Visual findings in children exposed to Zika in utero in Nicaragua.

Knowledge regarding the frequency of ocular abnormalities and abnormal visual function in children exposed to Zika virus (ZIKV) in utero but born without congenital Zika syndrome (CZS) is limited. We hypothesized that children exposed to ZIKV in utero born without CZS may have visual impairments in...

Full description

Bibliographic Details
Main Authors: Evelin Martinez, Ryan Max, Filemón Bucardo, Elizabeth M Stringer, Sylvia Becker-Dreps, Christian Toval-Ruíz, Meylin Chavarria, María J Meléndez-Balmaceda, Carlos Nuñez, Matthew H Collins, Michael Boivin, Shiara Ortiz-Pujols, Omar Zepeda, Kaitlyn Cross, Emily W Gower, Natalie M Bowman, Sara F Grace
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2023-05-01
Series:PLoS Neglected Tropical Diseases
Online Access:https://doi.org/10.1371/journal.pntd.0011275
_version_ 1797752469461139456
author Evelin Martinez
Ryan Max
Filemón Bucardo
Elizabeth M Stringer
Sylvia Becker-Dreps
Christian Toval-Ruíz
Meylin Chavarria
María J Meléndez-Balmaceda
Carlos Nuñez
Matthew H Collins
Michael Boivin
Shiara Ortiz-Pujols
Omar Zepeda
Kaitlyn Cross
Emily W Gower
Natalie M Bowman
Sara F Grace
author_facet Evelin Martinez
Ryan Max
Filemón Bucardo
Elizabeth M Stringer
Sylvia Becker-Dreps
Christian Toval-Ruíz
Meylin Chavarria
María J Meléndez-Balmaceda
Carlos Nuñez
Matthew H Collins
Michael Boivin
Shiara Ortiz-Pujols
Omar Zepeda
Kaitlyn Cross
Emily W Gower
Natalie M Bowman
Sara F Grace
author_sort Evelin Martinez
collection DOAJ
description Knowledge regarding the frequency of ocular abnormalities and abnormal visual function in children exposed to Zika virus (ZIKV) in utero but born without congenital Zika syndrome (CZS) is limited. We hypothesized that children exposed to ZIKV in utero born without CZS may have visual impairments in early childhood. We performed ophthalmic examination between 16 and 21 months of age and neurodevelopment assessment at 24 months of age with the Mullen Scales of Early Learning test (MSEL) on children enrolled in a cohort born to women pregnant during and shortly after the ZIKV epidemic in Nicaragua (2016-2017). ZIKV exposure status was defined based on maternal and infant serological testing. Visual impairment was defined as abnormal if the child had an abnormal ophthalmic exam and/or low visual reception score in the MSEL assessment. Of 124 children included in the analysis, 24 (19.4%) were classified as ZIKV-exposed and 100 (80.6%) unexposed according to maternal or cord blood serology. Ophthalmic examination showed that visual acuity did not differ significantly between groups, thus, 17.4% of ZIKV-exposed and 5.2% of unexposed had abnormal visual function (p = 0.07) and 12.5% of the ZIKV-exposed and 2% of the unexposed had abnormal contrast testing (p = 0.05). Low MSEL visual reception score was 3.2-fold higher in ZIKV-exposed than unexposed children, but not statistically significant (OR 3.2, CI: 0.8-14.0; p = 0.10). Visual impairment (a composite measure of visual function or low MESL visual reception score) was present in more ZIKV-exposed than in unexposed children (OR 3.7, CI: 1.2, 11.0; p = 0.02). However, the limited sample size warrants future investigations to fully assess the impact of in utero ZIKV exposure on ocular structures and visual function in early childhood, even in apparently healthy children.
first_indexed 2024-03-12T17:03:50Z
format Article
id doaj.art-47c0c81ff40345999c8425f1aac25384
institution Directory Open Access Journal
issn 1935-2727
1935-2735
language English
last_indexed 2024-03-12T17:03:50Z
publishDate 2023-05-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS Neglected Tropical Diseases
