Ophthalmologic Manifestations Associated With Zika Virus Infection

Abstract

Vision plays an important role in the development of communication, social interaction, spatial awareness, and the motor skills needed to explore the environment. In the past 2 years, researchers have described the broad spectrum of clinical features that comprise congenital Zika syndrome (CZS). The ocular manifestations are considered 1 important pillar of this new entity. The most characteristic ophthalmic findings include chorioretinal scars and focal pigmentary changes seen in the macular region. Since these findings were first reported, other researchers have validated and extended them, leading to a more complete picture of the spectrum of ocular manifestations related to CZS. In this article, we summarize the current knowledge on the ocular implications of CZS and emphasize the importance of early rehabilitation to enhance visual performance in affected children.

Cutaneous vaccination ameliorates Zika virus-induced neuro-ocular pathology via reduction of anti-ganglioside antibodies

“…It is increasingly apparent that the impact of ZIKV extends beyond microcephaly, as children born to infected mothers continually present new neurological and ocular clinical manifestations. 67,68 As a result, there has been substantial interest in understanding the mechanisms behind ZIKV invasion and persistence in immune-privileged tissues, as well as a sustained interest in viable vaccine candidates. Ocular and neurological pathology observed in humans has successfully been recapitulated in both WT and immunocompromised murine models, but has not been utilized to evaluate vaccine efficacy despite the potential correlation between GBS and ZIKV-induced long-term pathology.…”

The Impact of Maternal Infection on the Neonate

“…Both the central and peripheral nervous systems are impacted, with resultant effects on musculoskeletal, auditory and ophthalmologic systems and symptoms including conductive hip dysplasia, abnormal posturing of extremities, conductive hearing loss and abnormalities of the retina and optic nerve [43]. Up to 55% of infants with CZS have structural ocular abnormalities, making visual screening and interventions critically important to occur early in life to allow for neuroplasticity optimizing the outcomes [44]. This has led to the recommendation of any infant with suspected CZS or exposure to ZIKV to have an ocular examination before hospital discharge and again at 3 months of age [44].…”

“…Up to 55% of infants with CZS have structural ocular abnormalities, making visual screening and interventions critically important to occur early in life to allow for neuroplasticity optimizing the outcomes [44]. This has led to the recommendation of any infant with suspected CZS or exposure to ZIKV to have an ocular examination before hospital discharge and again at 3 months of age [44].…”

Novel approaches to study the Zika virus in the brain

“…This is caused by a particular tropism ZIKV exhibits to the central nervous system, impairing the development of the fetal brain, generating cerebral calcifications, ventriculomegaly, intrauterine growth restriction, and in some cases, fetal demise. Congenital ZIKV infection was also linked to ocular abnormalities and blinding inflammatory disease in infants with or without reported microencephaly (Ventura & Ventura, 2018). Neurological manifestations were also reported in some adults, with most patients presenting Guillain-Barré syndrome, meningoencephalitis, or transverse myelitis (Da Silva, Frontera, De Filippis, & Do Nascimento, 2017).…”