Camila V Ventura1, Liana O Ventura2, Vasco Bravo-Filho2, Thayze T Martins2, Audina M Berrocal3, Adriana L Gois2, João Rafael de Oliveira Dias4, Leandro Araújo2, Paulo Escarião2, Vanessa van der Linden5, Rubens Belfort6, Mauricio Maia6. 1. Department of Ophthalmology, Altino Ventura Foundation, Recife, Brazil2Department of Ophthalmology, Pernambuco Eye Hospital, Recife, Brazil3Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil4Bascom Palmer Eye Institute, Miami, Florida. 2. Department of Ophthalmology, Altino Ventura Foundation, Recife, Brazil2Department of Ophthalmology, Pernambuco Eye Hospital, Recife, Brazil. 3. Bascom Palmer Eye Institute, Miami, Florida. 4. Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil4Bascom Palmer Eye Institute, Miami, Florida. 5. Department of Pediatric Neurology, Barão de Lucena Hospital, Recife, Brazil. 6. Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Federal University of São Paulo, São Paulo, Brazil.
Abstract
IMPORTANCE: Zika virus (ZIKV) can cause severe changes in the retina and choroid that may result in marked visual impairment in infants with congenital Zika syndrome (CZS), the term created for a variety of anomalies associated with intrauterine ZIKV infection. OBJECTIVE: To evaluate the affected retinal layers in infants with CZS and associated retinal abnormalities using optical coherence tomography (OCT). DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional, consecutive case series included 8 infants (age range, 3.0-5.1 months) with CZS. Optical coherence tomographic images were obtained in the affected eyes of 7 infants with CZS who had undergone previous ophthalmologic examinations on March 17, 2016, and in 1 infant on January 1, 2016. An IgM antibody-capture enzyme-linked immunosorbent assay for ZIKV was performed on the cerebrospinal fluid samples of 7 of the 8 infants (88%), and other congenital infections were ruled out. MAIN OUTCOMES AND MEASURES: Observation of retinal and choroidal findings in the OCT images. RESULTS: Among the 8 infants included in the study (3 male; 5 female; mean [SD] age at examination, 4.1 [0.7] months), 7 who underwent cerebrospinal fluid analysis for ZIKV had positive findings for IgM antibodies. Eleven of the 16 eyes (69%) of the 8 infants had retinal alterations and OCT imaging was performed in 9 (82%) of them. Optical coherence tomography was also performed in 1 unaffected eye. The main OCT findings in the affected eyes included discontinuation of the ellipsoid zone and hyperreflectivity underlying the retinal pigment epithelium in 9 eyes (100%), retinal thinning in 8 eyes (89%), choroidal thinning in 7 eyes (78%), and colobomatouslike excavation involving the neurosensory retina, retinal pigment epithelium, and choroid in 4 eyes (44%). CONCLUSIONS AND RELEVANCE: Zika virus can cause severe damage to the retina, including the internal and external layers, and the choroid. The colobomatouslike finding seen in the OCT images relate to the excavated chorioretinal scar observed clinically.
