Cristiane Bezerra da Cruz Costa1,2,3, Denise Freitas4. 1. Instituto dos Cegos da Paraíba Adalgisa Cunha, João Pessoa, PB, Brazil. cristianebcruz@hotmail.com. 2. Hospital Universitário Lauro Wanderley, João Pessoa, PB, Brazil. cristianebcruz@hotmail.com. 3. Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil. cristianebcruz@hotmail.com. 4. Department of Ophthalmology and Visual Sciences, Paulista School of Medicine, Hospital São Paulo, Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil.
Abstract
PURPOSE: To describe ocular findings in infants with signs of congenital Zika virus syndrome (CZS) in Paraíba, Brazil, as well as to conduct a literature review and report correlations with published clinical cases. METHODS: In the Paraíba sample, infants with microcephaly suggestive of CZS were classified as Z (confirmed), PZ (probable), or SZ (suspected) according to serological testing and/or clinical findings of CZS. The patients underwent a clinical eye examination, and the results were correlated with published clinical cases. RESULTS: Ocular findings were present in 24 (42.9%) of 56 patients, consisting of gross retinal pigmentation in 11 (45.8%), macular chorioretinal atrophy in 11 (45.8%), optic nerve hypoplasia in 1 (4.2%), optic nerve pallor in 14 (58.3%), and increased cup-to-disk ratio in 2 (8.3%). The study revealed retina and optic nerve findings consistent with previous reports of ophthalmic involvement in CZS. However, external ocular changes observed in other studies were not detected. CONCLUSION: Ocular findings similar and consistent with the literature on CZS were observed with considerable frequency and severity, regardless of the patients' serological confirmation or classification. Infants with signs of CZS should undergo ocular examination.
PURPOSE: To describe ocular findings in infants with signs of congenital Zika virus syndrome (CZS) in Paraíba, Brazil, as well as to conduct a literature review and report correlations with published clinical cases. METHODS: In the Paraíba sample, infants with microcephaly suggestive of CZS were classified as Z (confirmed), PZ (probable), or SZ (suspected) according to serological testing and/or clinical findings of CZS. The patients underwent a clinical eye examination, and the results were correlated with published clinical cases. RESULTS: Ocular findings were present in 24 (42.9%) of 56 patients, consisting of gross retinal pigmentation in 11 (45.8%), macular chorioretinal atrophy in 11 (45.8%), optic nerve hypoplasia in 1 (4.2%), optic nerve pallor in 14 (58.3%), and increased cup-to-disk ratio in 2 (8.3%). The study revealed retina and optic nerve findings consistent with previous reports of ophthalmic involvement in CZS. However, external ocular changes observed in other studies were not detected. CONCLUSION: Ocular findings similar and consistent with the literature on CZS were observed with considerable frequency and severity, regardless of the patients' serological confirmation or classification. Infants with signs of CZS should undergo ocular examination.
Authors: Andrea A Zin; Irena Tsui; Julia Rossetto; Zilton Vasconcelos; Kristina Adachi; Stephanie Valderramos; Umme-Aiman Halai; Marcos Vinicius da Silva Pone; Sheila Moura Pone; Joel Carlos Barros Silveira Filho; Mitsue S Aibe; Ana Carolina C da Costa; Olivia A Zin; Rubens Belfort; Patricia Brasil; Karin Nielsen-Saines; Maria Elisabeth Lopes Moreira Journal: JAMA Pediatr Date: 2017-09-01 Impact factor: 16.193
Authors: Cynthia A Moore; J Erin Staples; William B Dobyns; André Pessoa; Camila V Ventura; Eduardo Borges da Fonseca; Erlane Marques Ribeiro; Liana O Ventura; Norberto Nogueira Neto; J Fernando Arena; Sonja A Rasmussen Journal: JAMA Pediatr Date: 2017-03-01 Impact factor: 16.193
Authors: Christopher J Gregory; Titilope Oduyebo; Aaron C Brault; John T Brooks; Koo-Whang Chung; Susan Hills; Matthew J Kuehnert; Paul Mead; Dana Meaney-Delman; Ingrid Rabe; Erin Staples; Lyle R Petersen Journal: J Infect Dis Date: 2017-12-16 Impact factor: 5.226