spelling doaj.art-47c0c81ff40345999c8425f1aac253842023-08-07T05:31:16ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352023-05-01175e001127510.1371/journal.pntd.0011275Visual findings in children exposed to Zika in utero in Nicaragua.Evelin MartinezRyan MaxFilemón BucardoElizabeth M StringerSylvia Becker-DrepsChristian Toval-RuízMeylin ChavarriaMaría J Meléndez-BalmacedaCarlos NuñezMatthew H CollinsMichael BoivinShiara Ortiz-PujolsOmar ZepedaKaitlyn CrossEmily W GowerNatalie M BowmanSara F GraceKnowledge regarding the frequency of ocular abnormalities and abnormal visual function in children exposed to Zika virus (ZIKV) in utero but born without congenital Zika syndrome (CZS) is limited. We hypothesized that children exposed to ZIKV in utero born without CZS may have visual impairments in early childhood. We performed ophthalmic examination between 16 and 21 months of age and neurodevelopment assessment at 24 months of age with the Mullen Scales of Early Learning test (MSEL) on children enrolled in a cohort born to women pregnant during and shortly after the ZIKV epidemic in Nicaragua (2016-2017). ZIKV exposure status was defined based on maternal and infant serological testing. Visual impairment was defined as abnormal if the child had an abnormal ophthalmic exam and/or low visual reception score in the MSEL assessment. Of 124 children included in the analysis, 24 (19.4%) were classified as ZIKV-exposed and 100 (80.6%) unexposed according to maternal or cord blood serology. Ophthalmic examination showed that visual acuity did not differ significantly between groups, thus, 17.4% of ZIKV-exposed and 5.2% of unexposed had abnormal visual function (p = 0.07) and 12.5% of the ZIKV-exposed and 2% of the unexposed had abnormal contrast testing (p = 0.05). Low MSEL visual reception score was 3.2-fold higher in ZIKV-exposed than unexposed children, but not statistically significant (OR 3.2, CI: 0.8-14.0; p = 0.10). Visual impairment (a composite measure of visual function or low MESL visual reception score) was present in more ZIKV-exposed than in unexposed children (OR 3.7, CI: 1.2, 11.0; p = 0.02). However, the limited sample size warrants future investigations to fully assess the impact of in utero ZIKV exposure on ocular structures and visual function in early childhood, even in apparently healthy children.https://doi.org/10.1371/journal.pntd.0011275
spellingShingle Evelin Martinez
Ryan Max
Filemón Bucardo
Elizabeth M Stringer
Sylvia Becker-Dreps
Christian Toval-Ruíz
Meylin Chavarria
María J Meléndez-Balmaceda
Carlos Nuñez
Matthew H Collins
Michael Boivin
Shiara Ortiz-Pujols
Omar Zepeda
Kaitlyn Cross
Emily W Gower
Natalie M Bowman
Sara F Grace
Visual findings in children exposed to Zika in utero in Nicaragua.
PLoS Neglected Tropical Diseases
title Visual findings in children exposed to Zika in utero in Nicaragua.
title_full Visual findings in children exposed to Zika in utero in Nicaragua.
title_fullStr Visual findings in children exposed to Zika in utero in Nicaragua.
title_full_unstemmed Visual findings in children exposed to Zika in utero in Nicaragua.
title_short Visual findings in children exposed to Zika in utero in Nicaragua.
title_sort visual findings in children exposed to zika in utero in nicaragua
url https://doi.org/10.1371/journal.pntd.0011275
work_keys_str_mv AT evelinmartinez visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT ryanmax visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT filemonbucardo visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT elizabethmstringer visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT sylviabeckerdreps visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT christiantovalruiz visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT meylinchavarria visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT mariajmelendezbalmaceda visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT carlosnunez visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT matthewhcollins visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT michaelboivin visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT shiaraortizpujols visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT omarzepeda visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT kaitlyncross visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT emilywgower visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT nataliembowman visualfindingsinchildrenexposedtozikainuteroinnicaragua
AT sarafgrace visualfindingsinchildrenexposedtozikainuteroinnicaragua