Abstract
Purpose :
Clinical features of Congenital Zika Syndrome (CZS) arise from direct neurological damage and severe loss of intracranial volume. Currently, there remains limited data on the correlation between ophtalmologic injuries and specific lesions in the Central Nervous System (CNS) among patients with probable CZS. We conducted a cross-sectional study to examine the correlation between retinal and optic nerve lesions and CNS injuries identified radiologically in patients showing some degree of likelihood of having Congenital Zika Syndrome.
Methods :
This is a cross-sectional study. It included patients born on or after July 1, 2015, who underwent ophthalmological evaluation until August 19, 2020, at the Neurodevelopmental Reference Center for Children (NINAR) in São Luís, Brazil, with a clinical or laboratory diagnosis of CZS. The Chi-square test was performed to assess the association between structural ophthalmological alterations and CNS lesions identified radiologically, including the presence of calcifications, ventriculomegaly, cerebellar malformations, cortical malformations, and brainstem lesions.
Results :
The study included 98 patients. Among them, alterations were found in both the anterior and posterior segments of the eye, including optic nerve lesions, which manifested as diffuse or temporal paleness in 70.37% of patients. The presence of chorioretinal scars was associated with male gender, difficult-to-control epilepsy, and brainstem malformations. Difficult-to-control epilepsy was found in 90.9% of patients with scars and in 55.3% of patients without scars. Brainstem malformations were present in 40.9% of patients with scars and only in 16.4% of patients without scars. Additionally, there was a predominance of bilateral optic nerve abnormalities in patients with brainstem malformations (37.5%).
Conclusions :
The presence of chorioretinal scars is more frequently found in children with a more severe neurological condition, both clinically with difficult-to-control epilepsy and in terms of brainstem malformations. This present study aligns with recent research due to the significant association between CNS alterations and the presence of retinal and optic nerve changes in Congenital Zika Syndrome.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.