Navegando por Palavras-chave "Síndrome congênita do zika vírus"

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    Caracterização das manifestações oftalmológicas na síndrome congênita do zika vírus
    (Universidade Federal de São Paulo (UNIFESP), 2018-01-18) Ventura, Camila Vieira Oliveira Carvalho [UNIFESP]; Maia, Mauricio [UNIFESP]; Mattos Júnior, Rubens Belfort [UNIFESP]; http://lattes.cnpq.br/4270399167335564; http://lattes.cnpq.br/6377105744231862; http://lattes.cnpq.br/4175503620317639; Universidade Federal de São Paulo (UNIFESP)
    Objectives: To characterize the ocular abnormalities identified in infants with Congenital Zika Syndrome (CZS). For this purpose, three studies were conducted with the following specific objectives: 1 - To describe the ocular findings identified in infants with microcephaly exposed to the Zika virus (ZIKV) during pregnancy; 2 - To determine the risk factors related to ocular manifestations of SCZV; 3 - To analyze the retinal layers affected by the ZIKV using Optical Coherence Tomography (OCT). Methods: Infants with microcephaly and/or other neurological findings suggestive of congenital infection born between May and December 2015 in the state of Pernambuco were included in this line of research. Children who were positive serologically for any other congenital infection including toxoplasmosis, rubella, cytomegalovirus, herpes, syphilis, and HIV were excluded. In the three studies, all infants and their respective mothers underwent a thorough ophthalmic evaluation and fundus documentation using RetCam Shuttle® (Natus Medical Inc., USA). Results: The first study described the ocular morphological findings of 10 newborns with funduscopic findings and presumed diagnosis of CZSV. Anterior segment examination was normal in all patients. As for the ocular motility, 1 child (10.0%) presented horizontal nystagmus, 4 (40.0%) exophoria and 2 (20.0%) esophoria. In addition, 17 eyes (85.0%) presented with optic nerve and/or retina findings. The optic nerve findings were detected in 9 eyes (45.0%) and included disc hypoplasia, pallor, and increased disc cupping. Retinal abnormalities were detected in 16 eyes (80.0%) and included loss of foveal reflex, mild to gross focal pigmentation mottling, and well-defined chorioretinal scars. In the second study, 24 infants (60.0%) had their diagnosis confirmed using the serological test. Funduscopic findings were observed in 37 (46.3%) eyes of 22 (55.0%) infants. For statistical purposes, the children were divided into two groups: those with and those without ocular manifestations. The risk factors identified in this study were severe microcephaly at birth (frequency, -1.50; 95% CI, -2.56 to -0.51; P = 0.004) and the trimester when the maternal infection occurred (frequency, 0,36; 95% CI, 0.02-0.67; P = 0.04). The third study evaluated the affected retinal layers in eight eyes with chorioretinal scars using the OCT. The main findings of OCT included discontinuation of the ellipsoid zone and hyper-reflectivity underlying the retinal pigment epithelium in 9 eyes (100%), retinal thinning in 8 eyes (89.0%), choroidal thinning in 7 eyes (78.0%) and a colobomatous-like appearance in 4 eyes (44.0%). Conclusions: 1 - The main ocular lesions identified in children with CZS were focal pigment mottling and chorioretinal atrophy with a predilection for the macula, and optic disc abnormalities, including optic disc pallor, hypoplasia, and increased disc cupping. 2 - Ocular involvement in infants with presumed CZS was more frequently seen in infants with smaller cephalic diameter at birth and in infants whose mothers reported symptoms during the first trimester. 3 - Zika virus may cause severe damage to the retina, including the internal and external layers, as well as the choroid.