INTRODUCTION Congenital Zika syndrome (CZS) is a recently described disease. Our main objective was to evaluate and monitor, over 3 years, the ophthalmoscopic findings in children exposed to zika virus (ZIKV) during gestation. METHODS This prospective observational study was conducted in Rio de Janeiro, Brazil, between April 2016 and May 2019. We evaluated two groups with exanthema serving as a proxy for viremia: (i) children whose mothers had exanthema during pregnancy and (ii) children who had microcephaly without maternal exanthema during pregnancy. We performed indirect ophthalmoscopy at recruitment and every 6 months thereafter. We also tested the association between ocular findings with maternal exanthema, microcephaly, CZS and maternal infection confirmed by reverse transcriptase quantitative polymerase chain reaction and gender. RESULTS Of the 72 children included, 16 (22.2%) had optic nerve and/or retinal lesions. All 16 had CZS and 15 (93.7%) had microcephaly (14 at birth and 1 postnatally). The child with postnatally acquired microcephaly was born to a mother without exanthema during pregnancy. Fifty-six (77.8%) of the 72 children were followed for a median time of 24 months and none exhibited differences between admission and follow-up examinations. After logistic regression, only microcephaly at birth was associated with eye abnormalities (odds ratio, 77.015; 95% confidence interval, 8.85-670.38; p < 0.001). CONCLUSION We observed that there was no progression of the lesions over the follow-up period. We also showed that the eye findings were associated only with microcephaly at birth. Attention should be paid to all children born during a ZIKV epidemic, regardless of maternal exanthema and/or microcephaly at birth.

中文翻译：

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妊娠期间接触寨卡病毒的儿童眼部检查结果的评估和监测：3 年随访。

简介 先天性寨卡综合征 (CZS) 是最近描述的一种疾病。我们的主要目标是在 3 年多的时间内评估和监测妊娠期间接触寨卡病毒 (ZIKV) 的儿童的检眼镜检查结果。方法 这项前瞻性观察性研究于 2016 年 4 月至 2019 年 5 月在巴西里约热内卢进行。我们评估了两组以出疹作为病毒血症指标的儿童：(i) 母亲在怀孕期间出现出疹的儿童和 (ii)怀孕期间患有小头畸形，但没有母亲出疹。我们在招募时以及此后每 6 个月进行一次间接检眼镜检查。我们还测试了眼部表现与产妇皮疹、小头畸形、CZS 和通过逆转录酶定量聚合酶链反应证实的产妇感染和性别之间的关联。结果 在 72 名儿童中，16 名（22.2%）患有视神经和/或视网膜病变。所有 16 名患者均患有 CZS，其中 15 名（93.7%）患有小头畸形（14 名出生时，1 名出生后）。患有后天性小头畸形的孩子的母亲在怀孕期间没有出现皮疹。72 名儿童中的 56 名 (77.8%) 接受了平均 24 个月的随访，入院和随访检查之间没有表现出差异。逻辑回归后，只有出生时的小头畸形与眼睛异常相关（比值比，77.015；95% 置信区间，8.85-670.38；p < 0.001）。结论 我们观察到在随访期间病变没有进展。我们还表明，眼部检查结果仅与出生时的小头畸形有关。应关注 ZIKV 流行期间出生的所有儿童，无论出生时是否有母亲出疹和/或小头畸形。