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. 2021 Aug 14;10(6):730-737.
doi: 10.1093/jpids/piab010.

A Novel Radiologic Finding to Predict Ophthalmic Abnormalities in Children With Congenital Zika Syndrome

Virginia Vilar Sampaio  1   2   3 , Adriana S O Melo  2 , Anne L Coleman  1   3 , Fei Yu  3 , Sarah Rogeria Martins  2 , Luciana Portela Rabello  2 , Jousilene Sales Tavares  2 , Karin Nielsen-Saines  4
Affiliations

A Novel Radiologic Finding to Predict Ophthalmic Abnormalities in Children With Congenital Zika Syndrome

Virginia Vilar Sampaio et al. J Pediatric Infect Dis Soc. .

Abstract

Background: The Zika virus (ZIKV) epidemic had devastating consequences in Brazil. We investigated whether a radiologic finding (ie, infratentorial abnormalities) was associated with sight-threatening defects in children born with congenital Zika syndrome (CZS). We also investigated whether ophthalmic abnormalities correlated with head circumference (HC) and gestational age of infection.

Methods: Cross-sectional evaluation based upon a previous cohort from March 2016 to December 2018, in Paraíba, Brazil. The study population was comprised of children born to mothers with laboratory-confirmed ZIKV infection during pregnancy (ZIKV reverse transcriptase polymerase chain reaction [RT-PCR]+) and children born with clinical and radiologic features of CZS.

Results: A total of 75 infants had complete data. All 75 had brain calcifications. Microcephaly was present in 53 (71%) of them. Infratentorial abnormalities were present in 17 infants (22.7%). Ophthalmic abnormalities were seen in 16 of the 17 children (94%) with infratentorial abnormalities, while 28% of children without infratentorial abnormalities had ophthalmic findings (odds ratio [OR]: 42.0; 95% confidence interval [CI]: 5.1-342.9). Similar associations were observed when macular chorioretinal atrophy and optic nerve abnormalities were analyzed individually (OR: 23.7; 95% CI: 6.0-93.3 and OR: 11.5; 95% CI: 3.3-40.0, respectively). Infratentorial abnormalities were more frequently associated with ophthalmic abnormalities (94%) than microcephaly (43.4%) (P < .001). Mean HC was statistically different between groups with and without ophthalmic abnormalities (P = .01). A statistically significant difference in gestational age between both groups was not noted (P = .12).

Conclusions: In children with CZS, the presence of infratentorial abnormalities is a significant predictor of ophthalmic abnormalities. All neonates whose mothers had ZIKV exposure during pregnancy should have an ophthalmologic examination.

Keywords: Zika virus; congenital Zika syndrome; epidemic; ocular findings.

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Figures

Figure 1.
Figure 1.
Calcifications in the gray-white matter junction.
Figure 2.
Figure 2.
Patient flowchart.
Figure 3.
Figure 3.
Magnetic resonance imaging of 2 children with congenital Zika syndrome (from left to right sagittal, coronal, and transversal views). (A) Severe infratentorial abnormality (severe hypoplasia of cerebellum, vermis cerebelli, and brainstem). (B) Absence of severe infratentorial abnormality.
Figure 4.
Figure 4.
Chorioretinal macular atrophy, abnormal optic disk with coloboma and pallor and pigment mottling.
See this image and copyright information in PMC

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