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Graefe's Archive for Clinical and Experimental Ophthalmology

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25-10-2023 | Rubella | Retinal Disorders

Fundus imaging features of congenital rubella retinopathy

Authors: Benjamin I. Meyer, Albert Liao, Gregory E. Sanda, Caroline Craven, Jill R. Wells, Andrew M. Hendrick, Jiong Yan, Nieraj Jain

Published in: Graefe's Archive for Clinical and Experimental Ophthalmology | Issue 3/2024

Abstract

Purpose

To evaluate the clinical characteristics of congenital rubella retinopathy (CRR) with modern fundus imaging.

Methods

Single-center case series. Eleven patients (2005–2020) at the Emory Eye Center with known or presumed CRR. Trained image readers reviewed fundus imaging (color fundus photography, widefield pseudocolor imaging, near-infrared reflectance imaging, autofluorescence imaging, and spectral-domain optical coherence tomography) for pre-specified features suggestive of CRR.

Results

Eleven patients with confirmed (63.6%) or presumed (36.3%) CRR were identified. All were female with median (range) age of 53 (35–67) years. Six (54.5%) were born during the 1964–1965 United States rubella epidemic. All had congenital hearing loss. Two (18.2%) had a congenital heart defect. Eleven (50.0%) eyes had salt-and-pepper retinal pigmentary changes. Twenty-two eyes (100.0%) had irregularly distributed regions of speckled hypoautofluorescence. One eye (4.5%) had a presumed macular neovascularization.

Conclusion

Modern fundus imaging demonstrates characteristic features of CRR, even when pigmentary changes are not readily apparent on examination. Widefield autofluorescence findings of irregularly distributed speckled hypoautofluorescence are particularly revealing. This series of newly diagnosed adults with CRR may represent the milder end of the phenotypic spectrum of this condition, highlighting imaging findings that may aid in diagnostically challenging cases of CRR.

Bouthry E, Picone O, Hamdi G, Grangeot-Keros L, Ayoubi JM, Vauloup-Fellous C (2014) Rubella and pregnancy: diagnosis, management and outcomes. Prenat Diagn 34:1246–1253. https://doi.org/10.1002/pd.4467CrossRefPubMed

Cooper LZ, Alford CA (2006) Chapter 28 - Rubella. In: Remington JS, Klein JO, Wilson CB, Baker CJ (eds) Infectious diseases of the fetus and newborn infant, 6th edn. W.B. Saunders, Philadelphia, pp 893–926CrossRef

Gregg NM (1991) Congenital cataract following German measles in the mother. 1941. Aust N Z J Ophthalmol 19:267–276ADSPubMed

Vynnycky E, Adams EJ, Cutts FT, Reef SE, Navar AM, Simons E, Yoshida L-M, Brown DWJ, Jackson C, Strebel PM, Dabbagh AJ (2016) Using seroprevalence and immunisation coverage data to estimate the global burden of congenital rubella syndrome, 1996–2010: a systematic review. PLoS ONE 11:e0149160. https://doi.org/10.1371/journal.pone.0149160CrossRefPubMedPubMedCentral

(CDC) CfDCaP (2013) Three cases of congenital rubella syndrome in the postelimination era–Maryland, Alabama, and Illinois, 2012. MMWR Morb Mortal Wkly Rep 62:226–229

National Center for Immunization and Respiratory Diseases (NCIRD) DoVD (2020) Rubella in the U.S. In: Prevention CfDCa (ed) CDC.gov

Givens KT, Lee DA, Jones T, Ilstrup DM (1993) Congenital rubella syndrome: ophthalmic manifestations and associated systemic disorders. Br J Ophthalmol 77:358–363. https://doi.org/10.1136/bjo.77.6.358CrossRefPubMedPubMedCentral

Arnold JJ, McIntosh ED, Martin FJ, Menser MA (1994) A fifty-year follow-up of ocular defects in congenital rubella: late ocular manifestations. Aust N Z J Ophthalmol 22:1–6. https://doi.org/10.1111/j.1442-9071.1994.tb01687.xCrossRefPubMed

Yazigi A, De Pecoulas AE, Vauloup-Fellous C, Grangeot-Keros L, Ayoubi JM, Picone O (2017) Fetal and neonatal abnormalities due to congenital rubella syndrome: a review of literature. J Matern Fetal Neonatal Med 30:274–278. https://doi.org/10.3109/14767058.2016.1169526CrossRefPubMed

10.

Bukowska DM, Wan SL, Chew AL, Chelva E, Tang I, Mackey DA, Chen FK (2017) Fundus autofluorescence in rubella retinopathy: correlation with photoreceptor structure and function. Retina 37:124–134. https://doi.org/10.1097/iae.0000000000001130CrossRefPubMed

11.

Abdalla Elsayed MEA, Hamweyah K, Al-Kharashi A, Schatz P (2018) Multimodal imaging in serologically confirmed rubella retinopathy. Graefes Arch Clin Exp Ophthalmol 256:1791–1794. https://doi.org/10.1007/s00417-018-4045-2CrossRefPubMed

12.

Goldberg N, Chou J, Moore A, Tsang S (2009) Autofluorescence imaging in rubella retinopathy. Ocul Immunol Inflamm 17:400–402. https://doi.org/10.3109/09273940903118634CrossRefPubMedPubMedCentral

13.

Bhardwaj S, Modi YS (2017) Multimodal imaging of congenital rubella retinopathy. Ophthalmol Retina 1:559. https://doi.org/10.1016/j.oret.2017.07.017CrossRefPubMed

14.

