先天性寨卡病毒感染后的产前和产后眼部异常:系统回顾。

IF 2.6 4区 医学 Q2 OPHTHALMOLOGY Ocular Immunology and Inflammation Pub Date : 2024-11-01 Epub Date: 2024-02-13 DOI:10.1080/09273948.2024.2314086
Anis Mahmoud, Léo Pomar, Veronique Lambert, Olivier Picone, Najeh Hcini
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引用次数: 0

摘要

目的评估上一次 ZIKV 爆发期间胎儿和新生儿眼部异常及其进展情况,并总结经验教训:由产科医生和眼科医生组成的团队进行了系统回顾和荟萃分析:分析纳入了报告产前(5 例)和产后(24 例)期间眼部异常的研究。在产前,最常见的眼部发现是眼内钙化(4/6,66.6%)和小眼球症(3/6,50%)。479例先天性ZIKV感染患者在出生后出现眼部异常。其中13例(13/479,2.7%)出现小眼症。后段(视网膜和视神经)是受影响最严重的结构,包括色素变化(229/479,47.8%)、黄斑脉络膜视网膜萎缩(216/479,45%)、视神经萎缩(181/479,37.8%)、杯盘比增大(190/479,39.6.%)、视神经发育不全(93/479,19.4%)、血管病变(26/479,5.4%)和视网膜瘤(20/479,4.1%)。4.6%的病例(22/479)涉及前段,包括白内障(9/479,1.8%)、晶状体半脱位(1/479,0.2%)、虹膜巨痣(5/479,1%)和先天性青光眼(7/479,1.4%)。这些眼部异常在一个病例(1/479,0.2%)中是孤立的,而在其他病例中发现了多种异常。有病例描述了长期的视力障碍,之前观察到的一些眼部异常可能没有改善,甚至恶化。没有观察到眼部病变的再次激活:本综述强调了与先天性 ZIKV 感染相关的严重眼部异常。强调了产科医生、母胎医学专家和眼科医生之间多学科沟通的重要性:本系统综述已在国际系统综述前瞻性注册中心(PROSPERO)注册,注册号为440 188。
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Prenatal and Postnatal Ocular Abnormalities Following Congenital Zika Virus Infections: A Systematic Review.

Objective: To assess fetal and neonatal eyes abnormalities and their progression during the last ZIKV outbreak and summarize learned lessons.

Methods: A systematic review and meta-analysis was conducted by a team of obstetricians and ophthalmologists.

Results: Studies reporting ocular abnormalities during the prenatal (n = 5) and postnatal (n = 24) periods were included in the analysis. In the prenatal period, the most common ocular findings were intraocular calcification cases (4/6, 66.6%) and microphthalmia (3/6, 50%). Postnatal ocular abnormalities of congenital ZIKV infection were described after birth in 479 cases. Among them microphthalmia was reported in 13 cases (13/479, 2.7%). Posterior segment (retina and optic nerve) was the most affected structure, consisting of pigmentary changes (229/479, 47.8%), macular chorioretinal atrophy (216/479, 45%), optic nerve atrophy (181/479, 37.8%), increased cup-to-disk ratio (190/479, 39.6.%), optic nerve hypoplasia (93/479,19.4%), vascular changes (26/479, 5.4%), and retinal coloboma (20/479, 4.1%). The anterior segment was involved in 4.6% (22/479) of cases, including cataract (9/479, 1.8%), lens subluxation (1/479, 0.2%), iris coloboma (5/479, 1%), and congenital glaucoma (7/479, 1.4%). These ocular anomalies were isolated in one case (1/479, 0.2%) and multiple anomalies were found in the other cases. Long-term visual disorders have been described, with no possible improvement and even a worsening of some of the ocular anomalies previously observed. No reactivation of ocular lesions was observed.

Conclusion: This review highlights the severe ocular abnormalities associated with congenital ZIKV infections. The importance of multidisciplinary communication between the obstetrician, the maternal-fetal medicine specialist, and the ophthalmologist is emphasized.

Protocol registration: This systematic review was registered with the International Prospective Register of Systematic Reviews (PROSPERO), registration440 188.

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来源期刊
CiteScore
6.20
自引率
15.20%
发文量
285
审稿时长
6-12 weeks
期刊介绍: Ocular Immunology & Inflammation ranks 18 out of 59 in the Ophthalmology Category.Ocular Immunology and Inflammation is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and vision scientists. Published bimonthly, the journal provides an international medium for basic and clinical research reports on the ocular inflammatory response and its control by the immune system. The journal publishes original research papers, case reports, reviews, letters to the editor, meeting abstracts, and invited editorials.
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