Denise Cunningham, MS, MEd, FOPS

Chief, Imaging Services Section
National Eye Institute, National Institutes of Health
US Department of Health and Human Resources
Bethesda, MD USA

Purpose: To describe a variety useful imaging modalities for identifying Ebola-specific retinal abnormalities and demonstrate the advantage of employing spectral domain optical coherence tomography longitudinally for follow-up.

Methods: A confocal scanning laser with multimodal imaging capability was used to document posterior segment ocular pathology discovered in survivors of Ebola virus disease (EVD). Disease-specific lesions, with the characteristic angulated appearance and dark surround, were identified in multi-color, infrared, blue reflectance, and fundus autofluorescence images. Cross-sectional three-dimensional views of these lesions were obtained using the instrument’s spectral domain optical coherence tomography (SD-OCT) module.

Results: A comprehensive ophthalmic photographer performed baseline and three-year follow-up SD-OCT scans on 10 Ebola-specific lesions found in 8 eyes of 7 EVD survivors by. Scans acquired of the Ebola-specific lesions during the initial image capture sessions demonstrated disruption of the retinal architecture and shadowing, or loss, of the inner segment ellipsoid and cone interdigitation zones. At the three-year mark, SD-OCT scans of 9/10 lesions exhibited remodeling of the inner retinal layers and reconstitution of the hyperreflective bands of the outer retina.

Conclusion: Ophthalmic imaging professionals play a crucial role in the documentation and discovery of the ocular manifestations of disease.