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1.
BMC Ophthalmol ; 21(1): 452, 2021 Dec 27.
Article in English | MEDLINE | ID: covidwho-1639496

ABSTRACT

BACKGROUND: We report one case of rare acute macular neuroretinopathy (AMN) in an elderly patient with hypertension and one case of common paracentral acute middle maculopathy (PAMM) in a patient with diabetes mellitus to illustrate the difference between the two diseases. CASE PRESENTATION: This report describes two cases, one involving AMN and the other PAMM. The first patient was a 70-year-old man complaining of blurred vision for 3 days. He was examined with fundus photography, optical coherence tomography angiography (OCTA) and optical coherence tomography (OCT); a diagnosis of AMN was established. The second patient was a 50-year-old woman who complained of decreased vision during the past month. She had had diabetes mellitus for 6 years. From the ophthalmic imaging examination, the patient was diagnosed with PAMM and non-proliferative diabetic retinopathy (NPDR). Both patients were treated with drugs for improving microcirculation and neurotrophic drugs; however, there was no significant improvement in visual acuity. CONCLUSIONS: AMN is more common in young patients and is rarely observed in elderly patients with systemic diseases. The OCTA examination has an auxiliary diagnostic value for deep retinal capillary network ischaemia. Meanwhile, OCT examination has important imaging value in differentiating AMN from PAMM and can help avoid missed diagnoses.


Subject(s)
Macular Degeneration , Retinal Diseases , White Dot Syndromes , Acute Disease , Aged , Female , Fluorescein Angiography , Humans , Male , Middle Aged , Retinal Diseases/diagnosis , Tomography, Optical Coherence
2.
Retina ; 41(4): 701-705, 2021 04 01.
Article in English | MEDLINE | ID: covidwho-1511061

ABSTRACT

PURPOSE: To describe our managing strategy for COVID-19 emergency, to evaluate the adherence to intravitreal treatment (AtT) rate during the outbreak in a referral hospital in Milan, and to correlate it with patients' clinical features. METHODS: The AtT rate of patients with scheduled intravitreal injections during the COVID-19 outbreak from February 23, 2020 to March 31, 2020 was compared with the previous trimester and with March 2019. The impact of age, sex, visual function, and diagnosis on the AtT rate during unlocked/locked weeks (from March 8th) was evaluated. RESULTS: Of 650 consecutive patients with scheduled intravitreal injections, the AtT rate during the COVID-19 outbreak was 0.37. This was significantly lower compared with AtT registered in the previous trimester (0.92) and in the same weeks in 2019 (0.90) (both P < 0.001). Patients adherent to treatment were significantly younger (P < 0.001) and had a lower best-corrected visual acuity in the fellow eye (P = 0.046). During the lockdown weeks, the AtT rate was significantly lower than in the two unlocked weeks (0.19 vs. 0.73, P < 0.001). In addition, the AtT rate in patients classified as "emergent" during the lockdown weeks was 0.60. CONCLUSION: These preliminary results can help the retina specialist community to foresee this unique scenario and to develop successful management strategies.


Subject(s)
Angiogenesis Inhibitors/therapeutic use , Appointments and Schedules , COVID-19/epidemiology , Choroidal Neovascularization/drug therapy , Macular Edema/drug therapy , SARS-CoV-2 , Wet Macular Degeneration/drug therapy , Aged , Aged, 80 and over , COVID-19/transmission , Choroidal Neovascularization/diagnostic imaging , Choroidal Neovascularization/physiopathology , Communicable Disease Control/methods , Female , Fluorescein Angiography , Humans , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Intravitreal Injections , Italy/epidemiology , Macular Edema/diagnostic imaging , Macular Edema/physiopathology , Male , Referral and Consultation/statistics & numerical data , Tomography, Optical Coherence , Visual Acuity/physiology , Wet Macular Degeneration/diagnostic imaging , Wet Macular Degeneration/physiopathology
3.
J Fr Ophtalmol ; 44(10): 1484-1490, 2021 Dec.
Article in French | MEDLINE | ID: covidwho-1509999

