ABSTRACT
Purpose : The main purpose of this study is to describe the fundoscopic alterations and retinal vessel caliber measurements in SARS-CoV2 positive patients admitted to a tertiary referral hospital in Madrid (Spain) and to correlate the retinal vessel caliber with the severity of the disease. Methods : A single-center cross-sectional observational study to document the retinal vascular findings in SARS-CoV2 patients admitted to a tertiary Hospital during the first wave in Madrid, Spain. Fundoscopy was performed in both eyes (when possible) with a manual retinography Zeiss Visuscout 100. All patients signed a consent form to participate in the study. Pharmacological mydriasis prior to retinography was achieved by applying one drop of tropicamide 1% in each eye. Data collected included previous medical and ophthalmic history, prescribed medical and postural treatments, and laboratory findings at the time of admission. All cases were classified according to their outcome as per the WHO clinical progression scale on a scale of 0 to 10, with being 0 the uninfected state and 10 being death. All the retinal images were analysed by two medical retina experts independently. Retinal vessel calibers were measured by a single masked grader using a validated research software with high reproducibility.The relationship between the WHO clinical progression scale and retinal vessel caliber was assessed by Kruskal-Wallis test for independent samples. Results : In total, 81 patients and 154 eyes were included in the study. The fundus retinal assessment disclosed signs of hypertensive retinopathy in 8 right eyes (OD) (8/77) and 9 left eyes (OS) (9/77);vascular tortuosity was present in 13 OD (13/77) and 13 OS (13/77);age-related macular degeneration was found in 13 OD (13/77) and 12 OS (12/77);myopic retinopathy in 3 OD (3/77) and 3 OS (3/77);finally incidental choroidal nevi were found in 4 OD (4/77) and 2 OS (2/77). The retinal microvascular caliber assessment was performed in a total of 72 eyes from 72 subjects, the right eye was used in 61 cases, left eye in the rest. There was no statistically significant difference according to vessel caliber and WHO outcome score. Conclusions : COVID-19 has been linked to an increase risk of cardiovascular events. However, we could not find a correlation among retinal vascular findings and clinical outcome in our cohort.
ABSTRACT
The diagnosis of the post-COVID condition is usually achieved by excluding other diseases; however, cognitive changes are often found in the post-COVID disorder. Therefore, monitoring and treating the recovery from the post-COVID condition is necessary to establish biomarkers to guide the diagnosis of symptoms, including cognitive impairment. Our study employs a prospected cohort and nested case-control design with mixed methods, including statistical analyses, interviews, and focus groups. Our main aim is to identify biomarkers (functional and structural neural changes, inflammatory and immune status, vascular and vestibular signs and symptoms) easily applied in primary care to detect cognitive changes in post-COVID cases. The results will open up a new line of research to inform diagnostic and therapeutic decisions with special considerations for cognitive impairment in the post-COVID condition.
ABSTRACT
PURPOSE: To explore whether the virtual retina clinic (VRC) has been a useful and safe platform for monitoring retinal diseases during the COVID-19 pandemic and assessing patient satisfaction. METHODS: A prospective observational study was conducted for patients with stable retinal diseases in Donostia University Hospital's Ophthalmology Service during the pandemic. All patients were assessed in the VRC with optical coherence tomography of the macula and widefield retinography, plus visual field tests in hydroxychloroquine retinopathy screenings. The VRC´s effectiveness was evaluated with repeat blind assessments and patient satisfaction with an adapted SERVQUAL scale. RESULTS: The most common diseases were diabetic retinopathy (30.3%) and age-related macular degeneration (21.8%). Most patients (74%) were eligible to continue in the VRC, 19.3% were referred to face-to-face (F2F) appointments and 6.6% were discharged. Patients underwent repeat blind assessments in F2F appointments to monitor VRC performance in 23.7% of the cases. The sensitivity to detect disease progression was 100%. The specificity was 80.1%. The VRC took half the time. The patient overall satisfaction rating was 9.8/10. CONCLUSION: The VRC, as an additional platform, supports F2F appointments. Almost three-quarters of patients could continue being safely seen in the VRC. The virtual approach decreases SARS-CoV-2 exposure. Patient satisfaction is very good. TRANSLATIONAL RELEVANCE: The VRC enables us to attend patients safely with decreased SARS-CoV-2 exposure.