Zika virus-related microcephaly may be associated with retinal, optic nerve damage

SEATTLE — Infants born with microcephaly caused by exposure to the Zika virus may be at risk for retinal and optic nerve damage, according to a speaker here.
“Ophthalmologists are well familiar with viral infections of the retina,” Lee M.Jampol, MD, said at the Association for Research in Vision and Ophthalmology meeting. He cited cytomegalovirus, herpes zoster and herpes simplex as endemic viral infections with known ophthalmic consequences that bear some similarities to the Zika virus.
The Zika virus is transmitted primarily by the Aedes aegypti mosquito, he said, and systemic findings from the infection are generally considered “very mild.”
The virus was first identified in East Africa, then traveled to West Africa, the Far East, Micronesia and Polynesia, and eventually “made the jump” to Brazil, where in 2015 a rash of cases of microcephaly were identified and presumed to be caused by the Zika virus.
In a study published in JAMA Ophthalmology, Bruno de Paula Freitas, MD, and colleagues described the ocular findings in 29 infants with microcephaly associated with presumed Zika virus congenital infection, Jampol said. The researchers found patterns of pigmentary clumps with mild atrophy as well as patterns of atrophic lesions. They also described optic nerve abnormalities, but Jampol said more investigation on optic nerve appearance is needed.
Jampol said ophthalmologists should rule out the more common causes of retinal lesions when treating patients with microcephaly. However, microcephaly is “definitively thought” to be due to the Zika virus, he said, and “with 30% of [these] babies having lesions, it seems certain that the retina lesions are as well.”– by Nhu Te
Jampol L. Late-breaking special session: Outbreaks: The global ophthalmic threat of Ebola, Zika and other viruses. Presented at: ARVO; May 1-5, 2016; Seattle, Washington.
Disclosure: Jampol reports no relevant financial disclosures.