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EW RETINA 102 October 2018 outer nuclear layer overlying discon- tinuities of the ellipsoid zone and interdigitation zone in the smaller lesions," Steptoe et al. wrote. Larger lesions appeared to col- lapse retinal layers and resulted in loss of retinal thickness, and while lesion shape varied, one characteris- tic was sharp angulations, frequently seen in lesions around the posterior pole. "Perilesional areas of dark with- out pressure (thinned ellipsoid zone hyporeflectivity) accompanied 125 of the 141 lesions (88.7%) to varying extents," Steptoe et al. wrote. Dr. Steptoe described all of these features as "fascinating." The cause for the sharp angulations, Dr. Steptoe said, was hypothesized to be secondary to the tight triangular packing of the retinal cone mosaic. Peripapillary lesions with a curvilin- ear appearance, which resembled the angulations of the retinal nerve fiber layer at the optic nerve, were also observed, Dr. Steptoe said. "The lesions appear to be con- fined to the retinal structure and are commonly surrounded by areas of dark without pressure of varying size," he continued. "In some cases, these areas are confined to the mar- gin of the lesion but were observed to involve 360 degrees of the retina in some cases." Why do some survivors of Ebola virus disease develop retinal lesions while others don't, even if they pres- ent with other ocular conditions, such as anterior or intermediate uve- itis? Dr. Steptoe said this question remains unresolved. "It may be due to differences in viral load among individuals or differences in host response to the virus," he said. According to the study authors, the importance of these findings has yet to be determined, and follow-up research is ongoing. "These findings suggest that survivors of [Ebola virus disease] in future outbreaks would benefit from ophthalmologic evaluation, includ- ing via OCT analysis of visual field assessment," Steptoe et al. wrote. EW References 1. Mattia JG, et al. Early clinical sequelae of Ebola virus disease in Sierra Leone: a cross-sectional study. Lancet Infect Dis. 2016;16:331–8. 2. Steptoe PJ, et al. Multimodal imaging and spatial analysis of Ebola retinal lesions in 14 survivors of Ebola virus disease. JAMA Ophthalmol. 2018;136:689–693. 3. Steptoe PJ, et al. Novel retinal lesion in Ebo- la survivors, Sierra Leone, 2016. Emerg Infect Dis. 2017;23:1102–1109. Editors' note: Dr. Steptoe has no finan- cial interests related to his comments. Contact information Steptoe: psteptoe@liverpool.ac.uk Emerging continued from page 100 News in brief R esearch published in the journal Optica describes the imaging technologies that went into creating a handheld device that has the ability to capture individual photoreceptors in the eye. This technology could be useful in diagnosing ocular diseases, as well as brain diseases and traumatic head injuries. "Until now, the imaging systems required for high-resolution photoreceptor imaging consisted of large, heavy components on an optical table that could only be used with cooperative adults sitting upright," research lead Sina Farsiu, PhD, Departments of Biomedical Engineering and Ophthalmology, Duke University, Durham, North Carolina, said in a press release. "Our por- table handheld system could expand this important imaging technique to children and infants, as well as to adults who may not be able to sit upright and stare straight ahead." Dr. Farsiu said that the application of this system extends beyond that of the eye. "Because of the limited resolution of MRI—the standard method for imaging the brain in living people—MRI-based assessment of disease or trauma to the brain cannot be done at the level of individual cells. In the retina, however, individ- ual photoreceptors can be imaged at 100 times higher resolution than using brain imaging, allowing very subtle changes to be seen." EW Reference DuBose T, et al. Handheld adaptive optics scanning laser ophthalmoscope. Optica. 2018;5:1027–1036. Handheld device images photoreceptors, holds promise for detection of eye and brain diseases, trauma Widefield fundus image demonstrating multifocal Ebola retinal lesions. The white triangles indicate the border of an extensive area of dark without pressure. Ebola retinal lesions demonstrating characteristic sharp angulations Source (all): CC-BY License. © 2018 Steptoe PJ et al. JAMA Ophthalmology

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