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Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands,
S Grace Prakalapakorn1, Lucas Bonafede1, Linda Lawrence2
1Department of Ophthalmology, Duke University, Durham, NC 27710, USA.
Insights
Zika virus (ZIKV) infection in infants can cause visual impairment (VI) even without obvious eye problems. Ophthalmological exams are crucial for all children with suspected ZIKV exposure, regardless of initial findings.
Area of Science:
- Ophthalmology
- Pediatrics
- Infectious Diseases
Background:
- Zika virus (ZIKV) infection during pregnancy can lead to congenital abnormalities.
- Visual impairment (VI) is a potential outcome in infants with laboratory-confirmed ZIKV infection.
- Ocular structure may appear normal despite the presence of VI in affected children.
Purpose of the Study:
- To describe ocular findings and visual function in children examined during a Zika Health Brigade (ZHB) in the U.S. Virgin Islands.
- To assess the prevalence of visual impairment among children with suspected antenatal ZIKV exposure.
Main Methods:
- Retrospective chart review of children eligible for the U.S. Zika Pregnancy and Infant Registry.
- Ophthalmological examinations were conducted by specialists during the ZHB.
- Analysis included data on gestational age, age at examination, microcephaly, structural eye abnormalities, and visual function.
Main Results:
- Out of 81 children with available charts, 19/72 (26.4%) had visual impairment (VI).
- Only 2.5% had structural eye abnormalities, and 6.2% had microcephaly at birth.
- Among children with normal ocular structure and neurological exams, 25.5% still exhibited VI.
Conclusions:
- A significant proportion of children with suspected antenatal ZIKV infection exhibit visual impairment, even with normal ocular and neurological examinations.
- Ophthalmological examinations are essential for all infants with suspected ZIKV exposure to detect visual deficits.
- Early detection and intervention are critical for managing visual impairment in children affected by ZIKV.
Abstract:
Among children born with laboratory-confirmed Zika virus (ZIKV) infection, visual impairment (VI) can occur despite normal ocular structure. The objective of this report is to describe ocular findings and visual function among children examined during the Department of Health Zika Health Brigade (ZHB) in the United States Virgin Islands in March 2018. This analysis is based on a retrospective chart review of children eligible to participate in the ZHB (i.e., part of the US Zika Pregnancy and Infant Registry) and who were examined by ophthalmologists. Eighty-eight children attended the ZHB. This report includes 81 children [48 (59.3%) males] whose charts were located [average gestational age = 37.6 weeks (range: 27.6-41.3) and average adjusted age at examination = 9.1 months (range: 0.9-21.9)]. Of those examined, 5/81 (6.2%) had microcephaly at birth, 2/81 (2.5%) had a structural eye abnormality, and 19/72 (26.4%) had VI. Among children with normal ocular structure and neurologic examination, 13/51 (25.5%) had VI. Despite a low incidence of abnormal ocular structure and microcephaly, about a quarter of children examined had VI. Our findings emphasize that ophthalmological examinations should be performed in all children with suspicion for antenatal ZIKV infection, even children with normal ocular structure and neurologic examination.
