Long-term visual and neurodevelopmental outcomes in children with Congenital Zika Syndrome after undergoing
Raíne Borba1, Tatiane Freitas1, Cláudia Marques1
1Rehabilitation Center, Altino Ventura Foundation, Recife, PE, Brazil.
Insights
Strabismus surgery improved ocular alignment in most children with congenital Zika syndrome (CZS). Functional vision showed improvement or stability in over 70% of assessed items, despite ongoing neurodevelopmental delays.
Area of Science:
- Ophthalmology
- Pediatrics
- Neurology
Background:
- Congenital Zika syndrome (CZS) presents complex ocular, neurological, and skeletal abnormalities.
- Strabismus is a common comorbidity in children with CZS, impacting visual development.
- Long-term outcomes of surgical interventions for strabismus in CZS patients require further investigation.
Purpose of the Study:
- To evaluate the long-term efficacy of strabismus surgery on ocular alignment in children with CZS.
- To assess the impact of strabismus surgery on visual function and neurodevelopmental milestones in this cohort.
- To correlate surgical outcomes with the underlying complex conditions associated with CZS.
Main Methods:
- A cohort of five children diagnosed with CZS underwent strabismus surgery.
- Pre- and postoperative assessments included best-corrected visual acuity (BCVA), ocular alignment, functional vision (FVDMT), and neurodevelopmental evaluation (BSID-III).
- Functional vision outcomes were analyzed relative to developmental age determined by BSID-III scores.
Main Results:
- 80% of children maintained successful ocular alignment post-surgery.
- Best-corrected visual acuity improved from a mean of 1.2 logMAR preoperatively to 0.7 logMAR postoperatively.
- Functional vision showed improvement or stability in 73.9% of items assessed, while significant neurodevelopmental delays persisted.
Conclusions:
- Strabismus surgery provides sustained ocular alignment in the majority of children with CZS.
- A significant proportion of functional vision items demonstrated improvement or stability following surgical intervention.
- Persistent visual and neurodevelopmental deficits in CZS are likely multifactorial, stemming from associated ocular, neurological, and skeletal abnormalities.
Abstract:
Purpose: To assess long-term visual and neurodevelopmental outcomes in children with congenital Zika syndrome (CZS) after strabismus surgery. Methods: A consecutive sample of five children with CZS who underwent strabismus surgery was enrolled. All children underwent a standardized pre- and postoperative protocol including binocular best-corrected visual acuity (BCVA) using the Teller Acuity Cards II (TAC II), ocular alignment, functional vision using the functional vision developmental milestones test (FVDMT), and neurodevelopmental milestone evaluation using the Bayley Scales of Infant Development-Third Edition (BSID-III). Scores of the FVDMT outcomes considering the child's developmental age based on the BSID-III score were compared with scores from postoperative assessment. Results: Five children with CZS (3 girls, 2 boys) were enrolled with a mean age at baseline (preoperative) of 35.0 ± 0.7 months (range, 34-36 months) and at final assessment of 64.4 ± 0.5 months (range, 64-65 months). Preoperative BCVA was 1.2 ± 0.5 logMAR and at final assessment 0.7 ± 0.1 logMAR. Successful strabismus surgery outcome was maintained in 4/5 (80.0%) of children at final assessment. The children's BSID-III scores showed significant neurodevelopment delay at the initial assessment (corresponding developmental mean age was 4.7 months) and at their final assessment (corresponding developmental mean age was 5.1 months). There was improvement or stability in 34/46 items evaluated in the FVDMT (73.9%) when comparing baseline with 2-year follow-up. Conclusions: Strabismus surgery resulted in long-term ocular alignment in the majority of children with CZS. All the children showed improvement or stability in more than 70.0% of the functional vision items assessed. Visual and neurodevelopmental dysfunction may be related to complex condition and associated disorders seen in CZS including ocular, neurological, and skeletal abnormalities.
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