Department of Ophthalmology, University Hospital of Martinique, Hôpital Pierre Zobda Quitman, Fort-de-France, Martinique, French West Indies, France.
Department of Ophthalmology, University Hospital of Guadeloupe, Le Abymes, Guadeloupe, French West Indies, France.
JAMA Ophthalmol. 2022 Oct 1;140(10):994-1001. doi: 10.1001/jamaophthalmol.2022.3405.
Most ocular lesions have been described for children with congenital Zika syndrome. The frequency of finding ocular abnormalities is unknown among children exposed to Zika virus (ZIKV) during pregnancy. This study was conducted on newborns whose mothers were positive for ZIKV, confirmed with reverse-transcription polymerase chain reaction (RT-PCR) testing.
To report ocular fundus manifestations in newborns with congenital ZIKV exposure in French Guiana, Martinique, and Guadeloupe, French West Indies, to assess its prevalence. Risk factors, such as the presence of extraocular fetopathies and the gestational term at infection, were sought.
DESIGN, SETTING, AND PARTICIPANTS: This was a cross-sectional multicentric study, conducted from August 1, 2016, to April 30, 2019, for which data were collected prospectively. The study inception was at the beginning of 2016 from the onset of the ZIKV epidemic in the French West Indies. Newborns whose mothers tested positive (by RT-PCR) for ZIKV during pregnancy were included.
Fundus examination was performed using widefield retinal imaging after pupil dilation. Infection date, delivery mode, and newborn measurements were collected.
Anomalies of the vitreous, choroid, retina, and optic disc.
A total of 330 children (mean [SD] age, 68 [IQR, 22-440] days; 170 girls [51.5%]) were included. Eleven children (3.3%) had perivascular retinal hemorrhages, and 3 (0.9%) had lesions compatible with congenital ZIKV infection: 1 child had torpedo maculopathy, 1 child had a chorioretinal scar with iris and lens coloboma, and 1 child had a chorioretinal scar. Retinal hemorrhages were found at childbirth during early screening. Lesions compatible with congenital ZIKV infection were not associated with the presence of extraocular fetopathy. Microcephaly was not associated with lesions compatible with congenital ZIKV infection (odds ratio [OR], 9.1; 95% CI, 0.8-105.3; P = .08), but severe microcephaly was associated with an OR of 81 (95% CI, 5.1-1297.8; P = .002).
Results of this cross-sectional study suggest that the ocular anomalies found may be associated with ZIKV in 0.9% of the exposed population. Ocular lesions were rare, affected mostly the choroid and retina, and seemed to be associated with choroiditis-related scarring that developed during fetal growth.
大多数眼部病变已在先天性寨卡综合征患儿中描述。在妊娠期间接触寨卡病毒（ZIKV）的儿童中，眼部异常的发生率尚不清楚。本研究对母亲 ZIKV 检测呈阳性的新生儿进行了研究，通过逆转录聚合酶链反应（RT-PCR）检测进行了确认。
报告法属圭亚那、马提尼克和瓜德罗普岛，法属西印度群岛中先天性 ZIKV 暴露新生儿的眼底表现，评估其患病率。寻找了与眼外胎儿病变和感染时的妊娠期限等相关的风险因素。
设计、地点和参与者：这是一项横断面多中心研究，于 2016 年 8 月 1 日至 2019 年 4 月 30 日进行，前瞻性收集数据。研究开始于 2016 年初，当时寨卡病毒在法属西印度群岛流行。纳入了在妊娠期间母亲 ZIKV 检测呈阳性（通过 RT-PCR）的新生儿。
瞳孔扩张后，使用广角视网膜成像进行眼底检查。收集感染日期、分娩方式和新生儿测量值。
玻璃体积血、脉络膜、视网膜和视盘异常。
共纳入 330 名儿童（平均[SD]年龄，68[IQR，22-440]天；170 名女孩[51.5%]）。11 名儿童（3.3%）有血管周围视网膜出血，3 名（0.9%）有符合先天性 ZIKV 感染的病变：1 名儿童有鱼雷黄斑病变，1 名儿童有脉络膜视网膜瘢痕合并虹膜和晶状体缺损，1 名儿童有脉络膜视网膜瘢痕。视网膜出血在早期筛查时在分娩时发现。符合先天性 ZIKV 感染的病变与眼外胎儿病变的存在无关。小头畸形与符合先天性 ZIKV 感染的病变无关（比值比[OR]，9.1；95%CI，0.8-105.3；P = .08），但严重小头畸形与 OR 为 81（95%CI，5.1-1297.8；P = .002）相关。
这项横断面研究的结果表明，在暴露人群中，有 0.9%的眼部异常可能与 ZIKV 相关。眼部病变罕见，主要影响脉络膜和视网膜，似乎与胎儿生长过程中发生的脉络膜炎相关的瘢痕有关。
