Visual Function Assessment in Children with Congenital Zika Virus Infection
Julia D. Rossetto, MD; Irena Tsui, MD; Luiza M. Neves, MD; Joel Carlos B. Silveira Filho, MD; Lorena Haefeli, MD; Maria Elisabeth L. Moreira, MD; Andrea A. Zin, MD
Fernandes Figueira Institute
Rio de Janeiro, RJ – Brazil
Introduction: To evaluate visual function of infants with presumed or confirmed in utero Zika virus infection at 3-6 months of age.
Methods: Prospective cohort of infants with presumed or confirmed congenital Zika virus infection (by reverse-transcriptase polymerase chain reaction – RT-PCR) at a referral center for high-risk pregnancies and infectious diseases in infants and children. ‘Fix and follow’ was used to evaluate visual function at 3 months and quarterly thereafter.
Results: 273 infants were evaluated, 169 (62%) had serological confirmation for Zika virus by RT-PCR; 92 (34%) had microcephaly and 72 (26%) had eye abnormalities. 229 infants (82%) were assessed at 3-6 months of age, and 69% (158/229) were able to fix and follow. Not being able to fix and follow was highly correlated (p<0.0001) to both eye abnormalities (OR 48, CI 21-114) and microcephaly associated with central nervous system abnormalities (OR 55, CI 16-183). No correlation was seen between visual function and symptoms of Zika infection during pregnancy (p=0.9) or a positive RT-PCR result (p= 0.2).
Discussion: Children with congenital Zika virus infection are at incread risk of developing visual impairment due to eye and central nervous system abnormalities. Accessing visual function is challenging in children with CZS due to cerebral and cognitive impairment. Early identification and management of visual impairment are crucial for adequate and comprehensive care of this children.
Conclusion: Children with visual impairment associated to congenital Zika virus infection should be provided integrated, long term eye care follow-up.
References: 1. Vercosa I, Carneiro P, Vercosa R, et al. The visual system in infants with microcephaly related to presumed congenital Zika syndrome. J AAPOS. 2017;21(4):300-304 e301.
2. Ventura LO, Ventura CV, Lawrence L, et al. Visual impairment in children with congenital Zika syndrome. J AAPOS. 2017;21(4):295-299 e292.
3. Zin AA, Tsui I, Rossetto J, et al. Screening Criteria for Ophthalmic Manifestations of Congenital Zika Virus Infection. JAMA Pediatr. 2017;171(9):847-854.