HISTOPATHOLOGIC BASIS FOR OCULAR MANIFESTATIONS OF CONGENITAL RUBELLA SYNDROME - 8TH WILDER,WH MEMORIAL LECTURE

For 20 years following the first publications by Gregg, Swan, and their Australian colleagues, no significant advances were made toward establishing the pathogenesis of malformations resulting from congenital rubella infection. Recovery of the virus and the development of microbiologic methods for detection of rubella infection in asymptomatic subjects and in newborn babies, followed almost immediately by the country's first massive epidemics of the disease in many years, permitted the acquisition of an amazing amount of information and tremendous advances in our knowledge of the pathologic anatomy and pathogenesis of ocular changes caused by maternal rubella. Now it is firmly established that the ocular malformations observed in rubella babies are the result of actual infection of the affected tissues of the eye, and that this infection may persist for months after birth. The infection characteristically is accompanied by a low-grade uveitis that previously had not been recognized as a typical clinical feature of congenital rubella. Microscopic examination of the eye has established a number of histopathologic characteristics that should prove useful in the differential diagnosis of congenital cataracts and glaucoma caused by rubella from similar malformations caused by other factors. Application of general principles that have been elucidated concerning the effects of the rubella virus on cell growth and function to the teratogenic effect of maternal rubella has largely accounted for many of the mysterious aspects of Gregg's syndrome, but there still remain certain problems for future research to answer. The development of the congenital rubella syndrome in laboratory animals should provide a welcome substitute for the serendipitous accumulation of knowledge that has characterized advances of the past few years. © 1968.