ABSTRACT

Coronavirus disease (COVID-19) can result in many ocular manifestations. We report a rare case of bilateral central serous chorioretinopathy post-infection with COVID-19 in a 38-year-old woman who presented with bilateral blurred vision 1 month after infection with COVID-19. She reported fever, cough, and shortness of breath and was COVID-PCR positive. During her 10-day hospital stay, she received oxygen, antibiotics, heparin and corticosteroids intravenously and then orally. After her recovery from COVID-19, the patient developed progressive visual loss in both eyes: her corrected visual acuity was 3/10 in both eyes, the anterior segment was normal, and the vitreous was clear. Fundus examination, optical coherence tomography and fluorescein angiography showed bilateral serous retinal detachments. Her course was characterized by improvement in visual acuity and regression of the retinal detachments. Central serous chorioretinopathy can occur after COVID-19 infection due to the administration of corticosteroids; thus, ophthalmologic examination is essential to detect ocular involvement as early as possible.


Subject(s)
COVID-19 , Central Serous Chorioretinopathy , Adult , Central Serous Chorioretinopathy/diagnosis , Central Serous Chorioretinopathy/etiology , Female , Fluorescein Angiography , Fundus Oculi , Humans , SARS-CoV-2 , Tomography, Optical Coherence
4.
BMJ Case Rep ; 14(11)2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1495132

ABSTRACT

To date, COVID-19 has no definite effective targeted therapy, and management is primarily supportive. Central retinal vein occlusion (CRVO) is frequently caused by systemic risk factors posing hypercoagulable states. In April 2020, a female patient with a history of hypertension, diabetes mellitus and chronic kidney disease presented with 2 days of loose, watery stools, nasal congestion and severe lethargy. The patient denied dyspnoea or fever. A week after the initial symptoms, the patient reported decreased vision from the left eye. Dilated funduscopy and fluorescein angiography suggested hemi-CRVO. The patient refused intravitreal antivascular endothelial growth factor agents because of non-severe visual loss. Testing was positive for COVID-19 IgG antibodies; reverse transcription PCR was not available. Vision improved within 3 weeks of presentation. We recommend that clinicians keep a high suspicion for acute onset of thrombotic events in patients with COVID-19 and thrombotic predisposing risk factors.


Subject(s)
COVID-19 , Retinal Vein Occlusion , Female , Fluorescein Angiography , Humans , Ophthalmoscopy , Retinal Vein Occlusion/diagnosis , Retinal Vein Occlusion/drug therapy , Retinal Vein Occlusion/etiology , SARS-CoV-2
5.
Sci Rep ; 11(1): 19373, 2021 09 29.
Article in English | MEDLINE | ID: covidwho-1442809

ABSTRACT

Coronavirus disease 2019 (COVID-19) is an infectious disease caused by SARS-CoV-2 primarily affecting the respiratory system which can damage vessels walls virtually in any body district. Changes affecting retinal vessels are a good marker for systemic vascular alterations. This study investigated retinal vessels during the acute phase of COVID-19 and after patients recovery. Fifty-nine eyes from 32 COVID-19 patients and 80 eyes from 53 unexposed subjects were included. Mean arteries diameter (MAD) and mean veins diameter (MVD) were assessed through semi-automatic analysis on fundus color photos at baseline and 6 months later in patients and subjects unexposed to the virus. At baseline MAD and MVD were significantly higher in COVID-19 patients compared to unexposed subjects (p < 0.0001). Both MAD and MVD significantly decreased in COVID-19 patients at follow-up (from 97.5 ± 10.9 to 92.2 ± 11.4 µm, p < 0.0001 and from 133.1 ± 19.3 to 124.6 ± 16.1 µm, p < 0.0001, respectively). Despite this reduction vessels diameter remained significantly higher in severe COVID-19 patients compared to unexposed subjects. Transient retinal vessels dilation could serve a biomarker for systemic inflammation while long-lasting alterations seen in severe COVID-19 likely reflect irreversible structural damage to the vessels walls and should be further investigated for their possible effects on tissues perfusion and function.


