Fundus Changes in the Offspring of Mothers With Confirmed Zika Virus Infection During Pregnancy in French Guiana, Guadeloupe, and Martinique, French West Indies.

Importance: Most ocular lesions have been described for children with congenital Zika syndrome. The frequency of finding ocular abnormalities is unknown among children exposed to Zika virus (ZIKV) during pregnancy. This study was conducted on newborns whose mothers were positive for ZIKV, confirmed with reverse-transcription polymerase chain reaction (RT-PCR) testing. Objective: To report ocular fundus manifestations in newborns with congenital ZIKV exposure in French Guiana, Martinique, and Guadeloupe, French West Indies, to assess its prevalence. Risk factors, such as the presence of extraocular fetopathies and the gestational term at infection, were sought. Design, Setting, and Participants: This was a cross-sectional multicentric study, conducted from August 1, 2016, to April 30, 2019, for which data were collected prospectively. The study inception was at the beginning of 2016 from the onset of the ZIKV epidemic in the French West Indies. Newborns whose mothers tested positive (by RT-PCR) for ZIKV during pregnancy were included. Interventions: Fundus examination was performed using widefield retinal imaging after pupil dilation. Infection date, delivery mode, and newborn measurements were collected. Main Outcomes and Measures: Anomalies of the vitreous, choroid, retina, and optic disc. Results: A total of 330 children (mean [SD] age, 68 [IQR, 22-440] days; 170 girls [51.5%]) were included. Eleven children (3.3%) had perivascular retinal hemorrhages, and 3 (0.9%) had lesions compatible with congenital ZIKV infection: 1 child had torpedo maculopathy, 1 child had a chorioretinal scar with iris and lens coloboma, and 1 child had a chorioretinal scar. Retinal hemorrhages were found at childbirth during early screening. Lesions compatible with congenital ZIKV infection were not associated with the presence of extraocular fetopathy. Microcephaly was not associated with lesions compatible with congenital ZIKV infection (odds ratio [OR], 9.1; 95% CI, 0.8-105.3; P = .08), but severe microcephaly was associated with an OR of 81 (95% CI, 5.1-1297.8; P = .002). Conclusions and Relevance: Results of this cross-sectional study suggest that the ocular anomalies found may be associated with ZIKV in 0.9% of the exposed population. Ocular lesions were rare, affected mostly the choroid and retina, and seemed to be associated with choroiditis-related scarring that developed during fetal growth.

Factors associated with the presence of parafoveal scotoma in glaucomatous eyes with optic disc hemorrhages.

PURPOSE: Glaucomatous eyes with disc hemorrhage (DH) have a greater risk of paracentral visual field (VF) loss. However, not every DH eye presents with parafoveal scotoma (PFS), and contributing factors are still to be determined. In the present study, we investigated clinical and ocular factors associated with the presence of PFS in glaucomatous eyes with DH. METHODS: A case-control study was carried out. One hundred thirty glaucomatous patients with DH were enrolled. They were divided into two groups based on two reliable 24-2 VF tests: those with PFS (defined as ≥3 adjacent points with p < 5% within the central 10 degrees of fixation, ≥1 point with p < 1% lying at the innermost paracentral points, in the same hemifield) and those without PFS. Clinical and ocular data from the time of DH detection were compared between groups. Factors associated with the presence of PFS were investigated through logistic regression. RESULTS: The PFS group had a higher prevalence of Caucasian patients (82 vs. 47%; p < 0.01). Eyes with PFS had a more negative spherical equivalent and worse VF mean deviation (MD) index (p ≤ 0.01). There was a marginally significant intraocular pressure (IOP) difference between eyes with (15 mmHg) and without PFS (18 mmHg) at the time of DH detection (p = 0.10). Univariable analysis revealed PFS to be significantly associated with Caucasian race (OR, 3.02; p = 0.004), myopia (<-3 diopters; OR, 3.44; p = 0.039), and lower IOP (≤16 mmHg; OR, 2.10; p ≤ 0.047). Multivariable analysis, controlling for VF MD, revealed that only Caucasian race and myopia (as a continuous or categorical variable) remained significant in this model (p ≤ 0.038). CONCLUSIONS: Caucasian race and the presence and magnitude of myopia were found to be significantly associated with the presence of PFS in glaucomatous eyes with DH. Our results may help clinicians in the identification and surveillance of these eyes at higher risk of central VF loss.

Asociación de la hemorragia prerretiniana con la presencia y la gravedad de la retinopatía del prematuro en pacientes de alto riesgo.

OBJECTIVE: To assess whether preretinal hemorrhage (PRH) is associated with the presence and severity of retinopathy of prematurity (ROP) in high-risk patients. METHOD: Prospective cohort study, patients referred to the Department of Ophthalmology for ROP screening during October-November 2016 were evaluated weekly on 4 occasions to assess the relationship with PRH and the development of ROP as well as degree of severity associated. We used absolute, median frequencies with minimum and maximum values, χ2 test and Mann-Whitney U-test, as well as relative risk with 95% confidence interval. RESULTS: A total of 30 patients, in the first week 11 females (36%) and 4 males (13%) had PRH; in the 2nd week 13 patients (43%) presented PRH and 14 (46%) developed ROP; on the 3rd week there were no changes; in the last week 8 presented HPR (26%) and 11 patients (36%) with ROP. Stage I severity occurred more frequently. Statistical significance (p = 0.040) was found in the presence of PRH and the development of ROP in the first week with. CONCLUSIONS: HPR is a risk factor for the development of ROP during the first weeks of life and is associated with stages of mild severity.

Terson's syndrome. Report of a case with favorable outcome.

Terson's syndrome is characterized by the presence of a subarachnoid hemorrhage accompanied by retinal and vitreous hemorrhage leading to a not very favorable prognosis. We describe a case with a good outcome, probably because of a early diagnosis and medical intervention. We emphasize the routine optician's check up as very important in the evaluation of a prognosis in the cases of a suspect intracranial hemorrhage.

Terson's syndrome: report of case with favorable outcome

Terson's syndrome is characterized by presence of a subarachnoid hemorrhage accompanied by retinal and vireous hemorrhage leading to a not very favorable prognosis. We describe a case with a good outcome, probably because of a early diagnosis and medical intervention. We emphasize the routine optician's check up as very important in the evaluation of a prognosis in the cases of a suspect intracranial hemorrhage.

Patologia corio-vitreo-retiniana por desaceleraçäo rápida / Corio-vitreo-retinal hemorrhage related to fast desaceleration

Os autores autores apresentam dois pacientes portadores de hemorragia corio-vitreo-retiniana relacionada com a desaceleraçäo rápida provocada pela queda livre em parque de diversöes. É de se esperar que estes hematomas reabsorvam espontaneamente. É discutida a possível etiologia desta nova entidade e o tratamento realizado nestes 2 casos

La utilidad de la ultrasonografía en el diagnóstico de patología del segmento posterior en pacientes con catarata / Ultrasonography usetulness in diagnosis ocular pathology in patients with cataracts

Debido a la alta incidencia de patología del segmento posterior en pacientes con catarata, el ultrasonido actualmente juega un papel muy importante en el estableimiento del pronóstico anatomo-funcional post-extracción de catarata. Decidimos determinar la utilidad de la ultrasonografía como método diagnóstico en estos casos. Se realizó el estudio ecográfico preoperatorio en 106 pacientes con cataratas de etiología variada y se corroboró el diagnóstico clinicamente en el postoperatorio mediato. Obtuvimos un 97.8%de aciertos en los diagnósticos ecográficos lo cual indica un alto índice de confiabilidad en el exámen