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1.
Indian J Ophthalmol ; 70(4): 1418-1420, 2022 04.
Article in English | MEDLINE | ID: covidwho-1939183

ABSTRACT

To report a case of MEWDS post-COVID-19 infection with multimodal imaging. A 17-year-old boy reported blurring of vision in both eyes 2 months and 10 days following the SARS-CoV-2 infection. Fundus examination revealed hypopigmented lesions nasal to the optic disc, inferior periphery, and near macula in both eyes. Multimodal imaging was consistent with MEWDS. A complete systemic workup was performed to exclude infectious etiology. Fundus lesions resolved with a course of oral corticosteroids and was confirmed on multimodal imaging.


Subject(s)
COVID-19 , Retinal Diseases , White Dot Syndromes , Adolescent , Fluorescein Angiography/methods , Humans , Male , Retinal Diseases/diagnosis , SARS-CoV-2
3.
Retin Cases Brief Rep ; 16(4): 403-406, 2022 Jul 01.
Article in English | MEDLINE | ID: covidwho-1909002

ABSTRACT

PURPOSE: To report a case of branch retinal artery occlusion associated with paracentral acute middle maculopathy on spectral-domain optical coherence tomography presumably related to heavy cannabis consumption. METHODS: Retrospective case report. Spectral-domain optical coherence tomography, fluorescein angiography, and optical coherence tomography angiography were performed. RESULTS: A 21-year-old healthy man described the acute onset of superior visual field loss in his right eye. He admitted smoking approximately 15 g daily of cannabis for several weeks during COVID-19 confinement. Ophthalmoscopic examination of the right eye showed inferotemporal retinal whitening. Spectral-domain optical coherence tomography illustrated evidence of the ischemic cascade with diffuse hyperreflectivity of the inner and middle retinal layers within the central region of the retinal infarct and paracentral acute middle maculopathy at the border of the infarct. Optical coherence tomography angiography demonstrated predominant flow signal loss at the level of the deep retinal capillary plexus. Fluorescein angiography and complete systemic workup were unremarkable. CONCLUSION: Branch retinal artery occlusion and paracentral acute middle maculopathy may be related to heavy cannabis use as the result of transient arterial vasospasm.


Subject(s)
COVID-19 , Cannabis , Macular Degeneration , Retinal Artery Occlusion , Retinal Diseases , Acute Disease , Adult , Cannabis/adverse effects , Fluorescein Angiography/methods , Humans , Infarction , Male , Retina , Retinal Artery Occlusion/chemically induced , Retinal Artery Occlusion/diagnosis , Retinal Diseases/chemically induced , Retinal Diseases/diagnosis , Retinal Vessels , Retrospective Studies , Tomography, Optical Coherence/methods , Young Adult
4.
BMJ Case Rep ; 15(5)2022 May 10.
Article in English | MEDLINE | ID: covidwho-1832380

ABSTRACT

We report a case of Susac syndrome after SARS-CoV-2 infection and subsequent vaccination that presented with meningitis and retinal microembolisation in the form of paracentral acute middle maculopathy (PAMM). After presenting with headache, fever and myalgia followed by scotomata, a woman in her 50s was hospitalised for meningitis; she had had mild COVID-19 infection 2 months prior to admission, having received the first vaccine dose 1 month prior to the neurological manifestation. Eye fundus examination and optical coherence tomography were suggestive of PAMM. D-dimer levels and erythrocyte sedimentation rate were elevated. Before infectious investigation results were available, she was started on empirical antibiotic and antiviral treatment. Having ruled out infectious causes, she was started on high-dose prednisolone. After 1 month, there was partial resolution of retinal lesions. This case highlights that exposure to SARS-CoV-2 antigen may be related to this rare syndrome; treatment with steroids may improve central and retinal impairment.