Subject(s)
COVID-19/complications , Retinal Vessels/pathology , Adult , Aged , Female , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Retina/diagnostic imaging , Retina/pathology , SARS-CoV-2 , Young Adult
7.
Indian J Ophthalmol ; 69(10): 2865-2866, 2021 10.
Article in English | MEDLINE | ID: covidwho-1441265

ABSTRACT

A central retinal vein occlusion (CRVO) case in a patient developed with sudden blurred vision in some hemifield areas of his left eye, maintaining 20/20 vision 15-days after the COVID-19 vaccination. Initial retinal findings were venous dilation and tortuosity with dispersing dot hemorrhages. Fluorescein angiography (FA) and optical coherence tomography (OCT) confirmed a non-ischemic CRVO diagnosis, and a complete blood panel was requested with average results. An intravitreal steroid dose was applied. A decrease in best-corrected visual acuity (BCVA) (20/30) with more intraretinal hemorrhages was documented. An intravitreal dose of bevacizumab and oral apixaban were added with a final BCVA of 20/20 with decreased hemorrhages. There is no specific causal relationship between COVID-19 vaccines and CRVO. Without previous risk factors and positive treatment response, this case may correlate the first COVID-19 vaccine dose and the event.


Subject(s)
COVID-19 , Macular Edema , Retinal Vein Occlusion , Angiogenesis Inhibitors/adverse effects , Bevacizumab/adverse effects , COVID-19 Vaccines , Fluorescein Angiography , Humans , Intravitreal Injections , Macular Edema/drug therapy , RNA, Messenger , Retinal Vein Occlusion/diagnosis , Retinal Vein Occlusion/drug therapy , Retinal Vein Occlusion/etiology , SARS-CoV-2 , Tomography, Optical Coherence , Treatment Outcome , Vaccination/adverse effects , Visual Acuity
8.
Indian J Ophthalmol ; 69(10): 2862-2864, 2021 10.
Article in English | MEDLINE | ID: covidwho-1441262

ABSTRACT

A 35-year-old male patient presented with blurring and black spots in vision after 1 month of the second dose of Covishield vaccination. His visual acuity was 6/6; both eyes and anterior and posterior segment examinations were normal. The optical coherence tomography (OCT) showed multiple hyperreflective lesions involving the nerve fiber layer with back shadowing. In addition, there were hyperreflective spots in the ganglion cell layer and outer plexiform layer with focal loss of external limiting membrane and an intact inner segment/outer segment junction involving the posterior pole in both eyes. The patient was diagnosed with paracentral acute middle maculopathy (PAMM) and acute macular neuroretinopathy (AMN) and advised observation. PAMM and AMN are unreported manifestations following the COVID-19 vaccination.


Subject(s)
COVID-19 , Macular Degeneration , Retinal Diseases , White Dot Syndromes , Acute Disease , Adult , COVID-19 Vaccines , Fluorescein Angiography , Humans , Male , Retinal Diseases/diagnosis , Retinal Diseases/etiology , Retinal Vessels , SARS-CoV-2 , Tomography, Optical Coherence , Vaccination
9.
Indian J Ophthalmol ; 69(10): 2867-2868, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1441257

ABSTRACT

A 33-year-old male presented with history of blurring of vision in the left eye for two months. He was seen by the local ophthalmologist and diagnosed as nongranulomatous anterior uveitis in the left eye with normal fundus. He had history of fever 20 days back and was diagnosed positive for COVID-19 by RT-PCR. He presented with acute anterior uveitis in the left eye. Fundus examination revealed a cotton wool spot close to the fovea, which was confirmed by swept-source optical coherence tomography (SS-OCT) of the macula. The patient after two months' follow-up showed resolution of the cotton wool spot, which was confirmed by SS-OCT. Our case indicates that cotton wool spot can be an ocular manifestation of COVID-19 infection, and swept-source optical coherence tomography can precisely document the resolution of the lesion.


