和第 2 阶段眼液取样中 EVD 诊断后 34 个月 (IQR 32-36) 时，所有患者通过 RT-PCR 在房水/玻璃体液和结膜中检测出 EBOV RNA 呈阴性。 34 名患者接受了 MSICS，术后三个月随访时，术前中位 VA 从手部运动改善至 20/30（P < 0.001）。通过 RT-PCR 检测，在 50 名患有眼部疾病的埃博拉病毒病幸存者的眼液或结膜中未发现埃博拉病毒持续存在。对于眼液样本中 EBOV RNA 检测呈阴性的患者，可以安全地进行白内障手术，并获得视力恢复结果。这些发现影响了数千名面临眼部并发症风险的西非埃博拉病毒病幸存者，他们在埃博拉病毒病康复期间也可能需要进行眼部手术。埃博拉病毒病（EVD）幸存者因葡萄膜炎和随后的白内障发展而面临严重视力障碍的风险。 50 名埃博拉病毒病幸存者接受了眼液取样，并通过 RT-PCR 检测发现埃博拉病毒呈阴性。 34 名幸存者接受了白内障手术，并获得了出色的安全措施和视力恢复结果。埃博拉病毒病 (EVD) 幸存者患葡萄膜炎的风险很高，葡萄膜炎是一种影响眼睛的炎症性疾病，可能导致严重的视力障碍，通常是白内障。由于持久性埃博拉病毒 (EBOV) 已在免疫特权眼内被发现，因此了解眼内 EBOV 持久性的流行情况对于患者、医疗服务提供者和公共卫生政策具有重要意义。在这项研究中，50 名埃博拉病毒病幸存者通过对其眼内液进行 RT-PCR 检测，埃博拉病毒呈阴性。三十四人接受了白内障手术并恢复了视力。这些发现提高了我们为数千名面临眼病风险的埃博拉病毒病幸存者提供视力保健和生活质量的能力。
Ebola virus disease (EVD) survivors are at risk for uveitis during convalescence. Vision loss has been observed following uveitis due to cataracts. Since Ebola virus (EBOV) may persist in the ocular fluid of EVD survivors for an unknown duration, there are questions about the safety and feasibility of vision restorative cataract surgery in EVD survivors. We conducted a cross-sectional study of EVD survivors anticipating cataract surgery and patients with active uveitis to evaluate EBOV RNA persistence in ocular fluid, as well as vision outcomes post cataract surgery. Patients with aqueous humor that tested negative for EBOV RNA were eligible to proceed with manual small incision cataract surgery (MSICS). We screened 137 EVD survivors from June 2016 – August 2017 for enrolment. We enrolled 50 EVD survivors; 46 with visually significant cataract, 1 with a subluxated lens, 2 with active uveitis and 1 with a blind painful eye due to uveitis. The median age was 24.0 years (IQR 17–35) and 35 patients (70%) were female. The median logMAR visual acuity (VA) was 3.0 (Snellen VA Hand motions; Interquartile Range, IQR: 1.2-3.0, Snellen VA 20/320 – Hand motions). All patients tested negative for EBOV RNA by RT-PCR in aqueous humor/vitreous fluid and conjunctiva at a median of 19 months (IQR 18-20) from EVD diagnosis in Phase 1 of ocular fluid sampling and 34 months (IQR 32-36) from EVD diagnosis in Phase 2 of ocular fluid sampling. Thirty-four patients underwent MSICS, with a preoperative median VA improvement from hand motions to 20/30 at three-month postoperative follow-up (P < 0.001). EBOV persistence by RT-PCR was not identified in ocular fluid or conjunctivae of fifty EVD survivors with ocular disease. Cataract surgery can be performed safely with vision restorative outcomes in patients who test negative for EBOV RNA in ocular fluid specimens. These findings impact the thousands of West African EVD survivors at-risk for ocular complications who may also require eye surgery during EVD convalescence. Ebola virus disease (EVD) survivors are at-risk for severe vision impairment due to uveitis and subsequent cataract development. Fifty EVD survivors underwent ocular fluid sampling and tested negative for Ebola virus by RT-PCR. Thirty-four survivors underwent cataract surgery with excellent safety measures and vision restorative outcomes. Ebola virus disease (EVD) survivors are at high risk for uveitis, an inflammatory condition affecting the eye that may lead to severe vision impairment, often from cataract. Because persistent Ebola virus (EBOV) has been identified within the immune privileged eye, understanding the prevalence of intraocular EBOV persistence is significant for patients, providers, and public health policy. In this study, 50 EVD survivors tested negative for EBOV by RT-PCR of their intraocular fluid. Thirty-four underwent cataract surgery with vision restorative outcomes. These findings improve our ability to impact vision care and quality-of-life for thousands of EVD survivors at-risk for eye disease.
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DOI：
10.1056/nejmoa1511410
发表时间：
2017-10-12
期刊：
The New England journal of medicine
影响因子：
--
作者：
Deen GF;Broutet N;Xu W;Knust B;Sesay FR;McDonald SLR;Ervin E;Marrinan JE;Gaillard P;Habib N;Liu H;Liu W;Thorson AE;Yamba F;Massaquoi TA;James F;Ariyarajah A;Ross C;Bernstein K;Coursier A;Klena J;Carino M;Wurie AH;Zhang Y;Dumbuya MS;Abad N;Idriss B;Wi T;Bennett SD;Davies T;Ebrahim FK;Meites E;Naidoo D;Smith SJ;Ongpin P;Malik T;Banerjee A;Erickson BR;Liu Y;Liu Y;Xu K;Brault A;Durski KN;Winter J;Sealy T;Nichol ST;Lamunu M;Bangura J;Landoulsi S;Jambai A;Morgan O;Wu G;Liang M;Su Q;Lan Y;Hao Y;Formenty P;Ströher U;Sahr F
通讯作者：
Sahr F
影响因子：
3.3
作者：
Bower, Hilary;Grass, Julian E.;Caleo, Grazia M.
通讯作者：
Caleo, Grazia M.
DOI：
10.1126/science.1259657
发表时间：
2014-09-12
期刊：
Science (New York, N.Y.)
影响因子：
--
作者：
Gire SK;Goba A;Andersen KG;Sealfon RS;Park DJ;Kanneh L;Jalloh S;Momoh M;Fullah M;Dudas G;Wohl S;Moses LM;Yozwiak NL;Winnicki S;Matranga CB;Malboeuf CM;Qu J;Gladden AD;Schaffner SF;Yang X;Jiang PP;Nekoui M;Colubri A;Coomber MR;Fonnie M;Moigboi A;Gbakie M;Kamara FK;Tucker V;Konuwa E;Saffa S;Sellu J;Jalloh AA;Kovoma A;Koninga J;Mustapha I;Kargbo K;Foday M;Yillah M;Kanneh F;Robert W;Massally JL;Chapman SB;Bochicchio J;Murphy C;Nusbaum C;Young S;Birren BW;Grant DS;Scheiffelin JS;Lander ES;Happi C;Gevao SM;Gnirke A;Rambaut A;Garry RF;Khan SH;Sabeti PC
通讯作者：
Sabeti PC
影响因子：
28.3
作者：
Zeng, Xiankun;Blancett, Candace D.;Sun, Mei G.
通讯作者：
Sun, Mei G.
影响因子：
13.7
作者：
Shantha, Jessica G.;Crozier, Ian;Yeh, Steven
通讯作者：
Yeh, Steven