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

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

doi:10.1016/j.jaapos.2019.03.005

Cited by 14 publications

(20 citation statements)

References 21 publications

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“…We included 39 case reports 24– 61 , 62 case series 62– 123 , 10 case-control studies 124– 133 , 35 cohort studies 134– 168 , 19 cross-sectional studies 169– 187 , seven ecological studies 188– 194 , three modelling studies 195– 197 and 20 outbreak reports 198– 217 that report on congenital abnormalities linked to ZIKV.…”

Section: Resultsmentioning

confidence: 99%

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

et al. 2019

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Background: The Zika virus (ZIKV) caused a large outbreak in the Americas leading to the declaration of a Public Health Emergency of International Concern in February 2016. A causal relation between infection and adverse congenital outcomes such as microcephaly was declared by the World Health Organization (WHO) informed by a systematic review structured according to a framework of ten dimensions of causality, based on the work of Bradford Hill. Subsequently, the evidence has continued to accumulate, which we incorporate in regular updates of the original work, rendering it a living systematic review. Methods: We present an update of our living systematic review on the causal relation between ZIKV infection and adverse congenital outcomes and between ZIKV and GBS for four dimensions of causality: strength of association, dose-response, specificity, and consistency. We assess the evidence published between January 18, 2017 and July 1, 2019. Results: We found that the strength of association between ZIKV infection and adverse outcomes from case-control studies differs according to whether exposure to ZIKV is assessed in the mother (OR 3.8, 95% CI: 1.7-8.7, I2=19.8%) or the foetus/infant (OR 37.4, 95% CI: 11.0-127.1, I2=0%). In cohort studies, the risk of congenital abnormalities was 3.5 times higher after ZIKV infection (95% CI: 0.9-13.5, I2=0%). The strength of association between ZIKV infection and GBS was higher in studies that enrolled controls from hospital (OR: 55.8, 95% CI: 17.2-181.7, I2=0%) than in studies that enrolled controls at random from the same community or household (OR: 2.0, 95% CI: 0.8-5.4, I2=74.6%). In case-control studies, selection of controls from hospitals could have biased results. Conclusions: The conclusions that ZIKV infection causes adverse congenital outcomes and GBS are reinforced with the evidence published between January 18, 2017 and July 1, 2019.

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Section: Resultsmentioning

confidence: 99%

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

et al. 2019

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“…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) .…”

Section: Discussionmentioning

confidence: 83%

“…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) .…”

Section: Discussionmentioning

confidence: 93%

“…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) .…”

Section: Resultsmentioning

confidence: 99%

“…(2019) (14) Assess visual acuity and development of visual acuity in children exposed to the zika virus in pregnancy.…”

Section: Portnoi Et Almentioning

confidence: 99%

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

et al. 2020

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Objective: To know the evidence available in the literature on the effects of the zika virus in children development after fetal exposure. Methods: This is an integrative literature review with 16 scientific articles found in five databases (PubMed, LILACS, CINAHL, Web of Science and Scopus), based on the guiding question: “What are the effects in the development of children aged 0 to 6 years exposed to the zika virus in the fetal period? The STROBE statement was used for data extraction and evaluation of primary studies. Results: Exposure to the zika virus in the fetal period resulted in several congenital anomalies and/or changes in the central nervous system: microcephaly, ocular problems, neurosensorial problems, ventriculomegaly, intracranial calcification, cardiopathy, arthrogryposis, among others. Conclusion: The zika virus is neurotropic; its effect in the fetal nervous system causes irreparable damage to the child, so health professionals, especially nurses, must intensify maternal and also childcare.

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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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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

Cited by 14 publications

References 21 publications

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

Zika virus infection as a cause of congenital brain abnormalities and Guillain-Barré syndrome: A living systematic review

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

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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