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1.
BMC Ophthalmol ; 22(1): 297, 2022 Jul 07.
Article in English | MEDLINE | ID: covidwho-1923532

ABSTRACT

BACKGROUND: Punctate inner choroidopathy (PIC) is a rare idiopathic inflammatory multifocal chorioretinopathy. Although the etiology of PIC is unknown, it is proposed to be an autoimmune disease that arises in the context of polygenic susceptibility triggered by an environmental stimulus, such as infection. We reported a case of PIC immediately after COVID-19 infection. CASE PRESENTATION: A 25-year-old woman complained of blurred vision in the right eye six days after the symptoms of COVID-19 infection first appeared. The patient visited our hospital and underwent comprehensive ophthalmological examination 18 days after the initial COVID-19 symptoms. Based on the characteristic fundus features observed with multimodal imaging, retinal specialists made a diagnosis of PIC. The patient was affected with high myopia. As her general COVID-19 symptoms disappeared, the patient was prescribed oral prednisolone 30 mg/day for 14 days to treat PIC. Fundus abnormality decreased and her ocular symptoms improved. No side effects were observed, including the recurrence of general COVID-19 symptoms. CONCLUSION: We experienced an extremely rare case of PIC immediately after COVID-19 infection and showed the potential safety and effectiveness of oral prednisolone in treating PIC in the active phase after the disappearance of the general COVID-19 infection symptoms.


Subject(s)
COVID-19 , Choroid Diseases , White Dot Syndromes , Adult , COVID-19/complications , Choroid Diseases/diagnosis , Choroid Diseases/etiology , Female , Fluorescein Angiography/methods , Humans , Prednisolone/therapeutic use , Tomography, Optical Coherence/methods
2.
Ophthalmic Surg Lasers Imaging Retina ; 53(6): 326-331, 2022 06.
Article in English | MEDLINE | ID: covidwho-1903576

ABSTRACT

BACKGROUND AND OBJECTIVE: The most common clinical features of X-linked retinoschisis (XLRS) include macular schisis in a spoke wheel pattern and peripheral schisis, though other findings such as vitreous veils, vascular attenuation, and subretinal fibrosis have been described. This is the first report to describe retinal folds as a characteristic feature in patients with XLRS. PATIENTS AND METHODS: This was a case series of patients presenting to the retina service at Bascom Palmer Eye Institute with genetically confirmed XLRS. Patients included in this report underwent examination under anesthesia with multimodality imaging. RESULTS: Three patients with XLRS were found to have retinal folds, including a newly characterized "retinal scroll" seen on examination and multimodality imaging. CONCLUSIONS: The presence of a retinal fold should yield a differential diagnosis that includes XLRS in the correct clinical context. Panel-based genetic testing and multimodal imaging are useful in guiding clinical management. [Ophthalmic Surg Lasers Imaging 2022;53(6):326-331.].


Subject(s)
Retinoschisis , Eye Proteins/genetics , Humans , Multimodal Imaging , Retina , Retinoschisis/diagnosis , Retinoschisis/genetics , Tomography, Optical Coherence/methods , Visual Acuity
3.
Indian J Ophthalmol ; 70(5): 1780-1786, 2022 05.
Article in English | MEDLINE | ID: covidwho-1835158

