The visual system in infants with microcephaly related to presumed congenital Zika syndrome

J AAPOS. 2017 Aug;21(4):300-304.e1. doi: 10.1016/j.jaapos.2017.05.024. Epub 2017 Jun 23.

Abstract

Purpose: To describe and analyze ocular features in infants with microcephaly due to presumed congenital Zika syndrome.

Methods: Ophthalmologic evaluation, including indirect ophthalmoscopy and eye fundus imaging, visual acuity testing with Teller Acuity Cards, and strabismus assessment were performed in infants with microcephaly at a nongovernmental organization clinic for visually disabled children.

Results: A total of 70 infants with microcephaly were referred to the clinic. Of these, 25 (mean age, 3 months; 14 males) had ophthalmologic changes: 18 (26%) had intraocular abnormalities, including macular chorioretinal atrophy, mottled retinal pigment epithelium and optic nerve pallor; 7 patients (10%) had strabismus or nystagmus without intraocular abnormalities. Visual acuity was below normal range in all 11 infants tested.

Conclusions: Ophthalmologic abnormalities occurred in 36% of the patients. Macular circumscribed chorioretinal atrophy, focal mottled retinal pigment epithelium, optic nerve pallor, early-onset strabismus, nystagmus and low visual acuity were common ophthalmological features in infants with microcephaly due to presumed congenital Zika syndrome.

MeSH terms

  • Eye Abnormalities / physiopathology
  • Eye Abnormalities / virology*
  • Female
  • Humans
  • Infant
  • Male
  • Microcephaly / physiopathology
  • Microcephaly / virology*
  • Nystagmus, Congenital / physiopathology
  • Nystagmus, Congenital / virology
  • Ophthalmoscopy
  • Strabismus / congenital
  • Strabismus / physiopathology
  • Strabismus / virology
  • Vision Disorders / physiopathology
  • Vision Disorders / virology*
  • Visual Acuity / physiology
  • Visually Impaired Persons
  • Zika Virus Infection / congenital*
  • Zika Virus Infection / physiopathology