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Optical Coherence Tomography of Retinal Lesions in Infants With Congenital Zika Syndrome

2016; American Medical Association; Volume: 134; Issue: 12 Linguagem: Inglês

10.1001/jamaophthalmol.2016.4283

2168-6173

Camila V. Ventura, Liana O. Ventura, Vasco Bravo-Filho, Thayze T. Martins, Audina M. Berrocal, Adriana L. Gois, João Rafael de Oliveira Dias, Leandro P. Araújo, Paulo Escarião, Vanessa van der Linden, Rubens Belfort, Maurício Maia,

Retinal Diseases and Treatments

Zika virus (ZIKV) can cause severe changes in the retina and choroid that may result in marked visual impairment in infants with congenital Zika syndrome (CZS), the term created for a variety of anomalies associated with intrauterine ZIKV infection.To evaluate the affected retinal layers in infants with CZS and associated retinal abnormalities using optical coherence tomography (OCT).This cross-sectional, consecutive case series included 8 infants (age range, 3.0-5.1 months) with CZS. Optical coherence tomographic images were obtained in the affected eyes of 7 infants with CZS who had undergone previous ophthalmologic examinations on March 17, 2016, and in 1 infant on January 1, 2016. An IgM antibody-capture enzyme-linked immunosorbent assay for ZIKV was performed on the cerebrospinal fluid samples of 7 of the 8 infants (88%), and other congenital infections were ruled out.Observation of retinal and choroidal findings in the OCT images.Among the 8 infants included in the study (3 male; 5 female; mean [SD] age at examination, 4.1 [0.7] months), 7 who underwent cerebrospinal fluid analysis for ZIKV had positive findings for IgM antibodies. Eleven of the 16 eyes (69%) of the 8 infants had retinal alterations and OCT imaging was performed in 9 (82%) of them. Optical coherence tomography was also performed in 1 unaffected eye. The main OCT findings in the affected eyes included discontinuation of the ellipsoid zone and hyperreflectivity underlying the retinal pigment epithelium in 9 eyes (100%), retinal thinning in 8 eyes (89%), choroidal thinning in 7 eyes (78%), and colobomatouslike excavation involving the neurosensory retina, retinal pigment epithelium, and choroid in 4 eyes (44%).Zika virus can cause severe damage to the retina, including the internal and external layers, and the choroid. The colobomatouslike finding seen in the OCT images relate to the excavated chorioretinal scar observed clinically.