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J AAPOS. 2017 Aug;21(4):295-299.e2. doi: 10.1016/j.jaapos.2017.04.003. Epub 2017 Apr 24.

Visual impairment in children with congenital Zika syndrome.

Author information

1
Altino Ventura Foundation (FAV), Recife, PE, Brazil; Department of Ophthalmology, HOPE Eye Hospital, Recife, PE, Brazil.
2
Altino Ventura Foundation (FAV), Recife, PE, Brazil; Department of Ophthalmology, HOPE Eye Hospital, Recife, PE, Brazil; Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
3
Private Ophthalmology practice, Salina, Kansas. Electronic address: lmlawrencemd@gmail.com.
4
Department of Pediatric Neurology, Disabled Children's Assistance Association (AACD), Recife, PE, Brazil.
5
Department of Pediatric Neurology, Materno Infantil Institute of Pernambuco (IMIP Hospital), Recife, PE, Brazil.
6
Altino Ventura Foundation (FAV), Recife, PE, Brazil; Department of Pediatric Neurology, Disabled Children's Assistance Association (AACD), Recife, PE, Brazil.
7
Altino Ventura Foundation (FAV), Recife, PE, Brazil.
8
Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
9
Department of Ophthalmology and Visual Sciences, University of Illinois, Chicago, Illinois.

Abstract

PURPOSE:

To describe the visual impairment associated with ocular and neurological abnormalities in a cohort of children with congenital Zika syndrome (CZS).

METHODS:

This cross-sectional study included infants with microcephaly born in Pernambuco, Brazil, from May to December 2015. Immunoglobulin M antibody capture enzyme-linked immunosorbent assay for the Zika virus on the cerebrospinal fluid samples was positive for all infants. Clinical evaluation consisted of comprehensive ophthalmologic examination including visual acuity, visual function assessment, visual developmental milestone, neurologic examination, and neuroimaging.

RESULTS:

A total of 32 infants (18 males [56%]) were included. Mean age at examination was 5.7 ± 0.9 months (range, 4-7 months). Visual function and visual developmental milestone could not be tested in 1 child (3%). Visual impairment was detected in 32 infants (100%). Retinal and/or optic nerve findings were observed in 14 patients (44%). There was no statistical difference between the patients with ocular findings and those without (P = 0.180). All patients (100%) demonstrated neurological and neuroimaging abnormalities; 3 (9%) presented with late-onset of microcephaly.

CONCLUSIONS:

Children with CZS demonstrated visual impairment regardless of retina and/or optic nerve abnormalities. This finding suggests that cortical/cerebral visual impairment may be the most common cause of blindness identified in children with CZS.

PMID:
28450178
DOI:
10.1016/j.jaapos.2017.04.003
[Indexed for MEDLINE]

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