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Journal of AAPOS : the official publication of the American Association for Pediatric Ophthalmology and Strabismus v.21 no.6, 2017년, pp.480 - 484.e1   SCIE
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Response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome

Ventura, Liana O.    (Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, PE, Brazil   ); Lawrence, Linda    (Private Ophthalmology practice, Salina, Kansas   ); Ventura, Camila V.    (Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, PE, Brazil   ); Dutton, Gordon N.    (Department of Optometry and Visual Science, Glasgow Caledonian University, Glasgow, United Kingdom   ); Marinho, Polyana    (Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, PE, Brazil   ); Ferro, Priscila F.    (Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, PE, Brazil   ); Gois, Adriana L.    (Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, PE, Brazil   ); Dias, Natalia C.    (Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, PE, Brazil   ); Ventura, Larissa    (Department of Ophthalmology, Altino Ventura Foundation (FAV), Recife, PE, Brazil   ); Moore, Cynthia A.    (National Office of Public Health Genomics Centers for Disease Control and Prevention, Atlanta, Georgia   ); Hyvärinen, Lea    (Faculty of Rehabilitation Sciences, University of Dortmund, Germany  );
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    Purpose To describe the immediate response to correction of refractive errors and hypoaccommodation in children with congenital Zika syndrome (CZS). Methods Children born between May and December 2015 with a confirmed diagnosis of CZS and enrolled in a multidisciplinary early intervention program were included in this study. All children received a comprehensive ophthalmic examination, including dynamic retinoscopy and cycloplegic refraction. Children were prescribed their full correction if they met the criteria for refractive error, and additional plus 3.00 overcorrection for strabismus, accommodative dysfunction, and/or low vision. Monocular and binocular visual responses to Lea Grating Test at 30 cm, with and without eyeglasses, were measured on day 1 of glasses wear. Results A total of 60 children were evaluated (mean age at evaluation, 11.5 ± 1.1 months; range, 9.0-16.0 months). Lea Grating Test responses were abnormal in all children prior to spectacle correction. Hypoaccommodation was present in 17 of 21 children (81%). Overcorrection was prescribed for all children. Visual responses were subnormal even with glasses use; however, immediate improvement in binocular vision was found in 37 children (62%) and in 74 of 119 eyes (62.2%). For the monocular visual improvement, 27 of 115 eyes (23.5%) had structural abnormalities, and 44 of 115 eyes (38.3%) were structurally normal. There was a statistical difference between the cycloplegic refraction of the children in August and in November, including emmetropia ( P = 0.001), hyperopia ( P = 0.000), myopia ( P = 0.007), and astigmatism ( P = 0.004). Conclusions Eyeglasses can improve visual acuity in children with CZS. Significant changes in their refractive status over time requires periodic updates.


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