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Optical complications in congenital rubella syndrome
Harrison Scott Weisinger1, Konrad Pesudovs
1Section of Neurobiology, Howard Florey Institute of Experimental Physiology and Medicine, University of Melbourne, Victoria, Australia. h.weisinger@hfi.unimelb.edu.au
Background:
Post-natal rubella (German measles) is a mild illness, occasionally complicated by arthritis or encephalitis. In contrast, in utero infection can have devastating effects. collectively known as congenital rubella syndrome (CRS).
Methods:
Through the introduction of measles, mumps, and rubella (MMR) vaccination programs, the incidence of notifications and deaths from rubella have been reduced by 96%, to 0.4 per 100,000 births. However, CRS persists in patients who predate the commencement of these programs (c. 1969), as well as those not immunized and--rarely--in re-infection of the immune. The stigmata of CRS are widespread, encompassing neural, ocular, and systemic development, and manifest as a spectrum of involvement.
Results:
In this report, we present a case of CRS, manifesting with both auditory and visual loss, including changes in visual acuity and visual fields. These losses were the result of bilateral pigment retinopathy and cataract, though the patient is also at risk for development of glaucoma.
Conclusion:
Management for ocular CRS is similar to that for age-related macular degeneration, including counseling, regular monitoring, and the provision of low vision devices, if required.