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Comment & Response |

Zika Virus, Microcephaly, and Ocular Findings—Reply

Lee M. Jampol, MD1; Debra A. Goldstein, MD1
[+] Author Affiliations
1Department of Ophthalmology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
JAMA Ophthalmol. 2016;134(8):946. doi:10.1001/jamaophthalmol.2016.1307.
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In Reply We thank Moshfeghi and colleagues for their comments on the article by de Paula Freitas et al and our Invited Commentary on the ocular finding of babies born with microcephaly presumed secondary to maternal ZIKV infection. Moshfeghi et al suggest that the ocular findings described by de Paula Freitas et al may be a result of the microcephaly itself rather than ZIKV involvement of the eye. Microcephaly is not a disease. It is a physical finding that results from neurodegeneration of the brain. The causes of this neurodegeneration are diverse, including genetic, metabolic, infectious, traumatic, and others. Although microcephaly from other causes, especially genetic, has been reported to be associated with retinal abnormalities, it is highly unlikely that the microcephaly itself causes the retinal abnormalities. Rather, it seems likely that each of these diseases damages the brain and some of them also damage the eye. Until ZIKV is isolated from the eye, as was done with Ebola virus, we will not be certain that the virus has actually invaded the eye. However, we doubt that the physical finding of microcephaly itself was the cause of the observed ocular abnormalities.

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August 1, 2016
Darius M. Moshfeghi, MD; Homero Augusto de Miranda II, MD; Marcelo Cavalcante Costa, MD
1Byers Eye Institute, Horngren Family Vitreoretinal Center, Department of Ophthalmology, Stanford University School of Medicine, Palo Alto, California
2Ophthalmic Telemedicine Santa Casa of São Paulo, São Paulo, Brazil
JAMA Ophthalmol. 2016;134(8):945. doi:10.1001/jamaophthalmol.2016.1303.
August 1, 2016
Daniel Vítor Vasconcelos-Santos, MD, PhD; Gláucia Manzan Queiroz Andrade, MD, PhD; Waleska Teixeira Caiaffa, MD, MPH, DSc
1Department of Ophthalmology, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil2Núcleo de Ações em Pesquisa e Apoio Diagnóstico, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
2Núcleo de Ações em Pesquisa e Apoio Diagnóstico, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil3Department of Pediatrics, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
2Núcleo de Ações em Pesquisa e Apoio Diagnóstico, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil4Department of Preventive and Social Medicine, Observatory of Urban Health, School of Medicine, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
JAMA Ophthalmol. 2016;134(8):946. doi:10.1001/jamaophthalmol.2016.1313.
August 1, 2016
Rubens Belfort Jr, MD, PhD; Bruno de Paula Freitas, MD; João Rafael de Oliveira Dias, MD
1Vision Institute, Department of Ophthalmology, Paulista Medical School, Federal University of São Paulo, São Paulo, Brazil
2Department of Ophthalmology, Hospital Geral Roberto Santos, Salvador, Brazil
JAMA Ophthalmol. 2016;134(8):946-947. doi:10.1001/jamaophthalmol.2016.1305.
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