{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,29]],"date-time":"2026-04-29T18:09:32Z","timestamp":1777486172270,"version":"3.51.4"},"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"12","license":[{"start":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T00:00:00Z","timestamp":1607558400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["P30-EY06360"],"award-info":[{"award-number":["P30-EY06360"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"crossref","award":["RO1 EY029594"],"award-info":[{"award-number":["RO1 EY029594"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000009","name":"Foundation for the National Institutes of Health","doi-asserted-by":"publisher","award":["K23 EY030158"],"award-info":[{"award-number":["K23 EY030158"]}],"id":[{"id":"10.13039\/100000009","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001818","name":"Research to Prevent Blindness","doi-asserted-by":"publisher","award":["Unrestricted Grant"],"award-info":[{"award-number":["Unrestricted Grant"]}],"id":[{"id":"10.13039\/100001818","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Retina Research Foundation Mills"},{"name":"Margarat Cox Macula Society Grant"},{"DOI":"10.13039\/100013884","name":"Macula Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013884","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Santen, Inc"},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Disease","doi-asserted-by":"crossref","award":["1R01AI123535-01A1"],"award-info":[{"award-number":["1R01AI123535-01A1"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100000060","name":"National Institute of Allergy and Infectious Disease","doi-asserted-by":"crossref","award":["1R01AI123535-01A1"],"award-info":[{"award-number":["1R01AI123535-01A1"]}],"id":[{"id":"10.13039\/100000060","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100005426","name":"Association for Research in Vision and Ophthalmology","doi-asserted-by":"publisher","award":["Mallinckrodt Foundation Young Investigator Award"],"award-info":[{"award-number":["Mallinckrodt Foundation Young Investigator Award"]}],"id":[{"id":"10.13039\/100005426","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Bayer Global Ophthalmology Awards Program"},{"name":"Sitaraman Family Foundation"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:p>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&lt;0.0001) for both anterior segment (p&lt;0.0001) and posterior segment disease (p&lt;0.013). Untreated cataract was a significant cause of visual acuity impairment (p&lt;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.<\/jats:p>","DOI":"10.1371\/journal.pone.0243766","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T19:25:52Z","timestamp":1607628352000},"page":"e0243766","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":21,"title":["Ophthalmic manifestations and vision impairment in Lassa fever survivors"],"prefix":"10.1371","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5235-6741","authenticated-orcid":true,"given":"Alexa L.","family":"Li","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Donald","family":"Grant","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Gbakie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lansana","family":"Kanneh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ibrahim","family":"Mustafa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nell","family":"Bond","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Engel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Schieffelin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Vandy","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Steven","family":"Yeh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica G.","family":"Shantha","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2020,12,10]]},"reference":[{"issue":"3","key":"pone.0243766.ref001","doi-asserted-by":"crossref","first-page":"437","DOI":"10.1093\/infdis\/155.3.437","article-title":"A prospective study of the epidemiology and ecology of Lassa fever","volume":"155","author":"JB McCormick","year":"1987","journal-title":"J Infect Dis"},{"key":"pone.0243766.ref002","article-title":"Epidemiologic and clinical features of lassa fever outbreak in Nigeria, january 1-may 6, 2018","author":"EA Ilori","year":"2019","journal-title":"Emerg Infect Dis"},{"key":"pone.0243766.ref003","unstructured":"Centers for Disease Control and Prevention. Lassa Fever in Nigeria [Internet]. 