Inner retinal vasculopathy in Zika virus disease

Abstract

PurposeZika virus infection is associated with vision-threatening ocular complications including uveitis and outer retinopathy. The aim of this report is to describe a case of an adult patient with serologically confirmed Zika infection who presented with retinal vascular abnormalities that coincided with systemic post-viral neurological manifestations of the disease.ObservationsA 34-year-old white female presented with symptoms of peripheral neuropathy following serologically confirmed Zika virus infection that was acquired in Puerto Rico four months prior to presentation. Ocular evaluation revealed perifoveal microaneurysms which were not associated with visual symptoms.Conclusions and importanceThese data potentially expand the phenotypic spectrum of Zika virus retinopathy. In addition to outer retinal abnormalities which are well-described in infants and adults, inner retinal vascular abnormalities may also occur and may be temporally associated with post-viral neurological sequelae of Zika virus infection. Clinicians should be aware of potential retinal involvement in affected patients who present with neurological symptoms after recovery from acute Zika virus infection.

Cellular Imprinting Proteomics Assay: A Novel Method for Detection of Neural and Ocular Disorders Applied to Congenital Zika Virus Syndrome

“…Clinical cases of adults infected by ZIKV presenting ocular abnormalities have been described. 99 These data indicate that the neurotropism of the virus is not a necessary factor to elicit ocular dysfunctions. The comparison between Zikv and Ctrl conditions revealed 166 differentially modulated proteins associated with pathways previously described for the Zikv CZS group ( Table S2 ).…”

Evolution of Two Major Zika Virus Lineages: Implications for Pathology, Immune Response, and Vaccine Development

“…Although the reported cases of African lineage infections were too few to identify similar symptomatology, ocular infections by the Asian lineage have been documented in humans and recapitulated in animal models. Inner retinal vasculopathy ( 79 ) or other ocular infections have been reported linked to international travel into South American and Caribbean island nations ( 79 , 80 ). Ocular abnormalities have been documented in infants with congenital Zika virus syndrome (CZS).…”

ZIKV Demonstrates Minimal Pathologic Effects and Mosquito Infectivity in Viremic Cynomolgus Macaques

“…Symptomatic ZIKV infections produce a nonspecific febrile illness (Zika fever [ZIKF]), characterized by fever, headache, conjunctivitis, myalgia, arthralgia and a maculopapular rash, which is difficult to distinguish from the cocirculating arboviruses DENV and CHIKV [ 23 , 27 ]. Despite the seemingly mild clinical presentation of ZIKV infection, the magnitude of the 2015–2016 outbreaks allowed for the discovery of ZIKV’s potential to cause serious sequelae: Congenital Zika Syndrome (CZS) in infants whose mothers were infected during pregnancy, as well as ophthalmic and auditory complications in infants [ 28 , 29 , 30 , 31 ], Guillain–Barré syndrome (GBS) in many age groups [ 32 , 33 , 34 ], and persistent shedding of viable virus and RNA in semen of infected men months after the primary infection [ 35 ]. Of these, the shedding of virus in semen and other bodily fluids have been shown to mediate sexual transmission [ 36 , 37 ], further complicating control of ZIKV’s spread.…”