Uveitis and Systemic Inflammatory Markers in Convalescent Phase of Ebola Virus Disease

Abstract

We report a case of probable Zaire Ebola virus-related ophthalmologic complications in a physician from the United States who contracted Ebola virus disease in Liberia. Uveitis, immune activation, and nonspecific increase in antibody titers developed during convalescence. This case highlights immune phenomena that could complicate management of Ebola virus disease-related uveitis during convalescence.

Keywords: Ebola; Ebola hemorrhagic fever; Ebola virus; Ebola virus disease; Liberia; conjunctivitis; convalescent phase; immune privilege; ocular manifestations; systemic inflammatory markers; uveitis; viruses.

Figure 1

Slit lamp examination of the left eye of a physician from the United States who contracted Ebola virus disease in Liberia and had eye inflammation develop during convalescence. Image shows diffuse conjunctival injection, mild corneal edema with fine inferior keratic precipitates, fibrin reaction, and leukocytes in the anterior chamber without hypopyon. Used with permission of the patient.

Figure 2

Color fundus and optical coherence tomography (OCT) images during active uveitis and after resolution for a physician from the United States who contracted Ebola virus disease in Liberia and had eye inflammation develop during convalescence. A) Color fundus image of the left eye showing a hazy view to the posterior pole during active uveitis (standardization of uveitis nomenclature classification grade 2–3). B) Color fundus image of the left eye showing a clear view to the posterior pole after resolution of uveitis. C) OCT of macula showing vitreous debris and small particles in a line of vitreous strands, consistent with inflammatory debris. D) OCT of macula showing resolution of vitreous and inflammatory debris. Scale bars indicate 200 μm.