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Abstract：
BACKGROUND: As the number of children with Zika virus-related complications grows, the long-term developmental trajectory and its effects on families are unknown. We present the first known case of congenital Zika syndrome seen at our institution with significant fundus findings.
METHODS: A 3-day-old Hispanic baby girl presented with severe microcephaly of 24 cm and temperature instability at birth. Her mother had traveled to Honduras early in pregnancy and testing of amniotic fluid was positive for Zika virus via polymerase chain reaction. A dilated fundus examination was significant for bilateral severe colobomatous chorioretinal atrophy of the macula and pigmentary changes. Neonatal magnetic resonance imaging revealed diffuse lissencephaly with decreased brain volume, atrophic corpus callosum and brainstem, periventricular calcifications, and ventriculomegaly of the lateral ventricles.
CONCLUSIONS: Our patient, who presented with the first known case of congenital Zika syndrome in Northern Florida, demonstrated profound bilateral colobomatous chorioretinal atrophy of the macula. The ophthalmologic findings along with severe microcephaly emphasize the neurotropism of the Zika virus, and ultimately are indicative of poor developmental and visual prognosis for affected infants. With the increased prevalence of Zika virus, ophthalmologists should be aware of the associated findings and the importance of an eye-screening examination with a dilated fundus examination within 1 month of life of infants in which congenital Zika syndrome is suspected. A multidisciplinary care approach is essential for the care of affected infants and their families.
METHODS: A 3-day-old Hispanic baby girl presented with severe microcephaly of 24 cm and temperature instability at birth. Her mother had traveled to Honduras early in pregnancy and testing of amniotic fluid was positive for Zika virus via polymerase chain reaction. A dilated fundus examination was significant for bilateral severe colobomatous chorioretinal atrophy of the macula and pigmentary changes. Neonatal magnetic resonance imaging revealed diffuse lissencephaly with decreased brain volume, atrophic corpus callosum and brainstem, periventricular calcifications, and ventriculomegaly of the lateral ventricles.
CONCLUSIONS: Our patient, who presented with the first known case of congenital Zika syndrome in Northern Florida, demonstrated profound bilateral colobomatous chorioretinal atrophy of the macula. The ophthalmologic findings along with severe microcephaly emphasize the neurotropism of the Zika virus, and ultimately are indicative of poor developmental and visual prognosis for affected infants. With the increased prevalence of Zika virus, ophthalmologists should be aware of the associated findings and the importance of an eye-screening examination with a dilated fundus examination within 1 month of life of infants in which congenital Zika syndrome is suspected. A multidisciplinary care approach is essential for the care of affected infants and their families.
摘要：
背景：随着寨卡病毒相关并发症患儿数量的增加，长期发展轨迹及其对家庭的影响尚不清楚。我们介绍了在我们机构发现的第一个已知的先天性寨卡综合症病例，并有明显的眼底发现。
方法：一名3天大的西班牙裔女婴表现为24厘米的严重小头畸形，出生时温度不稳定。她的母亲在怀孕初期曾前往洪都拉斯，通过聚合酶链反应对羊水的寨卡病毒检测呈阳性。扩张的眼底检查对于双侧严重的黄斑结瘤脉络膜视网膜萎缩和色素变化具有重要意义。新生儿磁共振成像显示弥漫性间脑畸形脑容量减少，萎缩性call体和脑干，脑室周围钙化,和侧脑室的脑室扩大。
结论：我们的病人，他在北佛罗里达出现了首例已知的先天性寨卡综合症病例，表现出严重的黄斑双侧结肠腺瘤性脉络膜视网膜萎缩。眼科发现以及严重的小头畸形强调了寨卡病毒的神经嗜性，并最终表明受影响婴儿的发育和视觉预后不良。随着寨卡病毒的流行，眼科医生应该意识到相关的发现以及怀疑先天性寨卡综合征的婴儿在出生后1个月内进行眼底扩张检查的重要性.多学科护理方法对于护理受影响的婴儿及其家庭至关重要。
方法：一名3天大的西班牙裔女婴表现为24厘米的严重小头畸形，出生时温度不稳定。她的母亲在怀孕初期曾前往洪都拉斯，通过聚合酶链反应对羊水的寨卡病毒检测呈阳性。扩张的眼底检查对于双侧严重的黄斑结瘤脉络膜视网膜萎缩和色素变化具有重要意义。新生儿磁共振成像显示弥漫性间脑畸形脑容量减少，萎缩性call体和脑干，脑室周围钙化,和侧脑室的脑室扩大。
结论：我们的病人，他在北佛罗里达出现了首例已知的先天性寨卡综合症病例，表现出严重的黄斑双侧结肠腺瘤性脉络膜视网膜萎缩。眼科发现以及严重的小头畸形强调了寨卡病毒的神经嗜性，并最终表明受影响婴儿的发育和视觉预后不良。随着寨卡病毒的流行，眼科医生应该意识到相关的发现以及怀疑先天性寨卡综合征的婴儿在出生后1个月内进行眼底扩张检查的重要性.多学科护理方法对于护理受影响的婴儿及其家庭至关重要。
