Visual function in infants with antenatal Zika virus exposure.

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.