Ebola and the Eye Allen Eghrari, MD Wilmer Eye Institute at Johns - PowerPoint PPT Presentation

Ebola and the Eye Allen Eghrari, MD Wilmer Eye Institute at Johns Hopkins Ophthalmic Anesthesia Society Annual Meeting

CDC/Cynthia Goldsmith

A high case fatality rate • <21 years old: 57% • >45 years old: 94%

28,555 affected 11,311 deaths

Credit: Liam Sharp

Early reports of survivor complaints An urgent need for knowledge and intervention Survivors Conference in Kenema, late 2014 http://www.who.int/features/2014/post-ebola-syndrome/en/

Eye sub-study objectives • Explore causes of decreased vision and other ocular problems reported by EVD survivors • Relate the timing of ocular complaints to disease course and other systemic problems • Classify the ocular pathology present in EVD survivors, and define the nature of associated ocular inflammation • Facilitate treatment for EVD-associated vision loss • Follow patients longitudinally for up to 5 years

Our clinic

Training • Practice with equipment Didactics on eye topics • • Monitoring and real-time feedback

Training

Training

Posterior synechiae

Lens Inflammatory anterior subcapsular plaque Posterior subcapsular cataract

Vitreous Cell Vitreous cells Clear vitreous with early PVD OD OS 2+ AC cell, 1+ vit cell, 1+ haze ERM, minimal CME, no vitreous cell

Focal retinal lesions Focal lesion Disruption of outer retina

Intraretinal fluid

Research in Liberia

History of Ophthalmology Clinical Research in Liberia • Infectious Diseases • Onchocerciasis • Cataract surgery in leprosy Am J Trop Med Hyg. 1963 Sep;12:761-6 • Case reports of Liberians abroad • West African Crystalline Maculopathy • Tuberculosis conjunctivitis

Prevail 7 Clinical Trial • Is it safe to do surgery in eyes of Ebola survivors? • Can the virus persist in the central nervous system?

Surgery, Anesthesia, and Ebola • Risks to anesthesiologist • Risks to patient • Risks to surgeon • Risks to staff