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

Abstract

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.

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

“…In contrast, the Prakalapakorn et al 21 study, with a microcephalia rate of 5.5%, did not find retinal anomalies. 21 In this study, we found an association between the presence of retinal anomalies and severe microcephalia. Indeed, the proportion of retinal anomalies is much higher when children have concurrent microcephalia: 26% in the study by Verçosa et al 22 and 28% in the study by Ventura et al 24 The kind of retinal anomalies that we observed was identical to that of other studies.…”

“…The optic nerve anomalies included hypoplasia, increased cup-to-disc ratio, and optic nerve pallor. 26 In the Prakalapakorn et al 21 study, there is only 1 optic nerve anomaly: 1 patient had optic nerve cupping.…”

“…This cross-sectional study reported the results of systematic screening of pregnant women for congenital ocular ZIKV in the French overseas territories of French Guiana, Guadeloupe, and Martinique. Except for the Prakalapakorn et al study in US Virgin Islands, results of screening all come from Brazil (Table 3). Comparison between our study and previous studies is limited because inclusion criteria are different, particularly regarding the proportion of individuals with microcephalia.…”

“…Torpedo maculopathy is usually a rare disorder with an estimated prevalence of 2 in 100 000 and of unknown etiology. 21,[30][31][32][33] The current study included 1 case of torpedo maculopathy. Shields et al 34 explain this lesion as a defect in the development of the RPE located at the level of the fetal temporal bulge.…”

“…Anomalies of the anterior segment appear to be much rarer. Prakalapakorn et al 21 found 1 patient with microphthalmia, and Zin et al 25 found 4 patients with microphthalmia, iris coloboma, and microcornea. Iris colobomas correspond to a lack of closure of the colobomic cleft between the fifth and seventh week of life during which the invagination of the optic vesicle and the closing of the fetal cleft take place.…”