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Abstract #79786 Published in IGR 20-2

Glaucoma Workup in Congenital Zika Syndrome

de Oliveira DR; Ventura CV; Esporcatte BLB; Gracitelli CPB; Dias NC; Ventura LO; Belfort R; Rolim-de-Moura C
Journal of Glaucoma 2019; 28: 313-317

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PURPOSE: The main aim of this study was to perform a glaucoma workup in infants with congenital Zika syndrome (CZS). PATIENT AND METHODS: This cross-sectional study included 188 eyes of 107 children (1.1±0.3 y; range, 0.3 to 1.8 y) with CZS. The confirmation of the syndrome was possible in 77 of 107 (72.0%) of the enrolled infants based on positive immunoglobulin M antibody capture enzyme-linked immunosorbent assay for Zika virus in the cerebrospinal fluid. All infants underwent a complete ophthalmic examination and bilateral fundus imaging was captured using a wide-angle digital fundus camera (RetCam). RESULTS: Five eyes (2.6%) presented 2 criteria for glaucoma diagnosis: 1 eye (0.5%) presented increased intraocular pressure and increased vertical cup-to-disc ratio (CDR); 3 eyes (1.6%) presented increased horizontal corneal diameter and increased vertical, and 1 eye (0.5%) presented myopia related to increased axial length and increased vertical CDR. When excluding the CDR criterion, there was no case of glaucoma in this sample. A significant correlation was observed between high vertical CDR and small cephalic perimeter at birth (P=0.002) and the presence of clinical macular lesions (P=0.031). CONCLUSION AND RELEVANCE: Although childhood glaucoma was not detected in this sample, increased vertical CDR is present in children with CZS, associated with microcephaly and clinical macular lesions at birth. This finding may lead to a misdiagnosis of glaucoma.

Department of Ophthalmology and Visual Sciences, Federal University of Sa[Combining Tilde]o Paulo, Sa[Combining Tilde]o Paulo.

Full article

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Classification:

9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
9.1.2 Juvenile glaucoma (Part of: 9 Clinical forms of glaucomas > 9.1 Developmental glaucomas)
10 Differential diagnosis e.g. anterior and posterior ischemic optic neuropathy

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