Subject(s)
COVID-19 , Tomography, Optical Coherence , Adult , Fluorescein Angiography , Fundus Oculi , Humans , Male , SARS-CoV-2
10.
Ocul Immunol Inflamm ; 29(4): 642-644, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1369009

ABSTRACT

Purpose: Coronavirus Disease 2019 (COVID-19) can cause conjunctivitis in up to 31.6% of patients. Additionally, retinal findings compatible with retinal microvascular ischemia have also been associated with coronavirus disease in asymptomatic patients. We describe a case of bilateral retinal changes compatible with microangiopathy occurring during the late phase of COVID-19.Case report: A 50-year-old man with bilateral pneumonia and positive polymerase chain reaction for SARS-CoV-2 developed an arcuate visual field defect in his left eye. Funduscopy revealed multiple, bilateral cotton-wool spots without haemorraghes. OCT-angiography revealed multifocal areas of retinal microvascular ischemia in the superficial plexus, the largest of which corresponded to the arcuate scotoma observed in the automated perimetry.Conclusion: Visual field defects due to retinal microangiopathy can occur during the late phase of COVID-19. Vascular changes observed in the retina may mimic what may be happening in other, less-accessible organs.


Subject(s)
COVID-19/complications , Capillaries/pathology , Retinal Diseases/etiology , Retinal Vessels/pathology , Fluorescein Angiography/methods , Fundus Oculi , Humans , Male , Middle Aged , Ophthalmoscopy , RNA, Viral/analysis , Retinal Diseases/diagnosis , SARS-CoV-2/genetics , Tomography, Optical Coherence/methods
11.
J Glaucoma ; 30(8): 711-717, 2021 08 01.
Article in English | MEDLINE | ID: covidwho-1358502

ABSTRACT

PRECIS: Vascular diseases have been linked to alterations in optic nerve head perfusion. PURPOSE: The main objective was to investigate the changes in peripapillary vessel density (VD) in post coronavirus disease (COVID-19) patients. METHODS: In this prospective pilot exploratory study, patients with COVID-19 that were attended in the Emergency Department of Hospital Clinico San Carlos (Madrid) were included. All patients underwent optic nerve head optical coherence tomography angiography using the Cirrus HD-OCT 500 with AngioPlex OCTA (Zeiss, Dublin, CA) 4 and 12 weeks after diagnosis by positive reverse transcriptase-polymerase chain reaction test from nasopharyngeal swab at the Emergency Department. Sociodemographic data, medical history, disease severity, and laboratory work-up were collected. RESULTS: One hundred and eighty eyes of 90 patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection were included. None of the patients reported visual changes. Severe patients were older, more frequently hispanic, dyslipidemic, and presented lower lymphocytes counts, as well as increased ferritin, D-dimer, fibrinogen, and international normalized ratio levels. No changes in optic nerve head vascularization were observed when both visits were compared. No correlation was found between VD and clinical parameters, disease severity and laboratory work-up. CONCLUSIONS: Changes to peripapillary VD were not observed in patients with COVID-19 in the early months following diagnosis.


