Ocular findings of congenital Zika virus infection with microcephaly

Int Ophthalmol. 2022 Oct;42(10):3117-3127. doi: 10.1007/s10792-022-02311-8. Epub 2022 May 15.


Purpose: To describe ocular findings in infants with signs of congenital Zika virus syndrome (CZS) in Paraíba, Brazil, as well as to conduct a literature review and report correlations with published clinical cases.

Methods: In the Paraíba sample, infants with microcephaly suggestive of CZS were classified as Z (confirmed), PZ (probable), or SZ (suspected) according to serological testing and/or clinical findings of CZS. The patients underwent a clinical eye examination, and the results were correlated with published clinical cases.

Results: Ocular findings were present in 24 (42.9%) of 56 patients, consisting of gross retinal pigmentation in 11 (45.8%), macular chorioretinal atrophy in 11 (45.8%), optic nerve hypoplasia in 1 (4.2%), optic nerve pallor in 14 (58.3%), and increased cup-to-disk ratio in 2 (8.3%). The study revealed retina and optic nerve findings consistent with previous reports of ophthalmic involvement in CZS. However, external ocular changes observed in other studies were not detected.

Conclusion: Ocular findings similar and consistent with the literature on CZS were observed with considerable frequency and severity, regardless of the patients' serological confirmation or classification. Infants with signs of CZS should undergo ocular examination.

Keywords: Congenital Zika virus syndrome; Eye; Macular chorioretinal scar; Microcephaly; Optic nerve hypoplasia; Zika virus.

Publication types

  • Review

MeSH terms

  • Female
  • Humans
  • Infant
  • Microcephaly* / diagnosis
  • Optic Nerve
  • Pregnancy
  • Pregnancy Complications, Infectious* / diagnosis
  • Vision Disorders
  • Zika Virus Infection* / complications
  • Zika Virus Infection* / congenital
  • Zika Virus Infection* / diagnosis
  • Zika Virus*