title: Ocular Complications in Survivors of the Ebola Outbreak in Guinea.
abstract: OBJECTIVE
  The Ebola outbreak of 2013-2016 severely affected West Africa and resulted in 2544 deaths and 1270 survivors in Guinea, the country where it began. This Ebola virus was the Zaire strain of the virus family Filoviridae. In this outbreak the case fatality rate was about 67%. The survivors, declared cured after 2 negative blood polymerase chain reaction (PCR) results, face psychosocial disorders and rheumatic, ear-nose-throat, neurocognitive, and ophthalmologic complications. The goal of this study was to detect and describe ocular complications afflicting these survivors and to observe their occurrence and recurrences.
  
  
  METHODS
  Prospective observational cohort study.
  
  
  METHODS
  This prospective observational multicenter cohort study was initiated in March 2015. The cohort study included 341 survivors followed up in the infectious disease ward of Conakry, Forecariah, and Nzérékoré as of May 2016. The patients received multidisciplinary medical follow-up expected to last at least 1 year that included an eye examination as part of complete, free treatment.
  
  
  RESULTS
  Systematic examination of 341 patients revealed 46 cases of uveitis (13.5%), 6 cases of episcleritis (1.8%), and 3 cases of interstitial keratitis (0.9%). Uveitis was most frequently unilateral (78.3%) and anterior (47.8%) and occurred within the 2 months after discharge from the Ebola treatment center. Moreover, uveitis relapses were found up to 13 months after the negative PCR result for Ebola in the blood.
  
  
  CONCLUSIONS
  Nearly 1 out of 6 survivors presented ocular disorders after discharge from the Ebola treatment center. An ophthalmologic follow-up for Ebola-infected patients should start, if possible, during the acute phase of the disease and last more than 1 year. Treatment guidelines need to be urgently developed and implemented.
authors.affiliation: IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France. Electronic address: oph.ehereth@gmail.com.
authors.forename: Esther
authors.initials: E
authors.lastname: Hereth-Hebert
authors.affiliation: CADESSO - Centre d'Application du Diplôme d'Etudes Supérieures Spécialisées en Ophtalmologie, Conakry, Guinea.
authors.forename: Mamadou Oury
authors.initials: MO
authors.lastname: Bah
authors.affiliation: IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France.
authors.forename: Jean François
authors.initials: JF
authors.lastname: Etard
authors.affiliation: Infectious Disease Department, Donka University National Hospital, Conakry, Guinea.
authors.forename: Mamadou Saliou
authors.initials: MS
authors.lastname: Sow
authors.affiliation: Brien Holden Vision Institute, University of New South Wales, Sydney, Australia; Organisation Pour la prévention de la Cécité (OPC), Paris, France.
authors.forename: Serge
authors.initials: S
authors.lastname: Resnikoff
authors.affiliation: Department of Ophthalmology, Pitié-Salpêtrière Hospital, APHP, Paris, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Fardeau
authors.affiliation: IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France; Public Health and Department of Pharmacy, Conakry University, Conakry, Guinea.
authors.forename: Abdoulaye
authors.initials: A
authors.lastname: Toure
authors.affiliation: CADESSO - Centre d'Application du Diplôme d'Etudes Supérieures Spécialisées en Ophtalmologie, Conakry, Guinea.
authors.forename: Alexis Niouma
authors.initials: AN
authors.lastname: Ouendeno
authors.affiliation: Department of Ophthalmology, Nzérékoré Regional Hospital, Nzérékoré, Guinea.
authors.forename: Isaac Ceougna
authors.initials: IC
authors.lastname: Sagno
authors.affiliation: IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France.
authors.forename: Laura
authors.initials: L
authors.lastname: March
authors.affiliation: IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Izard
authors.affiliation: CADESSO - Centre d'Application du Diplôme d'Etudes Supérieures Spécialisées en Ophtalmologie, Conakry, Guinea.
authors.forename: Pierre Louis
authors.initials: PL
authors.lastname: Lama
authors.affiliation: Infectious Disease Department, Donka University National Hospital, Conakry, Guinea.
authors.forename: Moumié
authors.initials: M
authors.lastname: Barry
authors.affiliation: IRD UMI 233 INSERM U 1175, University of Montpellier, Montpellier, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Delaporte
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004279:DNA, Viral / Q000032:analysis; D003941:Diagnostic Techniques, Ophthalmological; D004196:Disease Outbreaks; D029043:Ebolavirus / Q000235:genetics*; D015828:Eye Infections, Viral / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D005500:Follow-Up Studies; D016701:Guinea / Q000453:epidemiology; D019142:Hemorrhagic Fever, Ebola / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D007634:Keratitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D015423:Scleritis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D017741:Survivors; D014605:Uveitis / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D055815:Young Adult
chemical_list: D004279:DNA, Viral