Phadke VK, Bednarczyk RA, Omer SB (2020) Vaccine refusal and measles outbreaks in the US. JAMA. https://doi.org/10.1001/jama.2020.14828CrossRefPubMed

15.

Sadda SR, Guymer R, Holz FG, Schmitz-Valckenberg S, Curcio CA, Bird AC, Blodi BA, Bottoni F, Chakravarthy U, Chew EY, Csaky K, Danis RP, Fleckenstein M, Freund KB, Grunwald J, Hoyng CB, Jaffe GJ, Liakopoulos S, Monés JM, Pauleikhoff D, Rosenfeld PJ, Sarraf D, Spaide RF, Tadayoni R, Tufail A, Wolf S, Staurenghi G (2018) Consensus definition for atrophy associated with age-related macular degeneration on OCT: classification of atrophy report 3. Ophthalmology 125:537–548. https://doi.org/10.1016/j.ophtha.2017.09.028CrossRefPubMed

16.

Meyer BI, Jain N (2021) Salt-and-pepper retinopathy in a woman with hearing loss. JAMA Ophthalmol. https://doi.org/10.1001/jamaophthalmol.2020.4624CrossRefPubMedPubMedCentral

17.

Tsang SH, Sharma T (2018) Rubella retinopathy. Adv Exp Med Biol 1085:215–217. https://doi.org/10.1007/978-3-319-95046-4_45CrossRefPubMed

18.

Damasceno N, Damasceno E, Souza E (2010) Acquired unilateral rubella retinopathy in adult. Clin Ophthalmol 5:3–4. https://doi.org/10.2147/opth.S15273CrossRefPubMedPubMedCentral

19.

Slusher MM, Tyler ME (1982) Rubella retinopathy and subretinal neovascularization. Ann Ophthalmol 14:292–294PubMed

20.

Boniuk M, Zimmerman LE (1967) Ocular pathology in the rubella syndrome. Arch Ophthalmol 77:455–473. https://doi.org/10.1001/archopht.1967.00980020457008CrossRefPubMed

21.

Sarna T (1992) Properties and function of the ocular melanin–a photobiophysical view. J Photochem Photobiol B 12:215–258. https://doi.org/10.1016/1011-1344(92)85027-rCrossRefPubMed

22.

Williams LL, Lew HM, Shannon BT, Singley CT, Davidorf FH, Jin R, Wolinsky JS (1993) Phagocytosis of latex beads is defective in cultured human retinal pigment epithelial cells with persistent rubella virus infection. Am J Pathol 142:451–461PubMedPubMedCentral

23.

Lee JY, Bowden DS, Marshall JA (1996) Membrane junctions associated with rubella virus infected cells. J Submicrosc Cytol Pathol 28:101–108PubMed

24.

Claus C, Schönefeld K, Hübner D, Chey S, Reibetanz U, Liebert UG (2013) Activity increase in respiratory chain complexes by rubella virus with marginal induction of oxidative stress. J Virol 87:8481–8492. https://doi.org/10.1128/jvi.00533-13CrossRefPubMedPubMedCentral

25.

George S, Viswanathan R, Sapkal GN (2019) Molecular aspects of the teratogenesis of rubella virus. Biol Res 52:47. https://doi.org/10.1186/s40659-019-0254-3CrossRefPubMedPubMedCentral

26.

Mathur P, Yang J (2015) Usher syndrome: hearing loss, retinal degeneration and associated abnormalities. Biochim Biophys Acta 1852:406–420. https://doi.org/10.1016/j.bbadis.2014.11.020CrossRefPubMed

27.

Tsang SH, Aycinena ARP, Sharma T (2018) Mitochondrial disorder: maternally inherited diabetes and deafness. Adv Exp Med Biol 1085:163–165. https://doi.org/10.1007/978-3-319-95046-4_31CrossRefPubMed

28.

Bellmann C, Neveu MM, Scholl HP, Hogg CR, Rath PP, Jenkins S, Bird AC, Holder GE (2004) Localized retinal electrophysiological and fundus autofluorescence imaging abnormalities in maternal inherited diabetes and deafness. Invest Ophthalmol Vis Sci 45:2355–2360. https://doi.org/10.1167/iovs.03-1090CrossRefPubMed

29.

Birtel J, von Landenberg C, Gliem M, Gliem C, Reimann J, Kunz WS, Herrmann P, Betz C, Caswell R, Nesbitt V, Kornblum C, Charbel Issa P (2022) Mitochondrial retinopathy. Ophthalmology Retina 6:65–79. https://doi.org/10.1016/j.oret.2021.02.017CrossRefPubMed

30.

Pearce WA, Chen R, Jain N (2018) Pigmentary maculopathy associated with chronic exposure to pentosan polysulfate sodium. Ophthalmology 125:1793–1802. https://doi.org/10.1016/j.ophtha.2018.04.026CrossRefPubMed

Title: Fundus imaging features of congenital rubella retinopathy
Authors: Benjamin I. Meyer
Albert Liao
Gregory E. Sanda
Caroline Craven
Jill R. Wells
Andrew M. Hendrick
Jiong Yan
Nieraj Jain
Publication date: 25-10-2023
Publisher: Springer Berlin Heidelberg
Keyword: Rubella
Published in: Graefe's Archive for Clinical and Experimental Ophthalmology / Issue 3/2024
Print ISSN: 0721-832X
Electronic ISSN: 1435-702X
DOI: https://doi.org/10.1007/s00417-023-06284-x

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Fundus imaging features of congenital rubella retinopathy

Abstract

Purpose

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusion

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