Subject(s)
COVID-19 , Macular Degeneration , Retinal Diseases , Susac Syndrome , Female , Fluorescein Angiography/methods , Humans , Macular Degeneration/complications , Retinal Diseases/diagnosis , Retinal Diseases/drug therapy , Retinal Diseases/etiology , Retinal Vessels/pathology , SARS-CoV-2 , Tomography, Optical Coherence/methods
5.
JAMA Ophthalmol ; 140(5): 523-527, 2022 05 01.
Article in English | MEDLINE | ID: covidwho-1787614

ABSTRACT

Importance: COVID-19 is associated with systemic vascular damage; however, the risk posed to the retinal vasculature remains incompletely understood. Objective: To assess if there is a change in the incidence of retinal vascular occlusions after COVID-19 infection. Design, Setting, and Participants: This cohort study at an integrated health care organization (Kaiser Permanente Southern California) included patients without a history of retinal vascular occlusion who were diagnosed with COVID-19 infection between January 20, 2020, and May 31, 2021. Patients were excluded if they had a history of retinal artery occlusions (RAOs) or retinal vein occlusions (RVOs) more than 6 months before their COVID-19 diagnosis or if they were enrolled in Kaiser Permanente Southern California for less than 6 months before COVID-19 diagnosis. Exposures: COVID-19 infection. Main Outcomes and Measures: The change in the average biweekly incidence of new RAOs and RVOs after COVID-19 diagnosis. Adjusted incidence rate ratios (IRRs) were calculated to compare the incidence of retinal vascular occlusions before and after COVID-19 diagnosis after accounting for baseline demographic characteristics, medical history, and hospitalization. Results: A total of 432 515 patients diagnosed with COVID-19 infection were included in this study. The mean (SD) age was 40.9 (19.2) years, and 231 767 patients (53.6%) were women. Sixteen patients had an RAO (crude incidence rate, 3.00 per 1 000 000 patients), and 65 had an RVO (crude incidence rate, 12.20 per 1 000 000 patients) in the 6 months after COVID-19 diagnosis. The incidence of new RVOs was higher in the 6 months after COVID-19 infection compared with the 6 months before infection after adjusting for age; sex; self-reported race and ethnicity; body mass index; history of diabetes, hypertension, or hyperlipidemia; and hospitalization (adjusted IRR, 1.54; 95% CI, 1.05-2.26; P = .03). There was a smaller increase in the incidence of RAOs after COVID-19 diagnosis (IRR, 1.35; 95% CI, 0.64-2.85; P = .44). The peak incidence of RAOs and RVOs occurred 10 to 12 weeks and 6 to 8 weeks after COVID-19 diagnosis, respectively. Conclusions and Relevance: The findings of this study suggest that there was an increase in the incidence of RVOs after COVID-19 infection; however, these events remain rare, and in the absence of randomized controls, a cause-and-effect relationship cannot be established. Further large, epidemiologic studies are warranted to better define the association between retinal thromboembolic events and COVID-19 infection.


Subject(s)
COVID-19 , Retinal Artery Occlusion , Retinal Diseases , Retinal Vein Occlusion , Adult , COVID-19/epidemiology , COVID-19 Testing , Cohort Studies , Female , Humans , Incidence , Male , Retinal Artery Occlusion/diagnosis , Retinal Artery Occlusion/epidemiology , Retinal Diseases/diagnosis , Retinal Diseases/epidemiology , Retinal Vein Occlusion/diagnosis , Retinal Vein Occlusion/epidemiology , Retinal Vein Occlusion/etiology , Retrospective Studies , Risk Factors
6.
Am J Ophthalmol ; 236: 241-248, 2022 04.
Article in English | MEDLINE | ID: covidwho-1757062

