An epidemiological and clinical study of ocular manifestations of congenital rubella syndrome in Omani children.
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.
Khandekar
Rajiv
R
Eye and Ear Health Care Programme, Non-communicable Disease Control Department, Directorate General of Health Affairs, Ministry of Health, PO Box 393, Pin 113, Muscat, Oman. rajshpp@omantel.net.om
Al Awaidy
Salah
S
Ganesh
Anuradha
A
Bawikar
Shyam
S
D000293:Adolescent; D000328:Adult; D002386:Cataract / Q000175:diagnosis / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003316:Corneal Diseases / Q000175:diagnosis / Q000453:epidemiology; D005128:Eye Diseases / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D005500:Follow-Up Studies; D005901:Glaucoma / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008297:Male; D008850:Microphthalmos / Q000175:diagnosis / Q000453:epidemiology; D009850:Oman / Q000453:epidemiology; D015995:Prevalence; D011446:Prospective Studies; D012173:Retinitis / Q000175:diagnosis / Q000453:epidemiology; D012410:Rubella Syndrome, Congenital / Q000175:diagnosis / Q000453:epidemiology*