2020 [cited 2020 Jun 26]. https:\/\/wwwnc.cdc.gov\/travel\/notices\/watch\/lassa-fever-nigeria"},{"issue":"4","key":"pone.0243766.ref004","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1016\/j.idc.2019.08.002","article-title":"Lassa Fever: Epidemiology, Clinical Features, Diagnosis, Management and Prevention","volume":"33","author":"DA Asogun","year":"2019","journal-title":"Infectious Disease Clinics of North America"},{"issue":"10","key":"pone.0243766.ref005","doi-asserted-by":"crossref","first-page":"2031","DOI":"10.3390\/v4102031","article-title":"Pathogenesis of lassa fever","volume":"4","author":"NE Yun","year":"2012","journal-title":"Viruses"},{"issue":"3","key":"pone.0243766.ref006","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1038\/nri.2016.138","article-title":"Immunobiology of Ebola and Lassa virus infections","volume":"17","author":"JB Prescott","year":"2017","journal-title":"Nat Rev Immunol"},{"issue":"12","key":"pone.0243766.ref007","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1093\/ofid\/ofz512","article-title":"Sequelae of Lassa Fever: Postviral Cerebellar Ataxia","volume":"6","author":"C Ezeomah","year":"2019","journal-title":"Open Forum Infect Dis"},{"key":"pone.0243766.ref008","unstructured":"World Health Organization. Prioritizing diseases for research and development in emergency contexts [Internet]. [cited 2020 Jul 3]. https:\/\/www.who.int\/activities\/prioritizing-diseases-for-research-and-development-in-emergency-contexts"},{"issue":"5","key":"pone.0243766.ref009","doi-asserted-by":"crossref","first-page":"865","DOI":"10.3201\/eid2505.181254","article-title":"Lassa Virus Targeting of Anterior Uvea and Endothelium of Cornea and Conjunctiva in Eye of Guinea Pig Model","volume":"25","author":"JM Gary","year":"2019","journal-title":"Emerg Infect Dis"},{"issue":"1","key":"pone.0243766.ref010","doi-asserted-by":"crossref","first-page":"5939","DOI":"10.1038\/s41598-018-24246-w","article-title":"Field validation of recombinant antigen immunoassays for diagnosis of Lassa fever","volume":"8","author":"ML Boisen","year":"2018","journal-title":"Sci Rep"},{"key":"pone.0243766.ref011","unstructured":"Centers for Disease Control and Prevention. Infection Control: Standard Precautions for All Patient Care, Transmission-Based Precautions [Internet]. [cited 2020 Jun 26]. https:\/\/www.cdc.gov\/infectioncontrol\/basics\/transmission-based-precautions.html"},{"key":"pone.0243766.ref012","doi-asserted-by":"crossref","first-page":"287","DOI":"10.1016\/j.jcrs.2004.01.014","article-title":"Visual acuity measurements","volume":"30","author":"J Holladay","year":"2004","journal-title":"J Cataract Refract Surg"},{"key":"pone.0243766.ref013","unstructured":"World Health Organization [Internet]. https:\/\/www.who.int\/blindness\/ChangetheDefinitionofBlindness.pdf"},{"issue":"3","key":"pone.0243766.ref014","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1016\/0035-9203(72)90269-6","article-title":"Lassa Fever. A Study of 23 Hospital Cases","volume":"66","author":"HA White","year":"1972","journal-title":"Trans R Soc Trop Med Hyg"},{"issue":"3","key":"pone.0243766.ref015","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1093\/infdis\/155.3.445","article-title":"A Case-Control Study of the Clinical Diagnosis and Course of Lassa Fever","volume":"155","author":"JB McCormick","year":"1987","journal-title":"J Infect Dis"},{"issue":"9","key":"pone.0243766.ref016","doi-asserted-by":"crossref","first-page":"1744","DOI":"10.1016\/j.ophtha.2012.04.017","article-title":"Blindness and visual impairment in an urban west african population: The tema eye survey","volume":"119","author":"DL Budenz","year":"2012","journal-title":"Ophthalmology"},{"issue":"2","key":"pone.0243766.ref017","doi-asserted-by":"crossref","first-page":"166","DOI":"10.4103\/0300-1652.129664","article-title":"Allergic conjunctivitis in Jos-Nigeria","volume":"55","author":"K Malu","year":"2014","journal-title":"Niger Med J"},{"issue":"9","key":"pone.0243766.ref018","doi-asserted-by":"crossref","first-page":"690","DOI":"10.1136\/bjo.78.9.690","article-title":"Blindness from uveitis in a hospital population in Sierra Leone","volume":"78","author":"MJH Ronday","year":"1994","journal-title":"Br J Ophthalmol"},{"issue":"2","key":"pone.0243766.ref019","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1371\/journal.pntd.0006187","article-title":"Lassa fever\u2013induced