ABSTRACT

Purpose: To evaluate the retinal microvascular changes in patients, recovered from severe COVID-19 during the second wave of the pandemic in North India. Methods: In this observational cross-sectional study, 70 eyes of 35 patients who recovered from severe COVID-19 during the second wave underwent detailed ophthalmic evaluation 4-6 weeks after discharge. Twelve controls were also enrolled, and the difference in the findings between the case and control groups on optical coherence tomography (OCTA) were studied. Result: The ages of study participants ranged from 27 to 60 years with the male:female ratio being 1.05:1. The fundus changes suggestive of ischemia in the form of cotton wool spots and vascular tortuosity were seen in 25 eyes (35.71%). Increased venous tortuosity was the most common finding seen in 23 eyes (32.85%), of which 10 eyes (28.57%) had concurrent hypertensive retinopathy (HTR) changes. There was a significant reduction in the mean vascular density (VD) and perfusion density (PD) for both the superficial capillary plexus (SCP) and deep capillary plexus (DCP) at inner, outer ring, and whole (P < 0.05). Foveal avascular zone was significantly enlarged in both the SCP (P = 0.01) and the DCP (P = 0.03). The mean ganglion cell-inner plexiform layer (GC-IPL) was significantly reduced in comparison to controls (P < 0.001). Conclusion: Severe COVID-19 can result in microvascular changes at the macula in the form of reduction in vascular and perfusion density, which can be evaluated using OCTA. As structural changes precede functional changes, a close watch is recommended in patients showing compromise in retinal microvasculature.


Subject(s)
COVID-19 , Macula Lutea , Adult , COVID-19/complications , COVID-19/epidemiology , Female , Fluorescein Angiography/methods , Humans , Male , Middle Aged , Retinal Vessels/diagnostic imaging , Tomography, Optical Coherence/methods
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.
BMJ Open Ophthalmol ; 7(1): e000867, 2022.
Article in English | MEDLINE | ID: covidwho-1807429

ABSTRACT

OBJECTIVE: This study aims to analyse the possible recovery or worsening in retinal microvasculature after 8 months in a previously studied COVID-19 cohort. METHODS AND ANALYSIS: A cross-sectional case-control study and a prospective longitudinal cohort study. Participants were the subjects of our previous study who re-enrolled for a new examination including a fundus photograph (retinography), an optical coherence tomography (OCT) scan and an OCT angiography. COVID-19 diagnosed patients were divided into three groups: group 1: mild disease, asymptomatic/paucisymptomatic subjects who received outpatient care; group 2: moderate disease and group 3: severe disease, both of which required hospital admission because of pneumonia. Statistical analyses were performed using SPSS software (V.23.0). Cross-sectional intergroup differences were analysed by means of analysis of variance for normally distributed variables and the Kruskal-Wallis test for non-normally distributed ones. In reference to the prospective part of the study (intragroup differences, baseline with 8-month comparison), a paired t-test was used for normally distributed data and Wilcoxon signed ranks sum for non-normally distributed data. RESULTS: The fovea-centered superficial and deep vascular densities were significantly diminished in severe cases compared with mild cases (p=0.004; p=0.003, respectively, for superficial and deep) and to controls (p=0.014; p=0.010), also in moderate cases to mild group (p=0.004; p=0.003) and to controls (p=0.012; p=0.024). In the longitudinal study, no significant statistical differences were found between baseline and 8-month follow-up vessel density values. CONCLUSION: We demonstrated persistent reduction in the central vascular area over time in patients with moderate and severe COVID-19.


Subject(s)
COVID-19 , Case-Control Studies , Cross-Sectional Studies , Fluorescein Angiography/methods , Humans , Longitudinal Studies , Prospective Studies , Tomography, Optical Coherence/methods
6.
Klin Monbl Augenheilkd ; 239(7): 916-922, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1795627

