Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018
Abstract
:1. Introduction
2. Materials and Methods
3. Results
4. Discussion
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Adjusted Age | Milestone |
---|---|
8 weeks | Recognizes human face |
3 months | Social smile and regards hands |
5–6 months | Goal directed reach, moves to reach, hands midline |
7–10 months | Recognizes facial expressions |
12–18 month | Putting objects into and out of a container, reaches for dangling object |
18–24 months | Scribbling |
Characteristics of Children Included in This Report | |
---|---|
Gender | |
Male, n (%) | 48 (59.3) |
Gestational age (weeks); n = 81 | |
Mean (standard deviation (SD)) | 37.6 (2.9) |
Median (min, max) | 38.4 (27.6, 41.3) |
Preterm (Gestational age < 37 weeks) n (%) | 21 (25.9) |
Adjusted age at examination during ZHB (months); n = 81 | |
Mean (SD) | 9.1 (4.7) |
Median (min, max) | 8.1 (0.9, 21.9) |
Birth weight (grams); n = 67 | |
Mean (SD) | 2965 (693) |
Median (min, max) | 3120 (755–3960) |
Clinical Findings, n (%) | |
Confirmed Zika virus infection in mother and/or infant b | 14 (17.3) |
Microcephaly at birth | 5 (6.2) |
Developmental abnormalities c | 19 (23.5) |
At risk for developmental delays (areas) d | 18 (22.2) |
Fine motor | 8 (9.9) |
Communication | 7 (8.6) |
Gross motor | 6 (7.4) |
Problem solving | 4 (4.9) |
Social-emotional | 3 (3.7) |
Personal-social | 3 (3.7) |
Other neurodevelopmental abnormalities e | 5 (6.2) |
Abnormal tone | 4 (4.9) |
Arthrogryposis | 1 (1.2) |
Movement abnormality | 1 (1.2) |
Seizures | 1 (1.2) |
Overall b | Gestational Age <37 Weeks | Structural Eye Abnormalities | Microcephaly | At Risk for Developmental Delay c | Other Neuro-Developmental Abnormalities d | Confirmed ZIKV Infection e | Normal Eye, Neurologic, and Developmental Exam | |
---|---|---|---|---|---|---|---|---|
n = 78 | n = 21 | n = 2 | n = 5 | n = 18 | n = 5 | n = 14 | n = 58 | |
n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | n (%) | |
Visual Impairment | 19/72 (26.4) | 6/19 (31.6) | 0/2 (0.0) | 1/5 (20.0) | 5/16 (31.3) | 2/4 (50.0) | 5/13 (38.5) | 13/51 (25.5) |
| 18/75 (24.0) | 6/19 (31.6) | 0/2 (0.0) | 1/5 (20.0) | 5/16 (31.3) | 2/4 (50.0) | 5/13 (38.5) | 12/54 (22.2) |
| 6/77 (7.8) | 1/20 (5.0) | 0/2 (0.0) | 1/5 (20.0) | 2/17 (11.8) | 2/5 (40.0) | 1/14 (7.1) | 3/55 (5.5) |
| 1/73 (1.4) | 0/1 (0.0) | 0/2 (0.0) | 1/5 (20.0) | 1/16 (6.3) | 1/4 (25.0) | 1/12 (8.3) | 0/53 (0.0) |
| 1/71 (1.4) | 0/18 (0.0) | 0/2 (0.0) | 1/5 (20.0) | 1/15 (6.7) | 1/4 (25.0) | 1/13 (7.7) | 0/52 (0.0) |
| 2/78 (2.6) | 0/20 (0.0) | 0/2 (0.0) | 1/5 (20.0) | 1/17 (5.9) | 1/5 (20.0) | 1/14 (7.1) | 1/56 (1.8) |
Visual Impairment n (%) | p-Value | |
---|---|---|
Full-term versus preterm | ||
Preterm (gestational age <37 week) | 6/19 (31.6) | 0.56 |
Full-term (gestational age ≥37 weeks) | 13/53 (24.5) | |
Structural eye abnormalities | ||
With | 0/2 (0.0) | 1.0 |
Without | 19/70 (27.1) | |
Microcephaly | ||
With | 1/5 (20.0) | 1.0 |
Without | 18/67 (26.9) | |
At risk for developmental delay b | ||
With | 5/16 (31.3) | 0.75 |
Without | 14/56 (25.0) | |
Other neurodevelopmental abnormalities c | ||
With | 2/4 (50.0) | 0.28 |
Without | 17/68 (25.0) | |
Confirmed ZIKV infection d | ||
With | 5/13 (38.5) | 0.31 |
Without | 14/59 (23.7) |
Zin et al. [8] | Vercosa et al. [7] | Ventura et al. [6] | Ventura et al. [5] | Portnoi Baran et al. [11] | Lima et al. [12] | Current Report | |
---|---|---|---|---|---|---|---|
Year published | 2018 | 2017 | 2017 | 2018 | 2019 | 2020 | |
Subjects | Infants with suspected ZIKV infection a | Infants with microcephaly due to presumed congenital zika syndrome | Infants with neurologic or neuro-radiologic abnormalities with laboratory confirmed ZIKV infection b | Infants born with laboratory confirmed ZIKV infection b | Children exposed to or infected by ZIKV during gestation c | Children exposed to or infected by ZIKV during gestation with at least 2 eye examinations c | Infants/children with suspected ZIKV infection d |
