Correlation between cephalic circumference at birth and ocular alterations in patients with microcephaly potentially associated with Zika Virus infection

Abstract

SUMMARY INTRODUCTION: The Zika virus (ZIKV) is an arbovirus isolated for the first time in 1947 and transmitted to humans by the Aedes aegypti mosquito. In Brasil, it was first detected in May 2015. Since then, ZIKV has been identified as the etiological agent of acute exanthematous disease in Brasil, and Neuropediatricians of the Recife warned about an epidemic of microcephaly, and the Brazilian Ministry of Health confirmed the association between ZIKV and Congenital malformations and neurological syndromes. The eye, as an extension of the developing brain, has been examined in patients with microcephaly and maternal history of ZIKV infection. METHODS: Twenty newborn patients with microcephaly, whose mothers had presumed Zika virus during pregnancy, were analyzed through medical records. The nonparametric chi-square statistic was used to verify the association between head circumference and ocular alteration at a significance level of 0.0001. RESULTS: The significance of P = 0.000 in the value of non-parametric chi-square statistics was lower than the value of α = 0.0001, demonstrating that, at a level of 0.0001, there is an association between head circumference and ocular alteration. CONCLUSION: Although the knowledge of the natural evolution of the disease is still scarce, the current evidence is strong enough to establish a causal relationship between ZIKV infection during pregnancy and the increased incidence of the microcephaly and serious eye alterations that lead to the severe lower vision of these children.

Effects in the development of children exposed to zika virus in the fetal period: an integrative review

“…Only two studies (12.5%) (11,23) showed signs suggestive of sensorineural changes: in both, nearly 17% of children had hearing loss. Other evidence in this review was visual acuity abnormalities, reported in eight studies (43.7%) (11,(13)(14)(18)(19)23) . In a cohort of 173 children with microcephaly, 30% presented abnormalities in vision; of these, 50% had nystagmus (19) .…”

“…The primary studies grouped in this review showed evidence of exposure to ZIKV in the fetal period and the post exposure effects in newborns (NBs) and breastfeeding children. Neurological abnormalities and/or congenital malformations were present in all studies (5,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) . Microcephaly (62.8%) (5,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20) was predominant, however other studies have reported the occurrence of alterations in the central nervous system and multiple malformations (12,(21)(22)(23)(24)(25) .…”

“…Thus, in ten studies (62.5%) was observed the presence of microcephaly; in seven (43.7%), ocular alterations such as nystagmus or visual impairment; in four (25%), ventriculomegaly; in three (18.7%), subcortical calcifications, alterations in fine motor development, arthrogryposis; in two (12.5%), cortical development malformation, cerebral atrophy, cerebral palsy with microcephaly, changes in motor and cognitive development and hearing loss; and in one (6.25%), convulsions, restless movements at 12 months without microcephaly, changes in sleep pattern, severe hypertonia and heart malformation (5,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25) .…”

“…Trigueiro et al, (2019) (13) Describe the profile of children with microcephaly, whose mothers had zika infection during pregnancy.…”

“…Trigueiro et al, (2019) (13) Correlation between Cephalic Circumference at Birth and Ocular Alterations in Patients with Microcephaly Potentially Associated with Zika Virus Infection Cohort 63,6% Portnoi et al, (2019) (14) Alterations in Visual Acuity and Visual Development in Infants 1-24 Months Old either Exposed to or Infected by Zika Virus During Gestation, with and without Microcephaly Cohort 59% Einspieler et al, (2019) (15) Association of Infants Exposed to Prenatal Zika Virus Infection With Their Clinical, Neurologic, and Developmental Status Evaluated via the General Movement Assessment Tool…”