Longitudinal visual acuity development in ZIKV-exposed children

Lima, Diego da Silva; Baran, L; Hamer, Russell D.; Costa, Marcelo Fernandes; Vidal, Kallene Summer Moreira; Damico, Francisco Max; Barboni, Mirella Telles Salgueiro; França, Valtenice de Cássia Rodrigues de Matos; Martins, Cristiane Maria Gomes; Tabares, Heydi Segundo; Dias, Sarah Leonardo; Silva, Leonardo Aparecido; Decleva, Diego; Zatz, Mayana; Bertozzi, Ana Paula Antunes Pascalicchio; Gazeta, Rosa Estela; Passos, Saulo Duarte; Ventura, Dora Fix

doi:10.1016/j.jaapos.2019.11.005

Cited by 8 publications

(12 citation statements)

References 20 publications

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“…Among children exposed to ZIKV infection antenatally, studies have reported a broad array and prevalence of ophthalmic findings (e.g., structural ocular anomalies, glaucoma, strabismus, nystagmus, visual impairment). Six studies reporting on visual impairment in children affected by congenital ZIKV infection have all been published from Brazil ( Table 5 ) [ 5 , 6 , 7 , 8 , 11 , 12 ]. One study evaluating 32 infants (mean age = 5.7 months) with neurologic or neuro-radiologic abnormalities with confirmed ZIKV infection (100% had microcephaly) found a structural ophthalmic abnormality (retinal and/or optic nerve abnormality) in 44% of children and visual impairment in 100% of eyes, due mainly to not achieving visual milestones (97%), followed by abnormal Hiding Heidi testing (65%) [ 6 ].…”

Section: Discussionmentioning

confidence: 99%

“…More recently, another group initially evaluated 47 infants (mean age = 6.5 months) who were exposed to or infected by ZIKV antenatally and found 9% had microcephaly, 2% a retinal abnormality, and 11% with decreased vision by teller acuity testing (50% of those with microcephaly, 100% of those with a retinal abnormality, 7% of infants without microcephaly and/or retinal abnormalities, and 0% of infants exposed to ZIKV without confirmation of infection) [ 11 ]. Then, among a subset of 75% (33/44) of these infants, including 12% with microcephaly and 3% with a retinal abnormality, they reported that over time, all children had normal visual development, except for 3% with decreased visual acuity (i.e., one child with both microcephaly and chorioretinal scarring) [ 12 ]. In our study, 6% had microcephaly at birth, 2.5% a structural ophthalmic abnormality, and 26% visual impairment, 95% due to abnormal Hiding Heidi testing.…”

Section: Discussionmentioning

confidence: 99%

“…Most of our knowledge on ocular findings and visual impairment have come from South America, in particular Brazil [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 ]. The most commonly reported ocular findings associated with congenital ZIKV infection include macular (i.e., chorioretinal scarring and focal pigmentary changes) and optic nerve abnormalities (i.e., hypoplasia, cupping, and atrophy) [ 5 , 6 , 7 , 8 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

“…The most commonly reported ocular findings associated with congenital ZIKV infection include macular (i.e., chorioretinal scarring and focal pigmentary changes) and optic nerve abnormalities (i.e., hypoplasia, cupping, and atrophy) [ 5 , 6 , 7 , 8 , 13 ]. In cases of presumed and confirmed ZIKV infection both with and without structural ocular abnormalities, studies have reported abnormal visual acuity and function in children [ 5 , 6 , 7 , 8 , 11 , 12 ]. Among children born with laboratory-confirmed ZIKV infection, severe visual impairment can occur despite normal ocular structure due to presumed cortical visual impairment [ 5 , 6 , 7 , 8 ].…”

Section: Introductionmentioning

confidence: 99%

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Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018

Prakalapakorn

Bonafede

Lawrence³

et al. 2021

TropicalMed

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Among children born with laboratory-confirmed Zika virus (ZIKV) infection, visual impairment (VI) can occur despite normal ocular structure. The objective of this report is to describe ocular findings and visual function among children examined during the Department of Health Zika Health Brigade (ZHB) in the United States Virgin Islands in March 2018. This analysis is based on a retrospective chart review of children eligible to participate in the ZHB (i.e., part of the US Zika Pregnancy and Infant Registry) and who were examined by ophthalmologists. Eighty-eight children attended the ZHB. This report includes 81 children [48 (59.3%) males] whose charts were located [average gestational age = 37.6 weeks (range: 27.6–41.3) and average adjusted age at examination = 9.1 months (range: 0.9–21.9)]. Of those examined, 5/81 (6.2%) had microcephaly at birth, 2/81 (2.5%) had a structural eye abnormality, and 19/72 (26.4%) had VI. Among children with normal ocular structure and neurologic examination, 13/51 (25.5%) had VI. Despite a low incidence of abnormal ocular structure and microcephaly, about a quarter of children examined had VI. Our findings emphasize that ophthalmological examinations should be performed in all children with suspicion for antenatal ZIKV infection, even children with normal ocular structure and neurologic examination.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018

Prakalapakorn

Bonafede

Lawrence³

et al. 2021

TropicalMed

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“…Eye abnormalities and visual problems are also observed in neonates congenitally infected with ZikV (Ventura et al, 2019b;Lima et al, 2020). Clinical manifestations include microphthalmia, retinal pigment changes, chorioretinal atrophy, vascular changes and optic nerve hypoplasia (Ventura et al, 2016).…”

Section: Congenital Zika Virus Infectionmentioning

confidence: 99%

Implications of TORCH Diseases in Retinal Development—Special Focus on Congenital Toxoplasmosis

Campos

Calaza

Adesse

2020

Front. Cell. Infect. Microbiol.

