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Is there room for prompt routine ophthalmic examination in neonates with congenital cytomegalovirus (CMV) infection during the neonatal period?

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Abstract

Purpose

To establish the clinical necessity of routine targeted ophthalmic examination of newborns with congenital cytomegalovirus (CMV) infection during the neonatal period.

Methods

This retrospective study included consecutive neonates that were referred for ophthalmological screening within the context of a proven congenital CMV infection. The presence of CMV-related ocular and systemic findings was determined.

Results

Among the 91 patients included in this study, 72 (79.12%) were symptomatic with one or more of the following manifestations: abnormal brain ultrasound (42; 46.15%), small for gestational age (29; 31.87%), microcephaly (23; 25.27%), thrombocytopenia (14; 15.38%), sensory neural hearing loss (13; 14.29%), neutropenia (12; 13.19%), anemia (4; 4.4%), skin lesions (4; 4.4%), hepatomegaly (3; 3.3%), splenomegaly (3; 3.3%), direct hyperbilirubinemia (2; 2.2%). Not one single neonate in this cohort had any of the ocular findings surveyed.

Conclusion

The presence of ophthalmological findings among neonates with congenital CMV infection during the neonatal period is infrequent, suggesting that routine ophthalmological screening may be safely deferred for the post-neonatal period.

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References

  1. Fowler KB, Boppana SB (2018) Congenital cytomegalovirus infection. Semin Perinatol 42(3):149–154

    Article  PubMed  Google Scholar 

  2. James SH, Kimberlin DW (2016) Advances in the prevention and treatment of congenital cytomegalovirus infection. Curr Opin Pediatr 28(1):81–85

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Coats DK et al (2000) Ophthalmologic findings in children with congenital cytomegalovirus infection. J AAPOS 4(2):110–116

    Article  CAS  PubMed  Google Scholar 

  4. Anderson KS et al (1996) Ocular abnormalities in congenital cytomegalovirus infection. J Am Optom Assoc 67(5):273–278

    CAS  PubMed  Google Scholar 

  5. Puhakka L, et al (2018) The burden of congenital cytomegalovirus infection: a prospective cohort study of 20,000 infants in Finland. J Pediatric Infect Dis Soc

  6. Dollberg S et al (2005) Birth weight standards in the live-born population in Israel. Isr Med Assoc J 7(5):311–314

    PubMed  Google Scholar 

  7. Guerra B et al (2008) Ultrasound prediction of symptomatic congenital cytomegalovirus infection. Am J Obstet Gynecol 198(4):380 e1–7

    Article  PubMed  Google Scholar 

  8. Rare Disease Act of 2002. http://history.nih.gov/research/downloads/PL107-280.pdf

  9. Binnicker MJ, Espy ME (2013) Comparison of six real-time PCR assays for qualitative detection of cytomegalovirus in clinical specimens. J Clin Microbiol 51(11):3749–3752

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Kimberlin DW, Aban I, Acosta EP (2015) Valganciclovir for congenital cytomegalovirus. N Engl J Med 372(25):2463

    CAS  PubMed  Google Scholar 

  11. Capretti MG, Marsico C, Guidelli Guidi S, Ciardella A, Simonazzi G, Galletti S et al (2017) Neonatal and long-term ophthalmological findings in infants with symptomatic and asymptomatic congenital cytomegalovirus infection. J Clin Virol 97:59–63

    Article  PubMed  Google Scholar 

  12. Istas AS et al (1995) Surveillance for congenital cytomegalovirus disease: a report from the National Congenital Cytomegalovirus Disease Registry. Clin Infect Dis 20(3):665–670

    Article  CAS  PubMed  Google Scholar 

  13. Boppana S et al (1994) Late onset and reactivation of chorioretinitis in children with congenital cytomegalovirus infection. Pediatr Infect Dis J 13(12):1139–1142

