Manifestations ophtalmologiques de la rubéole congénitale

RésuméLa rubéole congénitale est une affection rare mais grave, associant des anomalies auriculaires, neurologiques, cardiaques, urinaires, et des anomalies oculaires à type de cataracte congénitale, de glaucome congénital, de microphtalmie, et de troubles oculomoteurs. Nous rapportons le cas d’une fillette âgée de 6 ans ayant consulté pour une baisse de l’acuité visuelle de l’œil droit qui révélait une cataracte unilatérale liée à une rubéole congénitale. La prévention de la rubéole congénitale repose sur la vaccination systématique des enfants. L’association cataracte congénitale-surdité et malformation cardiaque doit faire systématiquement rechercher cette affection puisqu’elle peut s’associer à des manifestations systématiques parfois plus graves.

SummaryCongenital rubella is a rare and serious disease including auditory neurological, cardiac, urinary, and ocular abnormalities. The eye complaints are often congenital cataract, congenital glaucoma, microphthalmia, and oculomotor disorders. We report the case of a 6-year-old girl presenting with a unilateral congenital cataract associated with congenital rubella. She was referred for complaints of high myopia in her right eye. She had a family history of cardiac and urogenital malformations, and presented deafness at birth. The ophthalmologic examination showed a microcornea and a unilateral dense congenital cataract in the right eye. B-scan ophthalmic ultrasound revealed a posterior microphthalmos. The anterior segment examination of the left eye was normal. Funduscopy revealed a salt-and-pepper appearance. Laboratory tests revealed a positive serology, confirming the congenital rubella. Given her complaints of loss of visual acuity in the right eye, the patient was operated on with a phacoaspiration implant in the capsular bag. The postoperative course was uneventful. The prevention of congenital rubella is based on routine vaccination of children. The association of cataract, congenital heart defects, and deafness must be systematically investigated as it may be more serious in association with systemic manifestations.