A Novel Radiologic Finding to Predict Ophthalmic Abnormalities in Children with Congenital Zika

In northeastern Brazil, following the Zika virus (ZIKV) outbreak, we investigated whether a specific radiologic finding was associated with sight-threatening abnormalities in children with Congenital Zika Syndrome (CZS). Cohort Study from March 2016 to December 2018, in Paraiba, Brazil. We evaluated children born to mothers with laboratory confirmed ZIKV infection during pregnancy (ZIKV RT-PCR) and children born with clinical and radiologic features of CZS.A total of 102 infants were evaluated; 75 infants had both brain imaging and complete eye exams. 22% of infants had infratentorial abnormalities; microcephaly was present in 71%; all had brain calcifications. 94% of children with infratentorial abnormalities had ophthalmic abnormalities. Conversely, 28% without infratentorial abnormalities, had ophthalmic abnormalities (OR 42.0; 95%CI 5.1-342.9). The presence of Infratentorial abnormalities a significant predictor of ophthalmic abnormalities. All neonates whose mothers had ZIKV exposure at any time during pregnancy should have ophthalmologic examination