Ophthalmic manifestations and vision impairment in Lassa fever survivors

Abstract

The purpose of this study was to describe the ocular findings, structural ocular complications, and vision impairment in a cohort of Lassa fever survivors in Kenema, Sierra Leone. A retrospective, uncontrolled, cross-sectional study of 31 Lassa fever survivors (62 eyes) who underwent an ophthalmic evaluation in January 2018 at the Kenema Government Hospital in Kenema, Sierra Leone was performed. Data collection included demographic information, ocular/systemic symptoms, visual acuity (VA), and ophthalmic examination findings. Main outcome measures included anterior and posterior segment ophthalmic manifestations and level of VA impairment in Lassa fever survivors. Anterior segment findings included cataract (18%) and pterygium (2%), while posterior segment manifestations consisted of glaucoma (6%), preretinal hemorrhage (2%), and lattice degeneration (2%). Findings suggestive of prior sequelae of uveitis included chorioretinal scarring (5%), retinal fibrosis (3%), and vitreous opacity (2%). Visual acuity was normal/mildly impaired in 53 eyes (85%), moderately impaired in 6 eyes (10%), and 3 eyes (5%) were considered blind by the World Health Organization (WHO) criteria. Median VA was worse in Lassa fever survivors with ophthalmic disease findings (p<0.0001) for both anterior segment (p<0.0001) and posterior segment disease (p<0.013). Untreated cataract was a significant cause of visual acuity impairment (p<0.0001). Lassa fever survivors in this cohort were found to have cataract and posterior segment findings that potentially represent sequelae of uveitis associated with visual impairment. Future studies are warranted to improve our understanding of the spectrum of ocular disease in this emerging infectious disease of public health consequence.

Impact of diabetes mellitus on in-hospital mortality in adult patients with COVID-19: a systematic review and meta-analysis

“…Although most patients infected with COVID-19 are asymptomatic or develop only mild symptoms [ 33 ], some patients require hospitalization and even treatment in the Intensive Care Unit conditions. Diabetes has been found to be a fairly comorbidity in patients requiring ICU support ranging from 17 [ 34 ] to 32% [ 35 ], indicating the need for a diligent blood glucose monitoring [ 36 ].…”

Lassa fever — the road ahead

“…Temporary or permanent unilateral or bilateral deafness has been reported to occur in ~30% of those who survive Lassa fever 73 , 78 – 80 . Other long-term sequelae in survivors include neurological and visual defects 81 – 83 . The risk of LASV recrudescence, as is well documented for Ebola virus 84 , 85 , has yet to be adequately investigated.…”

Implications of Innate Immunity in Post-Acute Sequelae of Non-Persistent Viral Infections

“…Besides EBOV and MARV, survivors of other hemorrhagic fevers also experience severe prolonged symptoms. For example, infection with Lassa virus (LASV) can cause inflammation in the eye, hearing loss and loss of coordination (ataxia) [52][53][54]. Infection of nonhuman primates revealed severe auto-immune mediated vasculitis in the inner ear.…”