    Article  CAS  PubMed  Google Scholar 

  14. Coors LE, Spencer R (2010) Delayed presentation of cytomegalovirus retinitis in an infant with severe congenital cytomegalovirus infection. Retina 30(4 Suppl):S59-62

    Article  PubMed  Google Scholar 

  15. Stagno S et al (1977) Auditory and visual defects resulting from symptomatic and subclinical congenital cytomegaloviral and toxoplasma infections. Pediatrics 59(5):669–678

    Article  CAS  PubMed  Google Scholar 

  16. Jin HD et al (2017) Long-term visual and ocular sequelae in patients with congenital cytomegalovirus infection. Pediatr Infect Dis J 36(9):877–882

    Article  PubMed  PubMed Central  Google Scholar 

  17. Ghekiere S et al (2012) Ophthalmological findings in congenital cytomegalovirus infection: When to screen, when to treat? J Pediatr Ophthalmol Strabismus 49(5):274–282

    Article  PubMed  Google Scholar 

  18. Shoji K et al (2010) Is a 6-week course of ganciclovir therapy effective for chorioretinitis in infants with congenital cytomegalovirus infection? J Pediatr 157(2):331–333

    Article  PubMed  Google Scholar 

  19. E D K (2019) When and how to treat neonatal CMV infection. In: Benitz WE (ed) Infectious Disease and pharmacology: neonatology questions and controversies. Elsevier, p 11

  20. Conboy TJ et al (1987) Early clinical manifestations and intellectual outcome in children with symptomatic congenital cytomegalovirus infection. J Pediatr 111(3):343–348

    Article  CAS  PubMed  Google Scholar 

  21. Lim Y, Lyall H (2017) Congenital cytomegalovirus - who, when, what-with and why to treat? J Infect 74(Suppl 1):S89–S94

    Article  PubMed  Google Scholar 

Download references

Funding

The authors declare that no funds, grants, or other support were received during the preparation of this manuscript.

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Author notes

  1. Michael Mimouni, Liron Naftali Ben-Haim, Liron Borenstein-Levin and Shiri Zayit-Soudry have contributed equally to this manuscript.

Authors and Affiliations

  1. Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel

    Michael Mimouni, Efrat Naaman, Yonina Ron, Eedy Mezer & Shiri Zayit-Soudry

  2. Ruth and Bruch Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    Michael Mimouni, Liron Naftali Ben-Haim, Efrat Naaman, Alex Bebin, Yonina Ron, Eedy Mezer, Ori Hochwald, Liron Borenstein-Levin & Shiri Zayit-Soudry

  3. Department of Neonatology, Ruth Rappaport Children’s Hospital, Rambam Health Care Campus, Haifa, Israel

    Ori Hochwald & Liron Borenstein-Levin

Authors
  1. Michael Mimouni
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  2. Liron Naftali Ben-Haim
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  3. Efrat Naaman
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  4. Alex Bebin
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  5. Yonina Ron
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  6. Eedy Mezer
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  7. Ori Hochwald
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  8. Liron Borenstein-Levin
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  9. Shiri Zayit-Soudry
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Contributions

M.M and S.Z.S conceived the presented idea, M.M, L.N.B.H and E.N wrote the manuscript with support from S.Z.S and L.B. S.Z.S, Y,R, E.M performed the patient's ophthalmological tests, L.B.L, O.H, A.B collected medical records data. M.M, L.N, B.H, LB and A.B analysed and interpreted the data. S.Z.S supervised the project. All authors provided critical feedback aided in interpreting the results and reviewed the manuscript.

Corresponding author

Correspondence to Michael Mimouni.

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No conflicting relationship exists for any author.

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Dr Michael Mimouni is a member of the editorial board of the International Ophthalmology journal

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Mimouni, M., Ben-Haim, L.N., Naaman, E. et al. Is there room for prompt routine ophthalmic examination in neonates with congenital cytomegalovirus (CMV) infection during the neonatal period?. Int Ophthalmol 43, 3667–3672 (2023). https://doi.org/10.1007/s10792-023-02775-2

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