Ocular abnormalities in congenital Zika syndrome: a case report, and review of the literature

Abstract

BackgroundAs the number of children with Zika virus-related complications grows, the long-term developmental trajectory and its effects on families are unknown. We present the first known case of congenital Zika syndrome seen at our institution with significant fundus findings.Case presentationA 3-day-old Hispanic baby girl presented with severe microcephaly of 24 cm and temperature instability at birth. Her mother had traveled to Honduras early in pregnancy and testing of amniotic fluid was positive for Zika virus via polymerase chain reaction. A dilated fundus examination was significant for bilateral severe colobomatous chorioretinal atrophy of the macula and pigmentary changes. Neonatal magnetic resonance imaging revealed diffuse lissencephaly with decreased brain volume, atrophic corpus callosum and brainstem, periventricular calcifications, and ventriculomegaly of the lateral ventricles.ConclusionsOur patient, who presented with the first known case of congenital Zika syndrome in Northern Florida, demonstrated profound bilateral colobomatous chorioretinal atrophy of the macula. The ophthalmologic findings along with severe microcephaly emphasize the neurotropism of the Zika virus, and ultimately are indicative of poor developmental and visual prognosis for affected infants. With the increased prevalence of Zika virus, ophthalmologists should be aware of the associated findings and the importance of an eye-screening examination with a dilated fundus examination within 1 month of life of infants in which congenital Zika syndrome is suspected. A multidisciplinary care approach is essential for the care of affected infants and their families.

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

“… 6 , 7 Indeed, several case reports and studies have described ocular pathologies in neonates born to mother infected with ZIKV during pregnancy. 8 − 14 However, microcephaly at birth is not the definitive hallmark of CZS. 15 Children born with normal head circumferences can still develop brain and other abnormalities as the prognosis for infants with congenital infection is not yet known.…”

A Review of Hearing Loss Associated with Zika, Ebola, and Lassa Fever

“…[77][78][79] The virus has been shown to have preference for undifferentiated neurons, which may explain the devastating complications resulting from congenital cases in comparison with adults and may serve as a possible explanation for the observed auditory neuropathy findings. 28,80 In contrast to the auditory neuropathy observed in Zika, HL associated with Ebola and LF is similar to common viral-mediated etiologies of HL and can be easily detected with traditional hearing screening. Prevalence of Ebola-and LF-mediated HL is likely underestimated in this review because of the paucity of studies using objective audiometric measurements.…”

Diagnóstico de alterações refracionais em crianças com microcefalia, presumidamente por síndrome congênita do Zika vírus

“…O Zika vírus (ZIKV) é um arbovírus pertencente ao gênero Flavivirus (família Flaviviridae) (Artral et al, 2016;Petersen et al, 2016). É transmitido principalmente pelo mosquito Aedes Aegypti o qual transmite outros 03 vírus, vírus da dengue, vírus chikungunya e febre amarela (Guevara;Agarwal-Sinha, 2018). Há relatos de que a infecção por ZIKV ocorre por relações sexuais, perinatais e transfusão de sangue.…”

“…No entanto, ainda não há explicação para o mecanismo dessas transmissões (Andrade et al, 2017). O Zika é relatado em países com altitude baixa e próximo ao nível do mar e as áreas de maior risco incluem América Central, América do Sul, África central, Sudeste da Ásia e ilhas do Pacífico (Guevara & Agarwal-Sinha, 2018).…”