Pediatric Ebola Eye Disease in the PREVAIL (Partnership for Research on Ebola Virus in Liberia) III Longitudinal Cohort Study

Authors

• Rhea Kulkarni, Kansas City University
• Nii Quartey-Papafio, Johns Hopkins University
• Jemma Larbelee, Redemption Hospital, Monrovia
• Fred Amegashie, Ministry of Health, Monrovia
• Robert Dolo, New Sight Eye Centre, Monrovia
• Catherine Gaisie, Karish Eye Care, Monrovia
• Catherine Gargu, Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL)
• Augustine Wallace, Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL)
• Anshuman Agrawal, Johns Hopkins University
• Mosoka P. Fallah, Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL)
• J. Soka Moses, Partnership for Research on Vaccines and Infectious Diseases in Liberia (PREVAIL)
• Katrina Harper, University of Minnesota
• Collin Van Ryn, University of Minnesota
• Caven Reilly, University of Minnesota
• J. Daniel Kelly, University of California, San Francisco
• Rachel J. Bishop, Johns Hopkins University
• Allen O. Eghrari, Johns Hopkins University
• S. Grace Prakalapakorn, Duke University Medical Center

Document Type

Article

Publication Title

Ophthalmology Science

Abstract

Purpose: Ebola virus disease (EVD) is associated with vision-threatening ophthalmic sequelae, yet outcomes in young survivors remain poorly characterized. We sought to distinguish ophthalmic pathology in pediatric EVD survivors relative to close contacts and adult EVD survivors.

Design: Cross-sectional baseline analysis of participants enrolled in the Partnership for Research on Ebola Virus in Liberia (PREVAIL) III longitudinal cohort study.

Participants: Eighty-eight pediatric EVD survivors (ages 6-17 years), 203 pediatric close contacts (ages 6-17 years), and 463 adult EVD survivors (ages ≥18 years).

Testing: Visual function testing, slit-lamp biomicroscopy, indirect ophthalmoscopy, and OCT.

Main outcome measures: Prevalence of ocular symptoms, functional vision measures, and evidence of inflammation on examination and imaging.

Results: Compared with close contacts, pediatric EVD survivors at their baseline visit experienced significantly higher rates of light sensitivity (43.2% vs. 31.2%, P < 0.05), best-corrected visual acuity less than 20/40 (6.8% vs. 0.5%, P = 0.013), impaired color discrimination with ≥3 incorrect Ishihara color plates (10.2% vs. 1.5%, P = 0.003), further accommodative near point (16.8 cm vs. 16 cm, P = 0.015), and lower intraocular pressure (13.0 vs. 14.3 mmHg, P = 0.001). Slit-lamp biomicroscopy revealed higher rates of anterior chamber cells (8% vs. 2.5%, P = 0.036), cataract (8% vs. 0.5%, P = 0.0078), vitreous cell (6.8% vs. 0.5%, P = 0.018), and peripheral retinal scars (9.1% vs. 3%, P = 0.03) in pediatric EVD survivors relative to pediatric close contacts. Relative to adult EVD survivors, pediatric EVD survivors experienced higher rates of anterior chamber cells (8% vs. 3.2%, P = 0.04), but were less likely to experience posterior uveitis (5.7% vs. 13.8%, P = 0.04), and less likely to demonstrate mild or greater vitreous opacities on OCT (20.9% vs. 34.1%, P = 0.017).

Conclusions: Pediatric EVD survivors exhibit a distinct profile of ocular sequelae compared with both close contacts and adult survivors, characterized by higher rates of anterior segment inflammation. These findings highlight the importance of considering the unique needs of children in the setting of emerging infectious diseases.

DOI

10.1016/j.xops.2026.101231

Publication Date

5-12-2026

Keywords

Anterior segment, EVD, Ebola virus disease, Pediatric, Uveitis

ISSN

2666-9145

Recommended Citation

Kulkarni R, Quartey-Papafio N, Larbelee J, Amegashie F, Dolo R, Gaisie C, Gargu C, Wallace A, Agrawal A, Fallah MP, Moses J, Harper K, Van Ryn C, Reilly C, Kelly J, Bishop RJ, Eghrari AO, Prakalapakorn S. Pediatric Ebola Eye Disease in the PREVAIL (Partnership for Research on Ebola Virus in Liberia) III Longitudinal Cohort Study. Ophthalmology Science. 2026; 6(7). doi: 10.1016/j.xops.2026.101231.