Abstract Details
9/09/2025 | 2:15 PM - 3:15 PM | Breakout 6 | Thomas H. Swain
Ophthalmic Findings in Newborns with cCMV since institution of Universal Newborn Screening in Minnesota
Abstract Summary
While one in 200 children are born with congenital CMV, there is little known about the findings and natural history of ophthalmic changes in immunocompetent infants. This is especially true for those infants who are otherwise asymptomatic. Recent adoption of universal newborn screening for cCMV has brought the need to understand ophthalmic outcomes, and who needs ophthalmic screening to the forefront. Since February 6, 2023 124,809 newborns were screened (through 2/28/25), with 396 screening positive for cCMV. Of these, four babies were found to have ocular abnormalities (1%). Two of these infants were otherwise asymptomatic and were found to have macular scars. The question remains as to how to best attribute these findings in context of cCMV. Experience has shown that to best determine how likely the ophthalmic changes are due to cCMV and to guide our understanding of how to screen and follow these patients in the future, a more consistent approach is needed. We recommend that all cCMV infants undergo an eye exam within weeks, a follow-up exam at 3 months of age, and then annually to age 5 if no abnormalities are found. As we do not yet understand if cCMV retinal changes are exclusive to the posterior pole we encourage providers to do scleral depression peripheral retinal exam as part of the initial evaluations. Finally, if exam is positive for a retinal or optic nerve finding these infants warrant an eye exam under anesthesia with intravenous fluorescein angiography and retcam photography. Consideration should be made to consulting a retinal specialist, ideally a pediatric retina specialist. With this data decisions can best be made in consultation with pediatric infectious disease specialists.
Learning Objectives
- Understand what is currently known about CMV ophthalmic/visual impacts in Minnesota’s screened population
- Learn about screening for ophthalmic findings
- Learn how to address positive findings
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Presenters
Sasha Strul | Primary Presenter
sstrul@umn.edu ;
Dr. Sasha Strul is a pediatric ophthalmologist, who provides care for a wide range of pediatric eye diseases and treats pediatric and adult strabismus. Beyond her clinical practice at the University of Minnesota, she has the privilege of directorship of the UMN’s Albinism Database and serves on the National Organization for Albinism and Hypopigmentation’s Scientific Board. Her research interests also include congenital CMV, pediatric diabetic retinopathy, medical education, strabismus, and amblyopia. Her goal is to center patients and families across care and research and prepare future providers to have long and fruitful careers.
ASHA DISCLOSURE
Financial - No relevant financial relationship exists.
Nonfinancial - No relevant nonfinancial relationship exists.
AAA DISCLOSURE
Financial - No relevant financial relationship exists.
Erick Bothun | Co-Author
Bothun.Erick@mayo.edu ;
Erick D. Bothun, M.D., is a pediatric ophthalmologist with expertise in pediatric cataract or lens abnormalities and strabismus. His areas of focus and research include:
Surgical and clinical care of complex pediatric cataract and anterior segment anomalies
Complex strabismus surgery including related to Cranial nerve palsy, Duane syndrome, post traumatic and Thyroid eye disease in adults and children
Surgical procedures for nystagmus and ocular torsion in adults and children
Dr. Bothun is recognized as a principal investigator for multiple national multicenter studies including the Infant Aphakia Treatment Study, the Toddler Aphakia and Pseudophakia Study, and the Pediatric Artisan Aphakic Lens study.
His current and past leadership roles include Mayo Clinic Department of Ophthalmology Quality Chair, the President of the Minnesota Academy of Ophthalmology, and Board member for American Association for Pediatric Ophthalmology and Strabismus. Dr. Bothun shares his expertise through international service and education endeavors.
ASHA DISCLOSURE
Financial -
Nonfinancial -
AAA DISCLOSURE
Financial - No relevant financial relationship exists.