This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on ISI (5)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Cataracts/ Lens  • Pediatric Ophthalmology  • Alert me on articles by topic  Social Bookmarking   What's this?

Rajiv Khandekar, MS (Ophth) PGDip Epi; Salah Al Awaidy, PGDip Epi; Anuradha Ganesh, MRCOphth; Shyam Bawikar, MD, MPH

Arch Ophthalmol. 2004;122:541-545.

Objective  To conduct a follow-up study in patients with congenital rubella syndrome (CRS) in Oman and analyze the prevalence of ophthalmic disorders and associated systemic problems.

Methods  This historical prospective cohort study included review of 32 surviving patients with CRS reported by the surveillance system in Oman from 1987 through 2002. All patients underwent a complete ophthalmic examination that included visual acuity estimation, refraction and anterior and posterior segment evaluation, and intraocular pressure measurement. Pediatric and otorhinolaryngologic consultations were also performed.

Results  The age-adjusted prevalence of CRS in Oman was 73.2 per million in the Omani population younger than 20 years, and the incidence was 0.6 per 1000 live births. Cataract, retinitis, microphthalmos, and glaucoma were observed in 11, 16, 6, and 4 patients, respectively. Keratoconus, corneal hydrops, and spontaneous resorption of lens were found in 1 patient each. Vision testing was possible in 16 children; 4 were bilaterally blind. Patients who had undergone eye surgery had significantly lower visual acuity, as compared with those who had not undergone surgery (relative risk 2.53; 95% confidence interval, 1.07-6.13). Among the 11 patients with CRS with cataract, we found hearing loss, cardiac anomalies, and neuropsychologic anomalies in 7, 4, and 6 children, respectively.

Conclusions  Congenital rubella syndrome has a wide variety of severe ophthalmic and systemic complications. High clinical vigilance for signs of CRS and regular observation of surviving patients with CRS is desirable. In patients with cataract, the functional results of surgery, despite state-of-the-art ophthalmic care, continue to be poor. Because of a high prevalence of visual, audiologic, and neurologic disabilities, surviving patients with CRS pose a burden on the medical and social communities. Emphasis in management ought to be prevention of CRS through effective immunization programs.

From the Eye and Ear Health Care Programme, Ministry of Health (Dr Khandekar); Department of Disease Surveillance and Disease Control, Ministry of Health (Dr Al Awaidy); Department of Ophthalmology, Sultan Qaboos University Hospital (Dr Ganesh); and Department of Disease Surveillance and Disease Control, Ministry of Health (Dr Bawikar), Muscat, Oman. The authors have no relevant financial interest in this article.

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?