Relação entre a infecção gestacional por Zika vírus (ZIKV) e alterações na acuidade visual e desenvolvimento visual em bebês e crianças de duas coortes: Jundiaí e Rio de Janeiro

Abstract

Relação entre a infecção gestacional por Zika vírus (ZIKV) e alterações na acuidade visual e desenvolvimento visual em bebês e crianças de duas coortes: Jundiaí e Rio de Janeiro. SãoPaulo 2019 Palavras-chave: Acuidade Visual, Desenvolvimento, Zika vírus, ZIKV, Teste dos Cartões de Acuidade de Teller, CAT. Abstract Luiz, C. P. B. (2019). Relação entre a infecção gestacional por Zika vírus (ZIKV) e alterações na acuidade visual e desenvolvimento visual em bebês e crianças de duas coortes: Jundiaí e Rio de Janeiro. (Dissertação de Mestrado). Instituto de Psicologia, Universidade de São Paulo, São Paulo. The Zika virus (ZIKV) is a flavivirus, such as the dengue virus, and like the dengue virus is also transmitted by the Aedes mosquitoes, especially the Aedes aegipty Restricted to the African Country until 2007, the ZIKV arrived in the Americas in 2013, with the first brazillian cases of the infection dating to 2014 -2015. In 2016, WHO classified the ZIKV spread as a World Health Emergency. The ZIKV, in gestationally exposed children, can lead to Congenital Zika Syndrome (CZS). Beyond its most marked and feared manifestation, microcephaly, and its other neurological damages, CZS is mostly associated with visual and ophthalmologic anomalies. However, little information is available on the literature about the impact of the ZIKV infection in the visual function and on the visual development in infected children without microcephaly. Little is also known about the impact of the infection in different brazillian populations from distinct areas. With that in mind, the present work intends to fill this gap in literature, evaluating the visual acuity (VA) and visual acuity development in children gestationally exposed to the ZIKV, using the Teller Acuity Cards Test (TAC). The evaluated children were from two different populations of the Southeast region of Brazil, the city of Jundiaí (SP) and the city of Rio de Janeiro (RJ). The Zika Jundiaí Cohort was composed of 118 children divided between the healthy control group (ZC) with 63 children and the experimental group, divided in two subgroups based on RT-qPCR, sorology or clinical evaluation, the Exposed subgroup (ZE) with 23 children, which only the mothers had ZIKV confirmed and the Infected subgroup (ZI), with 24 children, wich both mother and children had ZIKV confirmed infection. Eight children formed the Positive Control Group (M), composed of children with microcephaly due to other causes. The IFF Fiocruz Rio de Janeiro Cohort was composed of 32 children, all with confirmed ZIKV infection (ZI), either by RT-qPCR/sorology exam or by clinical evaluation. The results of the present work show that ZIKV exposition in absence of infection, does not seem to affect VA or its development. However when there's a gestational ZIKV infection, it may lead to VA damages even when the children does not show any apparent neurologic/ophtalmologic anomalies. This work, nonetheless, is in agreement with former studies that show a higher chance of VA losses when the children also have cogn...