Subject(s)
COVID-19 , Optic Disk , Fluorescein Angiography , Humans , Intraocular Pressure , Prospective Studies , Retinal Vessels , SARS-CoV-2 , Tomography, Optical Coherence
12.
Ocul Immunol Inflamm ; 29(4): 753-757, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1341060

ABSTRACT

Purpose: To report a case of bilateral choroiditis following COVID-19 vaccination.Study Design: Case report.Results: A 34-year old male presented with visual loss one week after the second dose of COVID-19 vaccine. Examination showed large serous detachment of the macula in the right eye and severe choroidal thickening noted on ultrasonography in both eyes. The patient's condition improved rapidly with oral corticosteroids with significant resolution of the serous detachments within two weeks of initiating treatment and complete visual recovery subsequently.Conclusions: The onset of ocular symptoms starting within one week following vaccination suggests an inflammatory or autoimmune response to the vaccine. Ophthalmologists should consider the option of autoimmune and other inflammatory ocular problems, which may manifest as uveitis, following COVID-19 vaccination. Timely diagnosis and treatment with corticosteroids can result in good visual and structural outcome.


Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , Multifocal Choroiditis/etiology , SARS-CoV-2 , Vaccination/adverse effects , Visual Acuity , Adult , COVID-19/virology , Choroid/pathology , Fluorescein Angiography , Fundus Oculi , Humans , Male , Multifocal Choroiditis/diagnosis , Tomography, Optical Coherence
13.
BMJ Case Rep ; 14(7)2021 Jul 27.
Article in English | MEDLINE | ID: covidwho-1329046

ABSTRACT

A 54-year-old male patient applied to our clinic with a sudden and painless loss of vision in his right eye. He was suffering from COVID-19. His best-corrected visual acuity of the right eye was finger counting from 30 cm. The fundus examination revealed the presence of a 'cherry-red spot' appearance in the right eye. In optical coherence tomography imaging, hyper-reflectivity was observed in the inner retinal layers as well as increased retinal thickness in the right eye. In fundus fluorescein angiography, delayed arterial filling and prolonged arteriovenous transit time were observed in the right eye. The patient was diagnosed with central retinal artery occlusion after the COVID-19 infection. In this study, we report this case and its management.


Subject(s)
COVID-19 , Retinal Artery Occlusion , Fluorescein Angiography , Fundus Oculi , Humans , Male , Middle Aged , Retinal Artery Occlusion/diagnosis , Retinal Artery Occlusion/etiology , SARS-CoV-2 , Tomography, Optical Coherence
15.
Ocul Immunol Inflamm ; 29(4): 730-733, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1287901

ABSTRACT

Purpose: To report acute macular neuroretinopathy (AMN) in two young women two days after receiving Vaxzevria Coronavirus disease (COVID-19) vaccination.Methods: Observational case reports.Observation: The first patient was an Italian 22-year-old female with acute onset of paracentral scotoma two days post vaccination. The second patient was an Austrian 28-year-old female who presented with sudden onset paracentral scotoma two days after vaccination. Multimodal retinal imaging was consistent with AMN in both cases. Both patients were on long-term oral contraceptives, had no history of COVID-19 and experienced one-day duration fever the day after the vaccination.Conclusions: Vaccination may represent a possible risk factor for AMN onset in women on oral contraceptives. We encourage ophthalmologists to investigate recent vaccination status when dealing with new onset AMN. Further studies are needed to assess the link between vaccinations and AMN.


Subject(s)
COVID-19 Vaccines/adverse effects , Retinal Vessels/diagnostic imaging , Vaccination/adverse effects , Visual Acuity , White Dot Syndromes/etiology , Adult , COVID-19 , Female , Fluorescein Angiography/methods , Fundus Oculi , Humans , SARS-CoV-2 , Tomography, Optical Coherence/methods , White Dot Syndromes/diagnosis
16.
Indian J Ophthalmol ; 69(7): 1956-1959, 2021 07.
Article in English | MEDLINE | ID: covidwho-1278600

