Ophthalmic Zika virus disease: ocular findings in two Costa Rican newborns with microcephaly render a new insight of the illness

Abstract

Zika virus infection is a vectorial tropical illness which has only recently been reported in Costa Rica. Inoculation by this flavivirus can cause a mild fever and rash in the general population. However, when contracted by pregnant women it may result in severe brain abnormalities and cognitive impairment of the newborn. We present the first two reported cases of combined microcephaly with retinopathy presumably due to this congenital viral infection. The ocular findings in both infants consisted in extensive chorioretinal atrophy and pigmented mottling throughout the macula. Despite both newborn turning in a positive result for Zika virus, only one of the mothers reported flu-like symptoms during pregnancy. We must consider the great threat this disease may pose on our health system since it generates a profound disability in the infant and will be therefore associated with long-term healthcare costs.