Evaluation and monitoring of eye findings in children exposed to Zika virus during gestation: 3 years of follow-up

Author:

Dos Santos Maria Luiza Bernardes1ORCID,Lima Luiz Cláudio Santos De Souza1,Zin Andrea Araújo2,Moreira Maria Elisabeth Lopes2,De Vasconcelos Zilton Farias Moreira2,Neves Luiza Maceira De Almeida2,Pereira Maurício Bastos1,Vianna Renata Artimos De Oliveira1,Velarde Luis Guillermo Coca3,De Oliveira Solange Artimos1,Riley Lee Woodland4,Cardoso Claudete Aparecida Araújo1

Affiliation:

1. Faculdade de Medicina, Universidade Federal Fluminense Rua Marquês de Paraná, 303, Centro , Niterói, RJ 24.033-900, Brazil

2. Instituto Fernandes Figueira, Unidade de Pesquisa Clínica Av Rui Barbosa, 716, Flamengo , Rio de Janeiro, RJ 22.250-020, Brazil

3. Instituto de Matemática e Estatística, Universidade Federal Fluminense Rua Mário Santos Braga, s/n, Centro , Niterói, RJ 24.020-110, Brazil

4. Division of Infectious Diseases and Vaccinology, University of California , Berkeley, CA 94720, USA

Abstract

Abstract Introduction Congenital Zika syndrome (CZS) is a recently described disease. Our main objective was to evaluate and monitor, over 3 years, the ophthalmoscopic findings in children exposed to zika virus (ZIKV) during gestation. Methods This prospective observational study was conducted in Rio de Janeiro, Brazil, between April 2016 and May 2019. We evaluated two groups with exanthema serving as a proxy for viremia: (i) children whose mothers had exanthema during pregnancy and (ii) children who had microcephaly without maternal exanthema during pregnancy. We performed indirect ophthalmoscopy at recruitment and every 6 months thereafter. We also tested the association between ocular findings with maternal exanthema, microcephaly, CZS and maternal infection confirmed by reverse transcriptase quantitative polymerase chain reaction and gender. Results Of the 72 children included, 16 (22.2%) had optic nerve and/or retinal lesions. All 16 had CZS and 15 (93.7%) had microcephaly (14 at birth and 1 postnatally). The child with postnatally acquired microcephaly was born to a mother without exanthema during pregnancy. Fifty-six (77.8%) of the 72 children were followed for a median time of 24 months and none exhibited differences between admission and follow-up examinations. After logistic regression, only microcephaly at birth was associated with eye abnormalities (odds ratio, 77.015; 95% confidence interval, 8.85–670.38; p < 0.001). Conclusion We observed that there was no progression of the lesions over the follow-up period. We also showed that the eye findings were associated only with microcephaly at birth. Attention should be paid to all children born during a ZIKV epidemic, regardless of maternal exanthema and/or microcephaly at birth.

Funder

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior

Publisher

Oxford University Press (OUP)

Subject

Infectious Diseases,Pediatrics, Perinatology and Child Health

Reference25 articles.

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2. Zika virus infection: past and present of another emerging vector-borne disease;Sakkas;J Vector Borne Dis,2016

3. Zika virus outbreak, Bahia, Brazil;Campos;Emerg Infect Dis,2015

4. First report of autochthonous transmission of Zika virus in Brazil;Zanluca;Mem Inst Oswaldo Cruz,2015

5. Zika virus: a new chapter in the history of medicine;Brito;Acta Med Port,2015

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