ABSTRACT

The purpose of the study is to describe cilioretinal artery (CILRA) occlusion that is presumed to be associated with COVID-19 without severe respiratory distress and inform ophthalmologists of unusual ocular presentations of COVID-19. Here, we present the first case of a patient with isolated CILRA occlusion and paracentral acute middle maculopathy (PAMM) after recently polymerase chain reaction-proven COVID-19. A 26-year-old female patient presented with a visual field defect in her left eye for 2 days and decreased vision compared to her right eye. It was learned that the patient had a laboratory-proven COVID-19 infection with mild respiratory symptoms that did not require hospitalization 2 weeks ago. Fundus examination revealed retinal edema in the left eye area supplied by the CILRA. Spectral-domain optical coherence tomography revealed a prominent hyperreflective band at the inner nuclear layer level. These findings led us to the diagnosis of isolated CILRA occlusion and PAMM associated with recent COVID-19. CILRA occlusion and PAMM could be associated with the inflammatory and procoagulant condition caused by the SARS-CoV-2 infection.


Subject(s)
COVID-19 , Macular Degeneration , Adult , Ciliary Arteries , Female , Fluorescein Angiography , Humans , Retrospective Studies , SARS-CoV-2 , Tomography, Optical Coherence , Visual Acuity
17.
Photodiagnosis Photodyn Ther ; 35: 102406, 2021 Sep.
Article in English | MEDLINE | ID: covidwho-1272658

ABSTRACT

INTRODUCTION: COVID-19 infection may also occur with ocular manifestations. Paracentral acute middle maculopathy(PAMM) is a condition that causes ischemia in the inner retinal layers characterized by disruptions in capillary plexus flow. Also, ischemia in inner retinal layers secondary to COVID-19 infection has not yet been reported. CASE REPORT: The case, presented with the complaint of gradually decreasing visual acuity in the right eye after COVID-19 infection. PAMM was suspected, however, ischemia was detected in all inner retinal layers with Optical coherence tomography angiography. DISCUSSION: We showed that it should be kept in mind that atypical retinal involvement of COVID-19 infection could present, with this case.


Subject(s)
COVID-19 , Photochemotherapy , Capillaries , Fluorescein Angiography , Humans , Ischemia , Photochemotherapy/methods , Photosensitizing Agents , Retina , Retinal Vessels/diagnostic imaging , SARS-CoV-2 , Tomography, Optical Coherence
18.
Diabetes Res Clin Pract ; 177: 108902, 2021 Jul.
Article in English | MEDLINE | ID: covidwho-1252663

ABSTRACT

AIMS: To study the possibility of constructing a remote interpretation system for retinal images. METHODS: An ultra-widefield (UWF) retinal imaging device was installed in the internal medicine department specializing in diabetes to obtain fundus images of patients with diabetes. Remote interpretation was conducted at Nagoya City University using a cloud server. The medical data, severity of retinopathy, and frequency of ophthalmologic visits were analyzed. RESULTS: Four hundred ninety-nine patients (mean age, 62.5 ± 13.4 years) were included. The duration of diabetes in 240 (48.1%) patients was less than 10 years and 433 (86.7%) patients had a hemoglobin (Hb) A1c below 8%. Regarding the retinopathy severity, 360 (72.1%) patients had no diabetic retinopathy (NDR), 63 (12.6%) mild nonproliferative retinopathy (NPDR), 38 (7.64%) moderate NPDR, 13 (2.6%) severe NPDR, and 25 (5.0%) PDR. Two hundred forty-one (48.3%) patients had an ophthalmologic consultation within 1 year, 104 (20.8%) had no history of an ophthalmologic consultation. DR was not present in 86 (82.7%) patients who had never had an ophthalmologic examination, 30 (78.9%) patients with severe NPDR or PDR had had an ophthalmologic visit within 1 year. The frequency of ophthalmic visits was correlated negatively with age, diabetes duration, HbA1c, and severity of retinopathy. CONCLUSION: Remote interpretation of DR using UWF retinal imaging was useful for retinopathy screening. During the COVID-19 pandemic, a remote screening system that can ensure compulsory social distancing and reduce the number of ophthalmic visits can be a safe system for patients and clinicians.