ABSTRACT

PURPOSE: To determine the feasibility and accuracy of nonmydriatic ultra-widefield (UWF) fundus photographs taken in a hematology clinic setting for screening of sickle cell retinopathy (SCR) DESIGN: Prospective cohort study. METHODS: This single-site study took place at the Johns Hopkins Sickle Cell Center for Adults and the Wilmer Eye Institute. The study population was 90 eyes of 46 consecutive adults with sickle cell disease (SCD). Bilateral nonmydriatic fundus photos taken by clinic personnel during the participants' routine hematology appointment were graded by 2 masked retina specialists at the Wilmer Eye Institute for the presence of nonproliferative SCR (NPSR) and proliferative sickle retinopathy (PSR). A third retina specialist adjudicated in cases of grader disagreement. All participants underwent the standard dilated fundus examination (DFE) within 2 years of acquisition of UWF photographs. The main outcome measure was the sensitivity and specificity of nonmydriatic UWF images for the detection of NPSR and PSR RESULTS: PSR was noted in 19 of 90 eyes that underwent DFE and in 9 of 67 gradable UWF images. Interrater agreement between the 2 graders was moderate, with κ = 0.65 (range 0.43-0.87) for PSR. For gradable UWF photos, the sensitivity and specificity of detecting SCR using the nonmydriatic photos compared with the DFE were 85.2% and 62.5% for NPSR, respectively, and 69.2% and 100% for detection of PSR, respectively. One participant required ophthalmic therapy in both eyes for active sea-fan neovascularization. CONCLUSIONS: UWF imaging shows utility in screening for SCR and may help identify patients with PSR who require a DFE and who may benefit from treatment.


Subject(s)
Anemia, Sickle Cell , Diabetic Retinopathy , Hematology , Retinal Diseases , Adult , Anemia, Sickle Cell/complications , Anemia, Sickle Cell/diagnosis , Diabetic Retinopathy/diagnosis , Fundus Oculi , Humans , Photography/methods , Prospective Studies , Retinal Diseases/diagnosis , Retinal Diseases/etiology
7.
Arq Bras Oftalmol ; 85(2): 186-189, 2022.
Article in English | MEDLINE | ID: covidwho-1742904

ABSTRACT

A 38-year-old woman presented with photopsias and progressive but painless loss of vision in her right eye. Of note, she had received the first dose of inactivated COVID-19 vaccine (Sinovac/China National Pharmaceutical Group) 2 weeks prior to the onset of symptoms. Ophthalmic evaluation revealed a wreath-like foveal pattern and multiple gray-white dots throughout the posterior pole associated with discrete vitreous inflammatory reaction. Multimodal imaging analysis confirmed a diagnosis of multiple evanescent white dot syndrome. The patient underwent treatment with corticosteroids and, over the following weeks, her visual acuity improved to standard pattern.


Subject(s)
COVID-19 , Retinal Diseases , White Dot Syndromes , Adult , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Fluorescein Angiography/methods , Humans , Retinal Diseases/diagnosis , Vaccination
8.
BMJ Open ; 12(2): e055845, 2022 Feb 01.
Article in English | MEDLINE | ID: covidwho-1673442

ABSTRACT

INTRODUCTION: Recent years have witnessed an upsurge of demand in eye care services in the UK. With a large proportion of patients referred to Hospital Eye Services (HES) for diagnostics and disease management, the referral process results in unnecessary referrals from erroneous diagnoses and delays in access to appropriate treatment. A potential solution is a teleophthalmology digital referral pathway linking community optometry and HES. METHODS AND ANALYSIS: The HERMES study (Teleophthalmology-enabled and artificial intelligence-ready referral pathway for community optometry referrals of retinal disease: a cluster randomised superiority trial with a linked diagnostic accuracy study) is a cluster randomised clinical trial for evaluating the effectiveness of a teleophthalmology referral pathway between community optometry and HES for retinal diseases. Nested within HERMES is a diagnostic accuracy study, which assesses the accuracy of an artificial intelligence (AI) decision support system (DSS) for automated diagnosis and referral recommendation. A postimplementation, observational substudy, a within-trial economic evaluation and discrete choice experiment will assess the feasibility of implementation of both digital technologies within a real-life setting. Patients with a suspicion of retinal disease, undergoing eye examination and optical coherence tomography (OCT) scans, will be recruited across 24 optometry practices in the UK. Optometry practices will be randomised to standard care or teleophthalmology. The primary outcome is the proportion of false-positive referrals (unnecessary HES visits) in the current referral pathway compared with the teleophthalmology referral pathway. OCT scans will be interpreted by the AI DSS, which provides a diagnosis and referral decision and the primary outcome for the AI diagnostic study is diagnostic accuracy of the referral decision made by the Moorfields-DeepMind AI system. Secondary outcomes relate to inappropriate referral rate, cost-effectiveness analyses and human-computer interaction (HCI) analyses. ETHICS AND DISSEMINATION: Ethical approval was obtained from the London-Bromley Research Ethics Committee (REC 20/LO/1299). Findings will be reported through academic journals in ophthalmology, health services research and HCI. TRIAL REGISTRATION NUMBER: ISRCTN18106677 (protocol V.1.1).


