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Visual function in infants with antenatal Zika virus exposure

Andrea A Zin1, Irena Tsui2, Julia D Rossetto1

  • 1Instituto Nacional de Saúde da Mulher, da Criança e do Adolescente Fernandes Figueira- Fundação Oswaldo Cruz, Rio de Janeiro.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|October 26, 2018
PubMed

Insights

Infants exposed to Zika virus (ZIKV) in utero often have visual impairments. Early visual function screening is crucial for identifying affected infants and enabling timely intervention for better outcomes.

Area of Science:

  • Ophthalmology
  • Pediatrics
  • Infectious Diseases

Background:

  • Antenatal Zika virus (ZIKV) infection poses a significant risk to infant neurodevelopment and sensory function.
  • Visual impairment is a recognized complication of congenital ZIKV syndrome, impacting long-term development.
  • Effective screening strategies are needed, especially in resource-limited settings affected by ZIKV outbreaks.

Purpose of the Study:

  • To evaluate visual function in infants with suspected or confirmed antenatal Zika virus (ZIKV) infection.
  • To assess the associations between abnormal visual function and other ZIKV-related complications.
  • To determine the utility of microcephaly as a screening criterion for detecting ocular abnormalities.

Main Methods:

  • A cross-sectional study was conducted on 173 infants with suspected antenatal ZIKV exposure.
  • Visual function was assessed by the ability to fix and follow a target by 3-6 months of age.
  • Associations with structural eye abnormalities, central nervous system (CNS) abnormalities, microcephaly, and nystagmus were analyzed.

Main Results:

  • Abnormal visual function was identified in 30.0% of infants.
  • Abnormal visual function was strongly associated with eye abnormalities (OR=44.2), CNS abnormalities (OR=64.0), microcephaly (OR=31.5), and nystagmus (OR=120.0).
  • Microcephaly demonstrated high sensitivity (88.9%) and specificity (82.8%) for detecting eye abnormalities; combining it with abnormal visual function yielded 100% sensitivity.

Conclusions:

  • Infants with suspected antenatal ZIKV infection and impaired visual function require ophthalmological referral.
  • Visual function assessment serves as a valuable screening tool for antenatal ZIKV exposure in resource-limited areas.
  • Early identification of visual deficits can facilitate timely visual habilitation and improve developmental outcomes.
Abstract

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