Subject(s)
Diabetes Mellitus , Diabetic Retinopathy , Remote Consultation , Aged , COVID-19 , Diabetic Retinopathy/diagnostic imaging , Diabetic Retinopathy/epidemiology , Fluorescein Angiography , Humans , Middle Aged , Pandemics
19.
BMJ Case Rep ; 14(5)2021 May 19.
Article in English | MEDLINE | ID: covidwho-1236430

ABSTRACT

This is a case report of central retinal vein occlusion (CRVO) associated with COVID-19 treated with oral aspirin therapy. A 56-year-old woman reported decreased vision in her left eye. Her left eye vision was 6/18, N10. Anterior segment was within normal limits. Left eye fundus was suggestive of CRVO and macular oedema. Optical coherence tomography showed cystoid macular oedema and neurosensory detachment. Blood work-up revealed elevated D-dimer levels and erythrocyte sedimentation rate (ESR). She was started on treatment with low-dose aspirin 150 mg/day. After 1 month, her vision improved to 6/6, N6. Left eye fundus showed reduced retinal haemorrhages and complete resolution of macular oedema. Her repeat blood work-up showed reduced D-dimer and ESR levels. The patient was asked to be reviewed after 3 months. This case highlights that specific treatment for reducing the hypercoagulable state caused by COVID-19 with oral aspirin therapy can result in complete resolution of CRVO macular oedema.


Subject(s)
COVID-19 , Retinal Vein Occlusion , Aspirin/therapeutic use , Female , Fluorescein Angiography , Humans , Middle Aged , Retinal Vein Occlusion/diagnosis , Retinal Vein Occlusion/drug therapy , SARS-CoV-2 , Tomography, Optical Coherence
20.
Graefes Arch Clin Exp Ophthalmol ; 259(8): 2243-2249, 2021 Aug.
Article in English | MEDLINE | ID: covidwho-1219305

ABSTRACT

PURPOSE: Thrombotic events (TE) represent one of the major complications of SARS-CoV-2 infection. The objective is to evaluate vessel density (VD) and perfusion density (PD) by optical coherence tomography angiography (OCTA) in COVID-19 patients, and compare the findings with healthy controls. The secondary objective is to evaluate if there are differences in OCTA parameters between COVID-19 patients with and without associated TE. METHODS: Cross-sectional case-control study that included patients with laboratory-confirmed diagnosis of COVID-19 with and without TE related to the infection and age-matched healthy controls. Ophthalmological examination and OCTA were performed 12 weeks after diagnosis. Demographic data and medical history were collected. Macular OCTA parameters in the superficial retinal plexus were analyzed according to ETDRS sectors. RESULTS: Ninety patients were included, 19 (20%) COVID-19 patients with associated TE, 47 (49.5%) COVID-19 patients without TE, and 29 (30.5%) healthy controls. Fifty-three (55.7%) were male, mean age 54.4 (SD 10.2) years. COVID-19 patients presented significantly lower VD than healthy controls: central (p = 0.003), inner ring (p = 0.026), outer ring (p = 0.001). PD was also significantly decreased: outer ring (p = 0.003), full area (p = 0.001). No differences in OCTA parameters were found between COVID-19 patients with and without TE. CONCLUSIONS: OCTA represents a promising tool for the in vivo assessment of microvascular changes in COVID-19. Patients with SARS-CoV-2 infection show lower VD and PD compared to healthy controls. However, no differences were found between COVID-19 when considering TE. Prospective studies are required to further evaluate the retinal microvascular involvement of SARS-CoV-2 and its impact on the vasculature of other organs.


Subject(s)
COVID-19 , Tomography, Optical Coherence , Adult , Case-Control Studies , Cross-Sectional Studies , Female , Fluorescein Angiography , Humans , Male , Middle Aged , Retinal Vessels/diagnostic imaging , SARS-CoV-2
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