Risk Factors for Ophthalmoscopic Findings in Infants With Congenital Zika Virus Infection
JAMA Ophthalmology, August 2016
In a cross-sectional study conducted in Pernambuco, Brazil, Ventura et al. sought to identify risk factors for ophthalmoscopic findings in infants born with microcephaly and Zika virus (ZIKV) intrauterine infection. They found that ocular involvement was associated with smaller cephalic perimeter and symptoms reported by the mothers as occurring during the first trimester of pregnancy.
This study included 40 infants with microcephaly presumed to be associated with ZIKV after other possible etiologies were ruled out. Cerebrospinal fluid was tested in 24 of these infants; among those tested, ZIKV was found in 100%. All 40 infants underwent ophthalmoscopic examination and were divided into 2 groups: 22 (37 eyes) who had fundus alterations on ophthalmoscopy and 18 who did not. Fundus abnormalities seen in the affected eyes included loss of foveal reflex, pigment mottling, and demarcated chorioretinal atrophy, as well as optic nerve hypoplasia, pallor, and increased cup-disc ratio.
Among all mothers, the major symptoms reported were rash (26 mothers; 65.0%), fever (9 mothers; 22.5%), headache (9 mothers; 22.5%), and arthralgia (8 mothers; 20.0%). No mothers reported any ocular symptoms during pregnancy or had signs of uveitis at the time of examination. Ten of 14 mothers (71.4%) whose infants had ocular findings and who had symptoms in pregnancy reported them in the first trimester. The mean cephalic perimeter differed between the groups of infants with and without ocular findings: 28.8 cm and 30.3 cm, respectively.
Based on these findings, the researchers concluded that fundus abnormalities in infants with presumed ZIKV congenital infection were associated with smaller cephalic perimeters at birth and with mothers who reported symptoms during the first trimester.
The original article can be found here.