Secondary Logo

Institutional members access full text with Ovid®

Glaucoma Workup in Congenital Zika Syndrome

de Oliveira, Daniela R., MD*; Ventura, Camila V., MD, PhD†,‡; Esporcatte, Bruno L.B., MD, PhD*; Gracitelli, Carolina P.B., MD, PhD*; Dias, Natalia de Carvalho, MD; Ventura, Liana O., MD, PhD†,‡; Belfort, Rubens Jr, MD, PhD*; Rolim-de-Moura, Christiane, MD, PhD*

doi: 10.1097/IJG.0000000000001150
Original Studies

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

Department of Ophthalmology, Altino Ventura Foundation

Department of Ophthalmology, HOPE Eye Hospital, Recife, Brazil

Disclosure: The authors declare no conflict of interest.

Reprints: Daniela R. de Oliveira, MD, Department of Ophthalmology and Visual Sciences, Federal University of Sa[Combining Tilde]o Paulo, Rua Botucatu, 821. Vila Clementino, Sa[Combining Tilde]o Paulo-SP 04023-062, Brazil (e-mail:

Received July 9, 2018

Accepted November 27, 2018

Copyright © 2019 Wolters Kluwer Health, Inc. All rights reserved.