Zika Virus Infection & the Eye

Zika Virus Infection & the Eye

Ocular findings in infants with microcephaly associated with presumed Zika Virus congenital infectionSalvador, BrazilBruno de Paula Freitas, MD; João Rafael de Oliveira Dias, MD; Juliana Prazeres, MD; Gielson Almeida Sacramento, BS; Albert Icksang Ko, MD; Maurício Maia, MD, PhD; Rubens Belfort Jr, MD, PhD

Department of Ophthalmology, Hospital Geral Roberto Santos, Salvador, Brazil Vision Institute, Department of Ophthalmology, Paulista Medical School, Federal University of São Paulo, São Paulo, Brazil Gonçalo Moniz Research Center, Oswaldo Cruz Foundation, Salvador, Brazil Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut

JAMA Ophthalmol. Published online February 09, 2016

Design

Case Series at Tertiary Hospital

29 infants with microcephaly and presumed congenital Zika

2015: 1st Dec - 25 th Dec

Interventions

Wide field digital imaging

DDx of infections ruled out through serological and clinical examinations

Design and Interventions

23/29 mothers suspected Zika during pregnancy. Trimester: 18 = 1st; 4 = 2nd; 1 = 3rd.

58 eyes of 29 children

17 eyes of 10 children = Ocular Abnormalities

7/10 = Bilateral

Results

Examples

2 month old infant

RE: granular, pigmentary mottling in the macular.

LE: Chorioretinal lobulated atrophic lesion and slight pigmentary mottling

1 month old infant

RE & LE: paramacular supertemporal round chorioretinal atrophy surrounded by a hyper pigmented halo and hyper pigmented mottling

I month old infant

RE: enlarged cup-disc ratio and macular pigmentary mottling

LE: roundish macular chorioretinal atrophic lesion with a hyper pigmented halo and pigmentary mottling, as well as an enlarged cup-disc ration

1 month old infant

RE & LE: supertemporal perimacular chorioretinal scar with perilesional pigmentary mottling

20 day old infant

RE: optic disc hypoplasia, peripapillary nasal atrophy and excavated nasal round lesion with a hyper hyper pigmented halo, with a colobomatous-like aspect

LE: optic disc hypoplasia, peripapillary nasal atrophy, and a retinal nasal lesion with a similar pattern

Findings in infants with microcephaly & presumed Zika Virus congenital infection

DiscussionMajor health problem

Retinal lesions

Posterior pole

Optic disc

Screen infected mothers without microcephalic infants?

Limitations

1 hospital

General findings

Lack of prior research

‘Presumed Zika’

ConclusionsRetinal lesions similar to West Nile virus

Need serological tests to confirm findings

Micro = routine exam

Ophthalmologists should be aware…

Article Link:http://archopht.jamanetwork.com/article.aspx?articleid=2491896