A one-year prospective study of chorioretinal scars and optic disk characteristics in children with congenital Zika syndrome.

PURPOSE: To evaluate early changes of chorioretinal scars and optic disk in congenital Zika syndrome (CZS).

METHODS

This prospective cohort study included 35 eyes of children with CZS who presented with chorioretinal scars, which were assessed by retinal imaging at diagnosis and at 1 year's follow-up. ImageJ software was used to measure the chorioretinal scar area. A comparison board was created to classify the lesions with regard to pigmentation. The vertical (v) and horizontal (h) cup:disk ratios (CDRs) were rated, and the CDR means at baseline and follow-up were analyzed. Ocular ultrasounds were performed to calculate the ocular growth rate and to compare with the chorioretinal scar growth rate.

RESULTS

The mean area of the chorioretinal scar at baseline and at 1 year later were 8.62 and 9.41 mm2, respectively (P < 0.001). The chorioretinal scar area increased in 32 eyes (91%) eyes, and pigmentation increased in 14 eyes (40%) eyes. The mean growth rate of the chorioretinal scar was 14.9% ± 21.5%. The vCDR presented a 4% increase (range, 0.15%-1%; P = 0.030) and the hCDR remained stable (range, 0.10%-1%; P = 0.530). No significant correlation was found between the vCDR (r = 0.272, P = 0.115) or hCDR (r = 0.106, P = 0.543) and chorioretinal scar growth. No correlation was observed between the chorioretinal scar growth rate and the ocular globe growth rate (r = 0.18; P = 0.63).

CONCLUSIONS

In our CZS study cohort, chorioretinal scars exhibited slight changes, including growth and increase in pigmentation after 1 year. A significant increase of the vCDR was also observed. Further research is needed to determine if these changes signify disease progression.