Subject(s)
Ophthalmology , Optometry , Retinal Diseases , Telemedicine , Artificial Intelligence , Humans , Ophthalmology/methods , Randomized Controlled Trials as Topic , Referral and Consultation , Retinal Diseases/diagnosis , Telemedicine/methods
9.
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
11.
Ocul Immunol Inflamm ; 29(6): 1225-1233, 2021 Aug 18.
Article in English | MEDLINE | ID: covidwho-1467232

ABSTRACT

The novel pandemic coronavirus disease 2019 (COVID-19) leading to health and economic problems worldwide is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Although COVID-19 mainly occurs as a lower respiratory tract infection, there is multiorgan involvement in infected patients. The disease is transmitted from person to person through air droplets or contact with contaminated surfaces. SARS-CoV-2 leads to this systemic involvement by attaching to angiotensin-converting enzyme 2 (ACE2) receptors located on several human cells. Since SARS-CoV-2 RNA has been found in tears of infected patients, ocular surface may allow the virus to transmit to nasopharynx via the nasolacrimal duct. This narrative review aims to sum up all segmental ocular complications, ocular adverse effects of COVID-19 treatment, and preventive measures suggested to minimize the SARS-CoV-2 transmission between patients and ophthalmologists by reviewing currently available literature.


Subject(s)
COVID-19/diagnosis , Eye Infections, Viral/diagnosis , SARS-CoV-2 , Tears/virology , COVID-19/prevention & control , COVID-19/virology , COVID-19 Nucleic Acid Testing , Conjunctivitis, Viral/diagnosis , Conjunctivitis, Viral/prevention & control , Conjunctivitis, Viral/virology , Encephalitis, Viral/diagnosis , Encephalitis, Viral/prevention & control , Encephalitis, Viral/virology , Eye Infections, Viral/prevention & control , Eye Infections, Viral/virology , Humans , Preventive Medicine/methods , Retinal Diseases/diagnosis , Retinal Diseases/prevention & control , Retinal Diseases/virology , SARS-CoV-2/pathogenicity
12.
Curr Opin Ophthalmol ; 32(6): 536-540, 2021 Nov 01.
Article in English | MEDLINE | ID: covidwho-1450463

ABSTRACT

PURPOSE OF REVIEW: The novel coronavirus disease in 2019 (COVID-19) has a wide range of systemic manifestations. Ocular manifestations are now well recognized, with conjunctivitis being the most common. Posterior segment involvement is uncommon and has mainly been described in case reports. This review provides an overview of the posterior segment involvement of COVID-19. RECENT FINDINGS: Severe acute respiratory syndrome coronavirus 2 affects the retina and the choroid through either direct entry or triggering an indirect inflammatory response. Majority of the retinal findings is a result of microvascular derangement leading to cotton wool spots, intraretinal hemorrhages, paracentral acute middle maculopathy, acute macular neuroretinopathy, or retinal vein occlusions. Rarely, inflammation involving the retina or the choroid, or reactivation of previously quiescent uveitis, can be seen. SUMMARY: It is important to recognize the possible correlation between ophthalmic conditions and COVID-19 as it can aid in diagnosis, management, and mitigation of the disease.


