eye manifestation of intrauterine infection
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eye manifestation of intrauterine infection TORCHS,ZIKA, etc. including picture and text explanation of each disease how to diagnose and treat
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eye manifestation of intrauterine infection
- 4. TOXOPLASMOSIS Syphilis Cytomegalovirus RUBELLA Zika virus Herpes virus Lymphocytic choriomeningitis virus
- 7. Gestational ages Risk of transmission to the fetus First trimester 25% Third trimester 75% Last few weeks of pregnancy >90%
- 22. Reported rubella and CRS: United States, 1966-2004 Meissner, H. C. et al. Pediatrics 2006;117:933-935
- 23. Gestational Ages Incidence of congenital infection First 11 weeks 90% Weeks 11-20 50% Weeks 20-35 37% Last month of pregnancy 100%
- 27. CORNEA • Edematous (from endotheliopathy or glaucoma) • microphthalmos IRIS+CILIARY BODY • Poorly developed (virus in 1st trimester) • Iris hypoplasia • Granulomatous iridocyclitis • Focal necrosis • Vacuolization of pigment epithelium • Glaucoma 10% LENS • Cataract formation (Nuclear type) RETINA • Salt and pepper retinopathy • Depigmentation of the RPE without ass. Inflammation • But normal ERG
- 31. Blueberry muffins skin lesion
- 42. Organ manifestation Anterior segments corneal opacities, bilateral anterior polar cataracts Retina Chorioretinitisscar similar to toxo Focal destructionpseudocolobomas Retinitis =diffuse retinal necrosis with area of retinal thickening and whitening, hemorrhages and venous sheathing +/-vitritis Optic nerve Optic nerve hypoplasia Optic nerve coloboma others Cyclopia and anophthalmia
- 53. Organ Manifestation Anterior segment Conjunctivitis Keratitis Iridocyclitis Iris atrophy Posterior synechiae Cataracts Retina Reitnitis Chorioretinitis Chorioretinal scarring White vitreous masses Optic nerve Optic neuritis Optic atrophy microphthalmia Microcornea Micropthalmia ass. IUGR and microcephaly suggest early infection during pregnancy
- 55. Causes of infectious retinitis, including cytomegalovirus (A), varicella-zoster virus(B), herpes simplex virus (C), toxoplasmosis (D) in four different patients with AIDS
- 59. From MMWR – Aug 2004
- 64. Hutchinson triad 8th nerve deafness interstitial keratitis peg-shaped teeth
- 66. Syphilictic interstitial keratitis showing inactive deep stromal vessels in retroillumination (A) and active deep stromal vessels with perivascular leukocytic cuffing in direct illumination (B) Large granulomatous KP in patient with syphilitic uveitis
- 67. Iris roseola in a patient with syphilitic uveitis, 2 patent iridotomies are visible at 2,10 o’clock A patch of peripheral “ground glass” retinitis and vasculitis in a patient with syphilitic uveitis
- 68. Interstitial keratitis in congenital syphilis
- 74. Centers for Disease Control and Prevention. Sexually transmitted diseases surveillance, 2011: syphilis. Available from www.cdc.gov/std/stats11/tables/1.htm. AccessedFebruary19, 2014.
- 82. The right eye of a 3-year-old child with a diagnosis of congenital lymphocytic choriomeningitis virus (LCVM) A large chorioretinal scar is visible temporal to the macular. There are peripapillary irregularities of the retinal pigment epithelium as well as some along the inferior arcade.
- 87. ucey DR, Gostin LO. The emerging Zika pandemic: enhancing preparedness [published online January 27, 2016]. JAMA. doi:10.1001/jama.2016.0904.
Editor's Notes
- These infections can cause ongoing tissue damage; long-term evaluation is thus required in order to determine their full impact. Most perinatal disorders have an exceedingly broad spectrum of clinical presentation, ranging from silent disease to life-threatening tissue and organ damage. The common types of congenital infections can be remembered by the acronym TORCH: toxoplasmosis; rubella; cytomegalovirus; and herpesviruses. Other infections discussed in this section include syphilis and lymphocytic choriomeningitis virus.
- Retina The retinal disease is a chorioretinitis, re- sulting in a chorioretinal scar similar to that of toxoplasmosis. Dobbins reported 15% of pa- tients showed retinal disease, and a later study by Coats, had 22% of symptomatic patients with retinal disease (7% macular and 14% peripheral scar^).'^,^^ The retinitis usually de- velops in patients with clinically apparent cy- tomegalic inclusion disease, but has been re- ported as the only manifestation of congenital CMV infection (Fig. 4).62 In addition, it has been reported that the retinal disease has de- veloped several weeks after birth.28 The histo- pathology has been reported as, many inclu- sion bodies in the retina and a few in the choroid, accompanied by extensive choriore- tinitis. Accumulation of inclusion bodies in the retina caused its focal destruction and gave rise to the development of pseudocolobomas.47 Optic Nerve Optic nerve hypoplasia and optic nerve coloboma have been described in association with cytomegalic inclusion disease.30 These findings are consistent with the teratogenic ef- fect on the central nervous system seen in this infection, which results in faulty organogen- esis. In a large study by Coats 7% of 42 symp- tomatic patients had bilateral optic atrophy.I3
- Gangciclovir and foscarnet sodium deliv- ered intravenously are being used and stud- ied. However, trials of both show that viruria returns to pre-treatment levels after cessation of the dr~g.~,~~,~~ Intravitreal therapy with gangciclovir implants has also been used for the eye disease.
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