September 27, 2017
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Vision impairments common in infants with Zika virus syndrome

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Vision impairment is a pervasive finding in infants with microcephaly related to congenital Zika virus syndrome, according to research.

Perspective from Roberto Warman, MD

In one Brazilian study, Islane Verçosa, MD, and colleagues analyzed ocular features in 70 such infants and found ophthalmic changes in 25 (36%). Visual acuity tested in 11 infants was below normal in all 11. Intraocular changes included macular chorioretinal atrophy, mottled retinal pigment epithelium and optic nerve pallor; non-intraocular changes included strabismus or nystagmus.

In another Brazilian study, Liana O. Ventura, MD, PhD, and colleagues found visual impairment in all 32 infants they examined.

“When evaluating visual function and visual milestones, all evaluated children presented abnormality in at least one of the visual function and visual developmental milestone tests,” Ventura and colleagues wrote.

The researchers related the visual impairment to the extensive damage to the central nervous system, regardless of fundus involvement.

“Given that all children presented with neurological and neuroimaging abnormalities, that less than half presented with retinal and/or optic nerve findings and that all presented with visual impairment, we believe that cortical/cerebral visual impairment is the main cause of visual impairment in children with [congenital Zika syndrome,” Ventura and colleagues wrote.

In an editorial related to both studies, S. Grace Prakalapakorn, MD, MPH, and colleagues wrote, “Even before [Zika virus] was recognized as a cause of birth defects, its effects on the eyes were suspected” and “our knowledge of the structural effects of [Zika virus] infection on the eye and on vision with or without concomitant structural anomalies is still growing.”

Prakalapakorn and colleagues suggested that the findings of the two Brazilian studies add evidence that “cortical visual impairment might be the most common cause of blindness among children with [congenital Zika syndrome].” – by Rebecca L. Forand

 

Disclosure: No products or companies that would require financial disclosure are mentioned in this article.