Ocular manifestations of Zika virus: A systematic review

 Carrie Yuen Ling Chan   Sunny Chi Lik Au

Abstract

Introduction: A recent endemic outbreak of Zika virus infection in newborn poses serious public health concern because of its associated complications such as microcephaly. Reports also suggest ocular complications associated with these diseases, but its findings are still limited. We therefore conduct this systematic review to summarize the ocular manifestations of Zika Virus.

Method: PubMed, OvidSP, EMBASE were searched for reports on Zika virus related ocular findings. Case series, reports and cohorts were identified from reference list of included studies. Studies with overlapped subjects were excluded. Clinical findings data were extracted, categorized and summarized to study the spectrum of ocular findings associated with Zika virus infection. Incidence was calculated.

Results: Twelve studies including a total of 51 infant cases with 84 affected eyes and 3 adult cases with 5 affected eyes were included for analysis. Macular pigment mottling (55.9%), foveal reflex loss (41.2%), chorioretinal atrophy (27.4%), optic nerve hypoplasia (20.6%) and increased cup-disc ratio (18.6%) were common ocular findings related to Zika virus in infants. Uveitis and maculopathy were seen in adult cases.

Conclusion: Macular and optic nerve abnormalities are the major ocular findings in Zika virus infected infants. Eventual visual outcome is still unknown. Screening guidelines have been established. Further studies on Zika virus related ocular findings are of paramount importance for the global public health.