zika virus and the eye
TRANSCRIPT
Zika Virus Infection & the Eye
Zika Virus Infection & the Eye
Ocular findings in infants with microcephaly associated with presumed Zika Virus congenital infectionSalvador, BrazilBruno de Paula Freitas, MD; João Rafael de Oliveira Dias, MD; Juliana Prazeres, MD; Gielson Almeida Sacramento, BS; Albert Icksang Ko, MD; Maurício Maia, MD, PhD; Rubens Belfort Jr, MD, PhD
Department of Ophthalmology, Hospital Geral Roberto Santos, Salvador, Brazil Vision Institute, Department of Ophthalmology, Paulista Medical School, Federal University of São Paulo, São Paulo, Brazil Gonçalo Moniz Research Center, Oswaldo Cruz Foundation, Salvador, Brazil Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut
JAMA Ophthalmol. Published online February 09, 2016
Design
Case Series at Tertiary Hospital
29 infants with microcephaly and presumed congenital Zika
2015: 1st Dec - 25 th Dec
Interventions
Wide field digital imaging
DDx of infections ruled out through serological and clinical examinations
Design and Interventions
23/29 mothers suspected Zika during pregnancy. Trimester: 18 = 1st; 4 = 2nd; 1 = 3rd.
58 eyes of 29 children
17 eyes of 10 children = Ocular Abnormalities
7/10 = Bilateral
Results
Examples
2 month old infant
RE: granular, pigmentary mottling in the macular.
LE: Chorioretinal lobulated atrophic lesion and slight pigmentary mottling
1 month old infant
RE & LE: paramacular supertemporal round chorioretinal atrophy surrounded by a hyper pigmented halo and hyper pigmented mottling
I month old infant
RE: enlarged cup-disc ratio and macular pigmentary mottling
LE: roundish macular chorioretinal atrophic lesion with a hyper pigmented halo and pigmentary mottling, as well as an enlarged cup-disc ration
1 month old infant
RE & LE: supertemporal perimacular chorioretinal scar with perilesional pigmentary mottling
20 day old infant
RE: optic disc hypoplasia, peripapillary nasal atrophy and excavated nasal round lesion with a hyper hyper pigmented halo, with a colobomatous-like aspect
LE: optic disc hypoplasia, peripapillary nasal atrophy, and a retinal nasal lesion with a similar pattern
Findings in infants with microcephaly & presumed Zika Virus congenital infection
DiscussionMajor health problem
Retinal lesions
Posterior pole
Optic disc
Screen infected mothers without microcephalic infants?
Limitations
1 hospital
General findings
Lack of prior research
‘Presumed Zika’
ConclusionsRetinal lesions similar to West Nile virus
Need serological tests to confirm findings
Micro = routine exam
Ophthalmologists should be aware…
Article Link:http://archopht.jamanetwork.com/article.aspx?articleid=2491896