Location | Brazil | Brazil | Brazil | Brazil | Brazil | Brazil | USVI |
n | 173 | 70 | 32 | 119 | 47 | 33 | 81 |
Age (months) | 3–6 (range) | 3.7 (mean, n = 25) e | 5.7 (mean) | 8.5 (mean) | 6.5 (mean) | NR | 9.1 (mean) |
All findings listed below are by subject unless otherwise noted | |||||||
Structural Eye Abnormality | 26% (45/173) | 26% (18/70) | 44% (14/32) | 46% (104/227) of eyes | 2.1% (1/47) | 3.0% (1/33) | 3% (2/81) |
| 2% (4/173) | 0% (0/70) | 0% (0/32) | NR | NR | NR | 1% (1/81) |
| 26% (45/173) | 26% (18/70) | 44% (14/32) | NR | 2.1% (1/47) | 3.0% (1/33) | 1% (1/81) |
Retinal abnormality | 19% (33/173) | 26% (18/70) | 28% of eyes (18/64) | 32% (74/234) of eyes | 2.1% (1/47) | 3.0% (1/33) | 0% (0/81) |
Optic nerve abnormality | 22% (38/173) | 14% (10/70) | 17% of eyes (11/64) | 27% (63/235) of eyes | NR | NR | 1% (1/81) |
Microcephaly | 36% (62/173) | 100% (70/70) | 100% (32/32) | 89% (100/113) | 8.5% (4/47) | 12.1% (4/33) | 6% (5/81) |
Visual impairment | 30% (52/173) e | 100% (11/11) f | 100% (32/32) g | 90% (204/227) of eyes h | 10.6% (5/47) f | 3.0% (1/33) f | 26% (19/72) i |
Among those with microcephaly | 71% (44/62) | 100% (11/11) | 100% (32/32) | NR | 50.0% (2/4) | 25.0% (1/4) | 20% (1/5) |
Among those with abnormal eye structure | 84% (38/45) | 100% (8/8) | 100% (14/14) | 96% (100/104) of eyes | 100.0% (1/1) | 100.0% (1/1) | 0% (0/2) |
Among those with normal eye structure | 11% (14/128) | 100% (3/3) | 100% (18/18) | 85% (104/123) of eyes | 8.7% (4/46) | 0.0% (0/32) | 27% (19/70) |
Among those with normal eye structure, neurologically normal, and no microcephaly or nystagmus | 0% (0/87) | not applicable | not applicable | NR | 7.0% (3/43) among those without microcephaly and/or structural ophthalmic abnormalities | 0% (0/29) among those without microcephaly and/or structural ophthalmic abnormalities | 26% (13/51) |
Type of visual acuity testing | Fix & Follow | Teller acuity card | Teller acuity card | Teller acuity card | Teller acuity card | Teller acuity card | NR |
Abnormalities of the following: | |||||||
Visual acuity testing | 30% (52/173) | 100% (11/11) | 73% (22/30) of subjects 78% (47/60) of eyes | 90% (107/119) of subjects 90% (210/233) of eyes | 10.6% (5/47) | 3.0% (1/33) | NR |
Visual function testing | NR | NR | 71% (22/31) | NR | NR | NR | 27% (19/72) |
Accommodation | NR | NR | 36% (5/14) | NR | NR | NR | 1% (1/71) |
Hiding Heidi 5% contrast testing | NR | NR | 65% (20/31) | 81% (87/107) | NR | NR | 24% (18/75) |
Shift of gaze | NR | NR | 42% (13/31) | NR | NR | NR | 8% (6/77) |
Visual field test | NR | NR | NR | 45% (41/91) | NR | NR | 1% (1/73) |
Visual developmental milestone | NR | NR | 97% (30/31) | 93% (100/108) | NR | NR | 3% (2/78) |
Strabismus | 14% (24/173) | 14% (10/70) | 75% (24/32) | 80% (95/119) | NR | NR | 1% (1/78) |
Nystagmus | 16% (27/173) | 9% (6/70) | 28% (9/32) | 45% (54/119) | NR | NR | 0% (0/80) |
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Prakalapakorn, S.G.; Bonafede, L.; Lawrence, L.; Lattin, D.; Kim, N.; House, R.D.; Hillman, B.; de Wilde, L.; Harrison, C.; Fehrenbach, N.; et al. Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018. Trop. Med. Infect. Dis. 2021, 6, 66. https://doi.org/10.3390/tropicalmed6020066
Prakalapakorn SG, Bonafede L, Lawrence L, Lattin D, Kim N, House RD, Hillman B, de Wilde L, Harrison C, Fehrenbach N, et al. Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018. Tropical Medicine and Infectious Disease. 2021; 6(2):66. https://doi.org/10.3390/tropicalmed6020066
Chicago/Turabian StylePrakalapakorn, S. Grace, Lucas Bonafede, Linda Lawrence, Daniel Lattin, Nicola Kim, Richard D. House, Braeanna Hillman, Leah de Wilde, Cosme Harrison, Nicole Fehrenbach, and et al. 2021. "Ocular Findings and Visual Function in Children Examined during the Zika Health Brigade in the US Virgin Islands, March 2018" Tropical Medicine and Infectious Disease 6, no. 2: 66. https://doi.org/10.3390/tropicalmed6020066