Subject(s)
COVID-19 , Retinal Diseases , Choroid , Humans , Retina , Retinal Diseases/diagnosis , Retinal Diseases/etiology , SARS-CoV-2
13.
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
14.
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
17.
Ophthalmol Retina ; 5(12): 1245-1253, 2021 12.
Article in English | MEDLINE | ID: covidwho-1249051

ABSTRACT

PURPOSE: We describe the large-scale self-initiated recruitment of patients to a self-monitoring initiative for macular pathologic features during the coronavirus disease 2019 (COVID-19) pandemic. DESIGN: Observational study with retrospective analysis. PARTICIPANTS: A total of 2272 patients from the Singapore National Eye Centre (SNEC) whose visits were rescheduled over lockdown (April 13-June 1, 2020) were offered participation in a self-monitoring initiative administered by SNEC with the Alleye application (Switzerland) as the testing instrument. METHODS: This was an observational study with retrospective analysis. Demographics and characteristics were compared between those who signed up and those who did not. Similar comparisons were made between patients who complied with the initiative versus those who did not. Outcomes were tracked for 6 months starting from the commencement of lockdown. MAIN OUTCOME MEASURES: Participation and compliance rates and characteristics of patients who were more likely to participate and comply with the initiative. RESULTS: Seven hundred thirty-two patients (32%) participated in this self-monitoring initiative. Those who participated were younger (62 years of age vs. 68 years of age; P < 0.001), men, and living with family. Patients not receiving treatment and those with poorer vision in the worse-seeing eye were more likely to participate. When grouped according to diagnosis, the proportion who participated was highest for diabetic macular edema (52%), nonneovascular age-related macular degeneration (AMD; 42%), diabetic retinopathy (35%), retinal vein occlusions (18%), and neovascular AMD (15%; P < 0.001). Testing compliance rate was 43% (315/732). Patients who complied with the initiative were older, were receiving treatment, and had poorer vision in the worse-seeing eye. Trigger events occurred in 33 patients, with 5 patients having clinically verified disease progression (1.6%). CONCLUSIONS: We provide clinical data on characteristics of patients with stable retinal diseases who were offered, participated in, and complied with a self-monitoring program. The lower participation rate compared with standardized clinical studies reflects the difficulties in implementation for such initiatives in clinical settings. Despite this, self-monitoring continues to show promise in relieving clinic resources, suggesting the feasibility of scaling such programs beyond the COVID-19 pandemic.


Subject(s)
COVID-19/epidemiology , Monitoring, Physiologic/methods , Retinal Diseases/diagnosis , SARS-CoV-2 , Self Care/methods , Aged , Female , Health Plan Implementation , Humans , Male , Middle Aged , Patient Compliance , Patient Participation , Retinal Diseases/physiopathology , Retrospective Studies , Singapore/epidemiology
18.
Ocul Immunol Inflamm ; 29(4): 675-676, 2021 May 19.
Article in English | MEDLINE | ID: covidwho-1185530

ABSTRACT

Background: To describe the first case of Coronavirus disease-2019 (COVID-19) vision loss from an acute outer retinopathy.Methods: A retrospective case report from a tertiary referral center using multimodal retinal imaging and clinical examination findingsFindings: A 40-year-old female developed significant vision loss in her right eye shortly after developing fever and myalgias. She was found to be COVID positive, while her systemic laboratory evaluation was otherwise unremarkable. Multimodal imaging was consistent with a white-dot-like outer retinopathy and she was started on systemic prednisone. Within 10 days of starting steroids, her vision, symptoms, and outer retinal changes on multimodal imaging were improving.Interpretation: While exceedingly rare, COVID-19 can cause inflammatory-associated changes of the outer retina and significant vision loss.


