Journal of American Association for Pediatric Ophthalmology and Strabismus
Major ArticlesOphthalmologic findings in children with congenital cytomegalovirus infection☆,☆☆
Section snippets
Methods
Since 1982, a long-term prospective study of ocular, auditory, and neurodevelopmental sequelae in children with congenital CMV infection has been conducted at Texas Children's Hospital and Texas Women's Hospital in Houston, Texas. From 1982 to 1992, all newborns were screened for congenital CMV by culture of the urine for virus. Those identified as infected were invited to participate in the study, along with control patients. After 1992, additional symptomatic patients have been referred to
Results
A total of 146 patients have undergone ophthalmologic examination, including 42 symptomatic patients, 83 asymptomatic patients, and 21 control patients (Table 1). Enrollment of control patients was limited by reluctance of parents to enroll their healthy children in a longitudinal study likely to last more than 20 years. In the symptomatic group, there were 22 males and 20 females. In the asymptomatic group, there were 45 males and 38 females, and in the control group, 16 males and 5 females.
Discussion
Congenital CMV infection is the most prevalent of the known congenital viral infections.1, 2, 3, 4 Cytomegalovirus is the largest member of the herpesvirus family. It consists of a double-stranded DNA core in an icosahedral capsule surrounded by amorphous material, which is, in turn, enclosed by a lipid envelope. The term cytomegalic inclusion disease is derived from the characteristic cells found on histopathologic examination, consisting of enlarged cells containing distinctive intranuclear
Conclusions
Visual impairment is common in patients with symptomatic congenital CMV infection. Cortical visual impairment and optic atrophy are the most common causes of severe visual impairment. Macular scars may produce visual impairment in a small number of patients. Additionally, because strabismus is common in symptomatic patients, strabismic amblyopia poses another risk to the visual status of this patient population. Ocular sequelae in asymptomatic patients with congenital CMV are uncommon.
Early
Acknowledgements
We would like to acknowledge Daniel Noyola, MD, for his help with the statistical analysis of the patient data.
The Congenital CMV Longitudinal Study Group includes: Frank Brown, MD, Francis Catlin, MD, David K. Coats, MD, Gail J. Demmler, MD, Jane Edmonds, MD, Daniel Franklin, MD, Jewel Greer, Carol Griesser, RN, Allison Istas, MPH, Judith Kozelle, Antone Laurente, PhD, Thomas Littman, PhD, Mary Murphy, Christopher Nelson, MD, Daniel Noyola, MD, Evelyn A. Paysse, MD, Alan Percy, MD, Sara Reis,
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Cited by (0)
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Supported by the following sources: An unrestricted grant from Research to Prevent Blindness, Inc, New York, New York; The Woman's Hospital of Texas Research Foundation; Deafness Foundation; General Clinical Research Center, National Institutes of Health (NIH) MOI RR 001-88-33; and Mental Retardation Research Center NIH-CHHD5 P30 HD24064, ID No. HD 9301.
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Reprint requests: David K. Coats, MD, Texas Children's Hospital, 1102 Bates, No. 300, Houston, TX 77030 (e-mail: [email protected]).