IMPORTANCE: Zika virus (ZIKV) can cause severe changes in the retina and choroid that may result in marked visual impairment in infants with congenital Zika syndrome (CZS), the term created for a variety of anomalies associated with intrauterine ZIKV infection. OBJECTIVE: To evaluate the affected retinal layers in infants with CZS and associated retinal abnormalities using optical coherence tomography (OCT). DESIGN, SETTING, AND PARTICIPANTS: This cross-sectional, consecutive case series included 8 infants (age range, 3.0-5.1 months) with CZS. Optical coherence tomographic images were obtained in the affected eyes of 7 infants with CZS who had undergone previous ophthalmologic examinations on March 17, 2016, and in 1 infant on January 1, 2016. An IgM antibody-capture enzyme-linked immunosorbent assay for ZIKV was performed on the cerebrospinal fluid samples of 7 of the 8 infants (88%), and other congenital infections were ruled out. MAIN OUTCOMES AND MEASURES: Observation of retinal and choroidal findings in the OCT images. RESULTS: Among the 8 infants included in the study (3 male; 5 female; mean [SD] age at examination, 4.1 [0.7] months), 7 who underwent cerebrospinal fluid analysis for ZIKV had positive findings for IgM antibodies. Eleven of the 16 eyes (69%) of the 8 infants had retinal alterations and OCT imaging was performed in 9 (82%) of them. Optical coherence tomography was also performed in 1 unaffected eye. The main OCT findings in the affected eyes included discontinuation of the ellipsoid zone and hyperreflectivity underlying the retinal pigment epithelium in 9 eyes (100%), retinal thinning in 8 eyes (89%), choroidal thinning in 7 eyes (78%), and colobomatouslike excavation involving the neurosensory retina, retinal pigment epithelium, and choroid in 4 eyes (44%). CONCLUSIONS AND RELEVANCE: Zika virus can cause severe damage to the retina, including the internal and external layers, and the choroid. The colobomatouslike finding seen in the OCT images relate to the excavated chorioretinal scar observed clinically.
Authors: Tomas S Aleman; Camila V Ventura; Milena M Cavalcanti; Leona W Serrano; Anastasia Traband; Akosua A Nti; Adriana L Gois; Vasco Bravo-Filho; Thayze T Martins; Charles W Nichols; Mauricio Maia; Rubens Belfort Journal: JAMA Ophthalmol Date: 2017-10-01 Impact factor: 7.389
Authors: Maria P Fernandez; Edgar Parra Saad; Martha Ospina Martinez; Sheryl Corchuelo; Marcela Mercado Reyes; Maria Jose Herrera; Miguel Parra Saavedra; Angelica Rico; Angela M Fernandez; Richard K Lee; Camila V Ventura; Audina M Berrocal; Sander R Dubovy Journal: JAMA Ophthalmol Date: 2017-11-01 Impact factor: 7.389
Authors: Rahul Mittal; Desiree Nguyen; Luca H Debs; Amit P Patel; George Liu; Vasanti M Jhaveri; Sae-In S Kay; Jeenu Mittal; Emmalee S Bandstra; Ramzi T Younis; Prem Chapagain; Dushyantha T Jayaweera; Xue Zhong Liu Journal: Front Cell Infect Microbiol Date: 2017-12-08 Impact factor: 5.293
Authors: Miranda Li; Alyssa Brokaw; Anna M Furuta; Brahm Coler; Veronica Obregon-Perko; Ann Chahroudi; Hsuan-Yuan Wang; Sallie R Permar; Charlotte E Hotchkiss; Thaddeus G Golos; Lakshmi Rajagopal; Kristina M Adams Waldorf Journal: Front Genet Date: 2021-07-05 Impact factor: 4.599
Authors: Emma L Mohr; Lindsey N Block; Christina M Newman; Laurel M Stewart; Michelle Koenig; Matthew Semler; Meghan E Breitbach; Leandro B C Teixeira; Xiankun Zeng; Andrea M Weiler; Gabrielle L Barry; Troy H Thoong; Gregory J Wiepz; Dawn M Dudley; Heather A Simmons; Andres Mejia; Terry K Morgan; M Shahriar Salamat; Sarah Kohn; Kathleen M Antony; Matthew T Aliota; Mariel S Mohns; Jennifer M Hayes; Nancy Schultz-Darken; Michele L Schotzko; Eric Peterson; Saverio Capuano; Jorge E Osorio; Shelby L O'Connor; Thomas C Friedrich; David H O'Connor; Thaddeus G Golos Journal: PLoS One Date: 2018-01-30 Impact factor: 3.240
Authors: C Gustavo De Moraes; Michele Pettito; Juan B Yepez; Anavaj Sakuntabhai; Etienne Simon-Loriere; Mussaret B Zaidi; Matthieu Prot; Claude Ruffie; Susan S Kim; Rando Allikmets; Joseph D Terwilliger; Joseph H Lee; Gladys E Maestre Journal: JMM Case Rep Date: 2018-03-14