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Response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome
Liana O Ventura1, Linda Lawrence2, Camila V Ventura1
1Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, PE, Brazil; Department of Ophthalmology, HOPE Eye Hospital, Recife, PE, Brazil.
Insights
Eyeglasses can improve vision in children with congenital Zika syndrome (CZS). Regular updates are necessary due to significant refractive changes over time.
Area of Science:
- Ophthalmology
- Pediatrics
- Genetics
Background:
- Congenital Zika syndrome (CZS) is associated with various developmental issues, including visual impairments.
- Early intervention is crucial for managing the long-term effects of CZS.
Purpose of the Study:
- To evaluate the immediate visual response to refractive error correction and hypoaccommodation in infants with CZS.
- To assess the impact of eyeglasses on visual acuity in this population.
Main Methods:
- A cohort of 60 children diagnosed with CZS underwent comprehensive ophthalmic examinations.
- Refractive errors were corrected with full prescription, and overcorrection was applied for specific visual conditions.
- Visual responses were measured using the Lea Grating Test before and after spectacle wear.
Main Results:
- All children exhibited abnormal visual responses pre-spectacle correction.
- Hypoaccommodation was prevalent in 81% of assessed children.
- Immediate improvement in binocular vision was observed in 62% of children, with varying degrees of monocular improvement.
Conclusions:
- Eyeglasses provide a measurable improvement in visual acuity for children with CZS.
- The refractive status of children with CZS changes significantly over time, necessitating periodic ophthalmic evaluations and prescription updates.
Purpose:
To describe the immediate response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome (CZS).
Methods:
Children born between May and December 2015 with a confirmed diagnosis of CZS and enrolled in a multidisciplinary early intervention program were included in this study. All children received a comprehensive ophthalmic examination, including dynamic retinoscopy and cycloplegic refraction. Children were prescribed their full correction if they met the criteria for refractive error, and additional plus 3.00 overcorrection for strabismus, accommodative dysfunction, and/or low vision. Monocular and binocular visual responses to Lea Grating Test at 30 cm, with and without eyeglasses, were measured on day 1 of glasses wear.
Results:
A total of 60 children were evaluated (mean age at evaluation, 11.5 ± 1.1 months; range, 9.0-16.0 months). Lea Grating Test responses were abnormal in all children prior to spectacle correction. Hypoaccommodation was present in 17 of 21 children (81%). Overcorrection was prescribed for all children. Visual responses were subnormal even with glasses use; however, immediate improvement in binocular vision was found in 37 children (62%) and in 74 of 119 eyes (62.2%). For the monocular visual improvement, 27 of 115 eyes (23.5%) had structural abnormalities, and 44 of 115 eyes (38.3%) were structurally normal. There was a statistical difference between the cycloplegic refraction of the children in August and in November, including emmetropia (P = 0.001), hyperopia (P = 0.000), myopia (P = 0.007), and astigmatism (P = 0.004).
Conclusions:
Eyeglasses can improve visual acuity in children with CZS. Significant changes in their refractive status over time requires periodic updates.
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