Eyes of Ebola survivors show localized pathological changes

(HealthDay)—Survivors of Ebola virus disease (EVD) have localized pathological changes in photoreceptors, according to a study published online May 3 in JAMA Ophthalmology.

Paul J. Steptoe, M.B.Ch.B., from the University of Liverpool in the United Kingdom, and colleagues conducted a prospective case series study to describe the appearance of EVD retinal lesions. Ophthalmological images were analyzed from 14 EVD survivors with Ebola retinal lesions. Ultra-widefield imaging revealed a total of 141 Ebola retinal lesions in 22 of 27 eyes (81 percent) of the 14 survivors.

The researchers found that 29.1 percent of these lesions were accessible to optical coherence tomography (OCT). Retinal lesions were mainly non-pigmented and had a pale gray appearance. In keeping with the retinal nerve fiber layer projections, variable curvatures were seen in peripapillary lesions. All lesions respected the horizontal raphe, and the fovea was spared. A V-shaped hyperreflectivity of the outer nuclear layer was seen with OCT imaging, overlying discontinuities of the ellipsoid zone and interdigitation zone in smaller lesions. Larger lesions caused the retinal layers to collapse, and loss of retinal thickness was seen. There were variable lesion shapes, with characteristic sharp angulations. Overall, 125 of the 141 lesions (88.7 percent) were accompanied, to varying extents, by perilesional areas of dark without pressure.

“We demonstrate OCT evidence of localized pathological changes at the level of the photoreceptors in small lesions among survivors of EVD with retinal lesions,” the authors write.

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