Deborah Lehman, MD reviewing Ventura CV et al. JAMA Ophthalmol 2016 May 26.

Infant ocular abnormalities were associated with maternal symptoms in early pregnancy and reduced head circumference.

Zika virus (ZIKV) is a newly recognized cause of congenital infection, and reports of affected infants with microcephaly and associated brain and ocular abnormalities are increasing from endemic areas in South America.

In a cross-sectional study, researchers examined factors associated with ocular abnormalities among 40 infants with microcephaly and presumed ZIKV infection born in the Brazilian state of Pernambuco between May and December 2015. Other congenital infections and causes of microcephaly were ruled out. Results were as follows:

Of the 40 infants who underwent ocular examination, just over half (22) had ocular abnormalities; these were bilateral in 68.2%, and both macular and optic nerve alterations were noted.

Of 24 infants who underwent cerebrospinal fluid (CSF) evaluation, all had ZIKV immunoglobulin M detected in their CSF.

Of 30 infants who underwent CT scan, all but one had cerebral calcifications.

Of the 22 infants with ocular findings, no correlation was seen with gestational age or mode of delivery.

Infants with ocular findings were significantly more likely to be born to women who recalled ZIKV infection–consistent symptoms in the first trimester (71% vs. 23%) and to have a smaller head circumference (28.8 cm vs. 30.3 cm) compared with those without ocular findings.

CITATION(S):

Ventura CV et al. Risk factors associated with the ophthalmoscopic findings identified in infants with presumed Zika virus congenital infection. JAMA Ophthalmol 2016 May 26; [e-pub]. 

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