Ophthalmic Manifestations and Causes of Vision Impairment in Ebola Virus Disease Survivors in Monrovia, Liberia
Ophthalmic Manifestations and Causes of Vision Impairment in Ebola Virus Disease Survivors in Monrovia, Liberia
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DOI：
10.1016/j.ophtha.2016.10.011
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发表时间：
2017-02-01
期刊：
影响因子：
13.7
通讯作者：
Yeh, Steven
中科院分区：
文献类型：
--
作者：
Shantha, Jessica G.;Crozier, Ian;Yeh, Steven
目的：描述利比里亚蒙罗维亚埃博拉病毒病（EVD）幸存者队列的眼部表现、视力损害以及葡萄膜炎结构性并发症与视力损害的相关性。设计：回顾性、非对照、横断面研究。参与者：在利比里亚蒙罗维亚永恒之爱赢得非洲（ELWA）医院眼科诊所接受评估的EVD幸存者。方法：对在ELWA医院接受基线眼科评价的EVD幸存者队列进行了回顾性分析，以了解人口统计学信息、埃博拉治疗单位（ETU）住院时间、视力（VA）和眼科检查结果。对于葡萄膜炎患者，根据葡萄膜炎命名标准化记录疾病活动性（活动性与非活动性）和炎症级别。根据世界卫生组织对VA损害的分类，将VA损害的水平分类如下：正常/轻度，VA 20/70或更好;中度，VA 20/70-20/200;重度，VA 20/200-20/400;失明，VA < 20/400。比较伴有和不伴有葡萄膜炎的EVD幸存者的视力、ETU停留时间和结构性并发症。结构性并发症与中度VA损害或较差进行了analysed.Main结果Measures：眼部并发症，包括葡萄膜炎和视神经病变的EVD幸存者，在EVD幸存者与葡萄膜炎的VA损害的水平的频率，和结构性并发症与VA损害EVD survivor.Results：共96 EVD幸存者进行了检查。共有21例患者发生EVD相关葡萄膜炎，3例患者发生EVD相关视神经病变。38.5%的葡萄膜炎患者视力盲（VA > 20/400）。葡萄膜炎的解剖亚型包括前葡萄膜炎2例，后葡萄膜炎13例，全葡萄膜炎6例。根据世界卫生组织标准，与至少中度视力损害相关的检查结果（VA < 20/70）包括角膜沉淀物后粘连（P < 0.002）（P < 0.002），玻璃体（P < 0.005），脉络膜视网膜瘢痕结论：EVD患者存在发生葡萄膜炎的危险，可能导致继发性结构并发症、视力损害和失明。应为西非的EVD幸存者动员眼科护理资源，因为这种疾病并发症的频率及其严重VA损伤和失明的可能性。(C)2016年美国眼科学会
Purpose: 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.Design: Retrospective, uncontrolled, cross-sectional study.Participants: Survivors of EVD who were evaluated in an ophthalmology clinic at Eternal Love Winning Africa (ELWA) Hospital in Monrovia, Liberia.Methods: 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, VA < 20/400. 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.Main Outcome Measures: 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.Results: 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 (VA > 20/400) 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 (VA < 20/70) included keratic precipitates (P < 0.002), posterior synechiae (P < 0.002), vitritis (P < 0.005), and chorioretinal scars (P < 0.02).Conclusions: 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. (C) 2016 by the American Academy of Ophthalmology