sensorineural hearing loss: A neglected public health and social burden","volume":"12","author":"EJ Mateer","year":"2018","journal-title":"PLoS Negl Trop Dis"},{"issue":"6","key":"pone.0243766.ref020","doi-asserted-by":"crossref","first-page":"2920","DOI":"10.1128\/JVI.02948-15","article-title":"Animal Model of Sensorineural Hearing Loss Associated with Lassa Virus Infection","volume":"90","author":"NE Yun","year":"2016","journal-title":"J Virol"},{"issue":"3","key":"pone.0243766.ref021","doi-asserted-by":"crossref","first-page":"360","DOI":"10.1093\/infdis\/146.3.360","article-title":"Experimental infection of rhesus monkeys with lassa virus and a closely related arenavirus, mozambique virus","volume":"146","author":"DH Walker","year":"1982","journal-title":"J Infect Dis"},{"issue":"2","key":"pone.0243766.ref022","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1016\/S0002-9394(00)00570-5","article-title":"Lymphocytic choriomeningitis virus: An underdiagnosed cause of congenital chorioretinitis","volume":"130","author":"MB Mets","year":"2000","journal-title":"Am J Ophthalmol"},{"key":"pone.0243766.ref023","first-page":"100","article-title":"Congenital lymphocytic choriomeningitis virus syndrome: a disease that mimics congenital toxoplasmosis or Cytomegalovirus infection","author":"R Wright","year":"1997","journal-title":"Pediatrics"},{"issue":"2","key":"pone.0243766.ref024","doi-asserted-by":"crossref","first-page":"245","DOI":"10.1016\/S0002-9394(00)00563-8","article-title":"Lymphocytic choriomeningitis virus chorioretinitis mimicking ocular toxoplasmosis in two otherwise normal children","volume":"130","author":"AP Br\u00e9zin","year":"2000","journal-title":"Am J Ophthalmol"},{"issue":"1","key":"pone.0243766.ref025","doi-asserted-by":"crossref","first-page":"159","DOI":"10.1128\/JVI.01211-08","article-title":"Immunopathological Basis of Lymphocytic Choriomeningitis Virus-Induced Chorioretinitis and Keratitis","volume":"83","author":"MS Zinkernagel","year":"2009","journal-title":"J Virol"},{"issue":"4","key":"pone.0243766.ref026","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1136\/bjo.61.4.265","article-title":"Uveal involvement in Marburg virus disease","volume":"61","author":"BS Kuming","year":"1977","journal-title":"Br J Ophthalmol"},{"issue":"2","key":"pone.0243766.ref027","doi-asserted-by":"crossref","first-page":"170","DOI":"10.1016\/j.ophtha.2016.10.011","article-title":"Ophthalmic Manifestations and Causes of Vision Impairment in Ebola Virus Disease Survivors in Monrovia, Liberia","volume":"124","author":"JG Shantha","year":"2017","journal-title":"Ophthalmology"},{"issue":"25","key":"pone.0243766.ref028","doi-asserted-by":"crossref","first-page":"2423","DOI":"10.1056\/NEJMoa1500306","article-title":"Persistence of Ebola Virus in Ocular Fluid during Convalescence","volume":"372","author":"JB Varkey","year":"2015","journal-title":"N Engl J Med"},{"issue":"12","key":"pone.0243766.ref029","doi-asserted-by":"crossref","first-page":"2626","DOI":"10.1016\/j.ophtha.2016.07.013","article-title":"Long-term Management of Panuveitis and Iris Heterochromia in an Ebola Survivor","volume":"123","author":"JG Shantha","year":"2016","journal-title":"Ophthalmology"},{"key":"pone.0243766.ref030","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1016\/j.ebiom.2018.03.020","article-title":"Ebola Virus Persistence in Ocular Tissues and Fluids (EVICT) Study: Reverse Transcription-Polymerase Chain Reaction and Cataract Surgery Outcomes of Ebola Survivors in Sierra Leone","volume":"30","author":"JG Shantha","year":"2018","journal-title":"EBioMedicine"},{"key":"pone.0243766.ref031","first-page":"1","article-title":"Clinical Manifestations and Pathogenesis of Uveitis in Ebola Virus Disease Survivors","volume":"3948","author":"S Yeh","year":"2018","journal-title":"Ocul Immunol Inflamm"}],"container-title":["PLOS ONE"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0243766","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T19:26:24Z","timestamp":1607628384000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0243766"}},"subtitle":[],"editor":[{"given":"Juan Carlos","family":"de la Torre","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2020,12,10]]},"references-count":31,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,12,10]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0243766","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,12,10]]}}}