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There are certain critical periods during pregnancy when the fetus is at high risk for exposure to teratogens. Some microorganisms, including Toxoplasma gondii, are known to exhibit teratogenic effects, interfering with fetal development and causing irreversible disturbances. T. gondii is an obligate intracellular parasite and the etiological agent of Toxoplasmosis, a zoonosis that affects one third of the world's population. Although congenital infection can cause severe fetal damage, the injury extension depends on the gestational period of infection, among other factors, like parasite genotype and host immunity. This parasite invades the Central Nervous System (CNS), forming tissue cysts, and can interfere with neurodevelopment, leading to frequent neurological abnormalities associated with T. gondii infection. Therefore, T. gondii is included in the TORCH complex of infectious diseases that may lead to neurological malformations (Toxoplasmosis, Others, Rubella, Cytomegalovirus, and Herpes). The retina is part of CNS, as it is derived from the diencephalon. Except for astrocytes and microglia, retinal cells originate from multipotent neural progenitors. After cell cycle exit, cells migrate to specific layers, undergo morphological and neurochemical differentiation, form synapses and establish their circuits. The retina is organized in nuclear layers intercalated by plexus, responsible for translating and preprocessing light stimuli and for sending this information to the brain visual nuclei for image perception. Ocular toxoplasmosis (OT) is a very debilitating condition and may present high severity in areas in which virulent strains are found. However, little is known about the effect of congenital infection on the biology of retinal progenitors/ immature cells and how this infection may affect the development of this tissue. In this context, this study reviews the effects that congenital infections may cause to the developing retina and the cellular and molecular aspects of these diseases, with special focus on congenital OT.

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Fundus Changes in the Offspring of Mothers With Confirmed Zika Virus Infection During Pregnancy in French Guiana, Guadeloupe, and Martinique, French West Indies

et al. 2022

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ImportanceMost ocular lesions have been described for children with congenital Zika syndrome. The frequency of finding ocular abnormalities is unknown among children exposed to Zika virus (ZIKV) during pregnancy. This study was conducted on newborns whose mothers were positive for ZIKV, confirmed with reverse-transcription polymerase chain reaction (RT-PCR) testing.ObjectiveTo report ocular fundus manifestations in newborns with congenital ZIKV exposure in French Guiana, Martinique, and Guadeloupe, French West Indies, to assess its prevalence. Risk factors, such as the presence of extraocular fetopathies and the gestational term at infection, were sought.Design, Setting, and ParticipantsThis was a cross-sectional multicentric study, conducted from August 1, 2016, to April 30, 2019, for which data were collected prospectively. The study inception was at the beginning of 2016 from the onset of the ZIKV epidemic in the French West Indies. Newborns whose mothers tested positive (by RT-PCR) for ZIKV during pregnancy were included.InterventionsFundus examination was performed using widefield retinal imaging after pupil dilation. Infection date, delivery mode, and newborn measurements were collected.Main Outcomes and MeasuresAnomalies of the vitreous, choroid, retina, and optic disc.ResultsA total of 330 children (mean [SD] age, 68 [IQR, 22-440] days; 170 girls [51.5%]) were included. Eleven children (3.3%) had perivascular retinal hemorrhages, and 3 (0.9%) had lesions compatible with congenital ZIKV infection: 1 child had torpedo maculopathy, 1 child had a chorioretinal scar with iris and lens coloboma, and 1 child had a chorioretinal scar. Retinal hemorrhages were found at childbirth during early screening. Lesions compatible with congenital ZIKV infection were not associated with the presence of extraocular fetopathy. Microcephaly was not associated with lesions compatible with congenital ZIKV infection (odds ratio [OR], 9.1; 95% CI, 0.8-105.3; P = .08), but severe microcephaly was associated with an OR of 81 (95% CI, 5.1-1297.8; P = .002).Conclusions and RelevanceResults of this cross-sectional study suggest that the ocular anomalies found may be associated with ZIKV in 0.9% of the exposed population. Ocular lesions were rare, affected mostly the choroid and retina, and seemed to be associated with choroiditis-related scarring that developed during fetal growth.

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Longitudinal visual acuity development in ZIKV-exposed children

Cited by 8 publications

References 20 publications

Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018

Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018

Implications of TORCH Diseases in Retinal Development—Special Focus on Congenital Toxoplasmosis

Fundus Changes in the Offspring of Mothers With Confirmed Zika Virus Infection During Pregnancy in French Guiana, Guadeloupe, and Martinique, French West Indies

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