Infant ocular lesions consistent with congenital Zika virus infection are rare

Pediatric Ophth/Strabismus, Retina/Vitreous

Zika virus infection during pregnancy is unlikely to result in Zika-related ocular anomalies in babies, with abnormalities most often seen in the retina and choroid.

Study design

This cross-sectional multi-centered study calculated the rate of ocular abnormalities among 330 children whose mothers were exposed to the Zika virus during pregnancy in French Guiana, Martinique, Guadeloupe, and the French West Indies between August 1, 2016, and April 30, 2019. Maternal Zika status was confirmed with reverse-transcription polymerase chain reaction (RT-PCR) during pregnancy. Babies born younger than 35 weeks gestational age were excluded.


Eleven children (3.3%) had perivascular retinal hemorrhages found during early screening. Three children (0.9%) had lesions compatible with congenital Zika virus infection (1 torpedo maculopathy, 1 chorioretinal scar with iris and lens coloboma, 1 chorioretinal scar), none of which were associated with extraocular manifestations of Zika virus infection. Seventy-four mothers (22.4%) were infected during the first trimester, 157 mothers (47.6%) during the second, and 99 mothers (30.0%) during the third.


Out of 1180 babies considered, only 330 were included in the study, which required RT-PCR–positive mothers. This may introduce a selection bias depending on the availability of RT-PCR testing.

Clinical significance

Ocular lesions compatible with congenital Zika infection are rare in infants and are associated with chorioretinal scarring that likely developed during fetal growth.

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