Subject(s)
COVID-19/complications , Fluorescein Angiography/methods , Retina/pathology , Retinal Diseases/etiology , SARS-CoV-2 , Tomography, Optical Coherence/methods , Adult , Female , Fundus Oculi , Humans , Retinal Diseases/diagnosis , Visual Acuity
19.
Am J Ophthalmol ; 227: 182-190, 2021 07.
Article in English | MEDLINE | ID: covidwho-1157088

ABSTRACT

PURPOSE: This study investigated changes in retinal vessel density in macular and papillary regions in post-SARS-CoV-2 pneumonia patients by means of optical coherence tomography angiography (OCTA). DESIGN: Prospective, observational, cohort study. METHODS: Forty eyes of 40 patients (mean age: 49.7 ± 12.6 years old) post-SARS-CoV-2 infection and 40 healthy subjects were enrolled in this study. COVID-19 patients had to be fully recovered from COVID-19 pneumonia and were evaluated 6 months after COVID-19 infection. The primary outcome resulted from OCTA studies of the following vascular structures: vessel density (VD) in the retinal superficial capillary plexus (SCP), deep capillary plexus (DCP), and radial peripapillary capillaries (RPC) compared to those of controls. Structural spectral domain (SD)-OCT parameters were also evaluated: ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL). RESULTS: The patients showed a significant reduction in VD of the SCP in whole images and in the DCP in all sectors compared to those in healthy subjects (P <.05). COVID-19 patients featured a reduced VD of the RPC compared to that in controls (P <.001). No differences were found in the GCC, whereas the RNFL was reduced in the COVID-19 group compared to that in controls (P = .012). Significant correlations were found between the RNFL and VD of the SCP, DCP, RPC, and FAZ area in the COVID-19 group (P <.05). CONCLUSIONS: OCTA showed retinal vascular changes in subjects fully recovered from COVID-19 pneumonia. These findings could be a consequence of a thrombotic microangiopathy that affected retinal structures as well as other systemic organs. OCTA could represent a valid, noninvasive biomarker of early vascular dysfunction after SARS-CoV-2 infection.


Subject(s)
COVID-19/epidemiology , Fluorescein Angiography/methods , Macula Lutea/pathology , Retinal Diseases/diagnosis , Retinal Vessels/diagnostic imaging , Tomography, Optical Coherence/methods , Capillaries/diagnostic imaging , Comorbidity , Female , Fundus Oculi , Humans , Male , Middle Aged , Pilot Projects , Prospective Studies , Retinal Diseases/epidemiology , SARS-CoV-2
20.
Curr Eye Res ; 46(12): 1934-1935, 2021 12.
Article in English | MEDLINE | ID: covidwho-1116525

ABSTRACT

Ophthalmologic nvolvement in SARS-CoV-infected patients is variegated. One of the ophthalmologic pathologies is optic neuritis. Optic neuritis in SARS-CoV-infected patients may precede the classical pulmonary manifestations of COVID-19 and can be unilateral or bilateral. Optic neuritis has been repeatedly reported in COVID-19 patients and may occur with or without affection of other cranial nerves. Since cerebro-spinal fluid parameters can be abnormal in COVID-19 associated optic neuritis, these patients require a spinal tap. Before diagnosing SARS-CoV-2 associated optic neuritis various differentials need to be excluded. Since SARS-CoV-2 causes endothelial damage complicated by thrombus formation and thromboembolism, ophthalmologic vascular complication due to an infection with SARS-CoV-2 such as anterior ischemic optic neuropathy (AION), central retinal artery occlusion (CRAO), and retinal vein occlusion need to be excluded. CRAO may result from arterial hypertension, myocarditis, heart failure, Takotsubo syndrome, atrial fibrillation, or atrial flutter, frequent cardiac complications of COVID-19. Since CRAO can be accompanied by ischemic stroke, patients with SARS-CoV-2 associated optic neuritis need to undergo a cerebral MRI.


Subject(s)
COVID-19/complications , Eye Infections, Viral/diagnosis , Optic Neuritis/diagnosis , Retinal Diseases/diagnosis , Retinal Vessels/pathology , Retinitis/diagnosis , SARS-CoV-2 , Aged , Blindness/diagnosis , Blindness/virology , Diagnosis, Differential , Eye Infections, Viral/virology , Female , Humans , Optic Neuritis/virology , Retinal Diseases/virology , Retinal Vessels/virology , Retinitis/virology
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