The Zika Virus: Review of Ocular Findings

Introduction: The Zika virus (ZIKV), an emerging mosquito-borne pathogen, reached epidemic proportions due to its rapid spread within the Americas after an outbreak in Brazil. An association between the ZIKV infection during pregnancy and microcephaly in newborns was first suspected from 6 months after the onset of the ZIKV outbreak in Brazil. Manifestations that extend beyond the central nervous system which include ophthalmologic abnormalities have been described as part of congenital Zika syndrome (CZS). Diagnosis and Ocular Features: The main ophthalmologic findings in infants with suspected ZIKV-related microcephaly are focal pigment mottling, chorioretinal atrophy, optic nerve hypoplasia, and/or increased cup-to-disc ratio. It’s necessary to rule out other congenital infections such as toxoplasmosis, rubella, cytomegalovirus, herpes simplex virus, syphilis, and human immunodeficiency virus. Conclusions and Relevance: All children with microcephaly of mothers presumably infected with the ZIKV during pregnancy should undergo at least one ocular examination since the exposure could be associated with vision-threatening findings.