Neurologic and Ocular Malformations Associated With Zika Virus Infection

Among patients with congenital Zika virus infection, neurologic and ocular malformations are commonly reported, according to results of a research database search published in the journal Pediatric Neurology.

Overall, 1182 relevant studies were identified between January 1966 and August 2018. After this, a final examination was conducted to identify any errors or duplications. A total of 1024 articles were excluded from the review because they focused on clinical and radiologic central nervous system malformations that were based on animal research and were not performed in children, were not clinical studies (ie, they were conducted in vitro), were related to other arboviruses, were not related to Zika virus, and were unrelated to neurologic congenital abnormalities. There were 121 articles deemed eligible for full-text analysis, with 28 ultimately selected for final review.

The majority of the published studies were conducted in Brazil (80%), followed by the United States (15%) and Colombia (5%). The most common neurologic congenital defect reported relative to Zika infection was calcifications, primarily at the cortical-subcortical junction, which was reported among 92.9% (104 of 112) of the newborns in 7 studies. Moreover, microcephaly occurred in 39.7% (1561 of 3931) of all infected infants in all of the studies. Ventriculomegaly and/or hydrocephalus was reported in 63.1% (157 of 249) of newborns evaluated in 12 studies.

Related Articles

Ocular findings were described in a total of 10 articles, which included macular lesions, focal pigment mottling of the retinal optic nerve abnormalities, chorioretinal atrophy, cataract, microphtalmia, and strabismus.

The investigators concluded that postnatal neurologic and ophthalmologic long-term follow-up studies in this field are warranted, as such studies are severely lacking.


Marques VM, Santos CS, Santiago IG, et al. Neurologic complications in congenital Zika virus infection [published online November 22, 2018]. Pediatr Neurol. doi: 10.1016/j.pediatrneurol.2018.11.003