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Vision-threatening abnormalities possible in infants with presumed Zika virus-associated microcephaly
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Infants who are born with microcephaly due to congenital infection from presumed exposure to the Zika virus may have vision-threatening abnormalities, according to a study.
The case series included 29 infants with microcephaly and a presumed diagnosis of congenital Zika virus infection. Ophthalmologists who specialized in medical/surgical retina, uveitis and neuro-ophthalmology evaluated the infants and their mothers in December 2015 at the Roberto Santos General Hospital in Salvador, Brazil.
During pregnancy, 23 of 29 mothers had signs and symptoms of Zika virus, including cutaneous rash, fever, arthralgia, headache and itch.
Of the mothers who reported signs and symptoms of Zika virus, 18 reported signs and symptoms during the first trimester, four during the second trimester and one during the third trimester.
The mothers did not show signs or symptoms of uveitis, and all had normal ocular examination findings.
Seventeen eyes of 10 infants (34.5%) showed ocular abnormalities in examination. Seven infants with ocular lesions had bilateral findings. The most common findings were focal pigment mottling of the retina and chorioretinal atrophy in 11 eyes, optic nerve abnormalities in eight eyes, iris coloboma in two eyes of one patient and lens subluxation in one eye. No active uveitis was seen.
“Infants with microcephaly should undergo routine ophthalmologic evaluations to identify such lesions. In high-transmission settings, such as South America, Central America and the Caribbean, ophthalmologists should be aware of the risk of congenital [Zika virus-associated] ophthalmologic sequelae,” the study authors said. – by Nhu Te
Disclosure: The authors report no relevant financial disclosures.
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de Paula Freitas B, et al. JAMA Ophthalmol. 2016;doi:10.1001/jamaophthalmol.2016.0267.
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