Ventura Liana O, Ventura Camila V, Lawrence Linda, van der Linden Vanessa, van der Linden Ana, Gois Adriana L, Cavalcanti Milena M, Barros Eveline A, Dias Natalia C, Berrocal Audina M, Miller Marilyn T
Altino Ventura Foundation (FAV), Recife, PE, Brazil; Department of Ophthalmology, HOPE Eye Hospital, Recife, PE, Brazil.
Altino Ventura Foundation (FAV), Recife, PE, Brazil; Department of Ophthalmology, HOPE Eye Hospital, Recife, PE, Brazil; Department of Ophthalmology, Bascom Palmer Eye Institute, Miller School of Medicine, University of Miami, Miami, Florida.
J AAPOS. 2017 Aug;21(4):295-299.e2. doi: 10.1016/j.jaapos.2017.04.003. Epub 2017 Apr 24.
To describe the visual impairment associated with ocular and neurological abnormalities in a cohort of children with congenital Zika syndrome (CZS).
This cross-sectional study included infants with microcephaly born in Pernambuco, Brazil, from May to December 2015. Immunoglobulin M antibody capture enzyme-linked immunosorbent assay for the Zika virus on the cerebrospinal fluid samples was positive for all infants. Clinical evaluation consisted of comprehensive ophthalmologic examination including visual acuity, visual function assessment, visual developmental milestone, neurologic examination, and neuroimaging.
A total of 32 infants (18 males [56%]) were included. Mean age at examination was 5.7 ± 0.9 months (range, 4-7 months). Visual function and visual developmental milestone could not be tested in 1 child (3%). Visual impairment was detected in 32 infants (100%). Retinal and/or optic nerve findings were observed in 14 patients (44%). There was no statistical difference between the patients with ocular findings and those without (P = 0.180). All patients (100%) demonstrated neurological and neuroimaging abnormalities; 3 (9%) presented with late-onset of microcephaly.
Children with CZS demonstrated visual impairment regardless of retina and/or optic nerve abnormalities. This finding suggests that cortical/cerebral visual impairment may be the most common cause of blindness identified in children with CZS.
描述先天性寨卡综合征（CZS）患儿队列中与眼部和神经异常相关的视力损害情况。
这项横断面研究纳入了2015年5月至12月在巴西伯南布哥州出生的小头畸形婴儿。对所有婴儿的脑脊液样本进行寨卡病毒免疫球蛋白M抗体捕获酶联免疫吸附测定，结果均为阳性。临床评估包括全面的眼科检查，包括视力、视觉功能评估、视觉发育里程碑、神经检查和神经影像学检查。
共纳入32名婴儿（18名男性[56%]）。检查时的平均年龄为5.7±0.9个月（范围4 - 7个月）。1名儿童（3%）无法进行视觉功能和视觉发育里程碑测试。32名婴儿（100%）均检测到视力损害。14名患者（44%）观察到视网膜和/或视神经病变。有眼部病变的患者与无眼部病变的患者之间无统计学差异（P = 0.180）。所有患者（100%）均表现出神经和神经影像学异常；3名（9%）出现小头畸形迟发。
CZS患儿无论有无视网膜和/或视神经异常均表现出视力损害。这一发现表明，皮质/大脑性视力损害可能是CZS患儿失明的最常见原因。