ABSTRACT

PURPOSE: To investigate early covid measurements of central macular thickness (CMT), retinal nerve fiber layer (RNFL), ganglion cell layer (GCL) thickness, and choroidal thickness (ChT) in children recovered from coronavirus disease 2019 (COVID-19). METHODS: This cross-sectional study was carried out 4 weeks after completed COVID-19 treatment. The diagnosis of the Alpha variant COVID-19 was made by the polymerase chain reaction test after prediagnosis with clinical, laboratory, and radiological findings. A total of 46 children were included in the study. Pediatric patients who received COVID-19 treatment comprised the COVID-19 group (24 children), and healthy children were enrolled in the control group (22 children). Only the right eyes of the participants were enrolled in the study. All pediatric patients in the COVID-19 group required hospitalization without the need for intubation. Swept-source optical coherence tomography (SS-OCT) was used to measure CMT, RNFL, and GCL thickness, and ChT measurements. RESULTS: The COVID-19 and control groups had similar mean values of visual acuity, intraocular pressure, spherical equivalent, axial length, and CMT (p > 0.05 for all). RNFL thickening, GCL, and choroidal thinning were observed in all SS-OCT measurements of COVID-19 children. However, RNFL thickening was significant only in the global and nasal peripapillary quadrants. GCL thinning was significant in the nasal/inferior sector (p < 0.002 for all). Some significant correlations were observed between the mean levels of inflammatory markers and OCT measurements (p < 0.002). CONCLUSION: This study may be among the first reports of SS-OCT examination of COVID-19 children. OCT measurements showed changes in retinal and ChT in the COVID-19 children as in adult patients.


Subject(s)
COVID-19 , Nerve Fibers , Adult , COVID-19/drug therapy , Child , Cross-Sectional Studies , Humans , Retinal Ganglion Cells , SARS-CoV-2 , Tomography, Optical Coherence/methods
7.
J Glaucoma ; 31(6): 399-405, 2022 Jun 01.
Article in English | MEDLINE | ID: covidwho-1758887

ABSTRACT

PRCIS: Face mask wearing has no significant effects on artifacts or vessel density measurements in optic nerve head (ONH) and macular optical coherence tomography-angiography (OCT-A) scans. PURPOSE: The aim was to assess the difference in area of artifacts observed in optical OCT-A scans with and without face mask wear and to verify if mask wear interferes with OCT-A vessel density measurements. SUBJECTS AND CONTROLS: A total of 64 eyes of 10 healthy subjects, 4 ocular hypertensive, 8 glaucoma suspects, and 17 glaucoma patients were included. MATERIALS AND METHODS: High-density ONH and macula OCT-A scans were obtained in patients with and without surgical masks. Seven different artifacts (motion, decentration, defocus, shadow, segmentation failure, blink, and Z-offset) were quantitatively evaluated by 2 trained graders. The changes in the area (% of scan area) of artifacts, without and with mask wearing, and differences of vessel density were evaluated. RESULTS: Trends of increasing motion artifact area for the ONH scans [4.23 (-0.52, 8.98) %, P=0.08] and defocus artifact area for the macular scans [1.06 (-0.14, 2.26) %, P=0.08] were found with face mask wear. However, there were no significant differences in the mean % area of any artifacts (P>0.05 for all). Further, the estimated mean difference in vessel density in images acquired without and with masks was not significant for any type of artifact. CONCLUSION: Face mask wearing had no significant effect on area of artifacts or vessel density measurements. OCT-A vessel density measurements can be acquired reliably with face mask wear during the pandemic.


Subject(s)
COVID-19 , Glaucoma , Angiography/methods , Artifacts , COVID-19/epidemiology , Fluorescein Angiography/methods , Humans , Intraocular Pressure , Masks , Pandemics , Retinal Vessels , Tomography, Optical Coherence/methods
8.
Graefes Arch Clin Exp Ophthalmol ; 260(8): 2687-2693, 2022 Aug.
Article in English | MEDLINE | ID: covidwho-1750706

ABSTRACT

PURPOSE: To examine retinal and corneal neurodegenerative and retinal microvascular changes in patients after mild or asymptomatic COVID-19 disease compared to age-matched controls. METHODS: Thirty-five (35) patients after PCR-proven SARS-CoV-2 infection and 28 age-matched controls were enrolled. Swept-source optical coherence tomography (OCT), OCT angiography, and in vivo corneal confocal microscopy were performed in both groups. Corneal subbasal nerve plexus was quantified. Vessel density for superficial (SCP) and deep capillary plexus (DCP) and structural OCT parameters were recorded. RESULTS: Significantly lower nerve branch density (P = 0.0004), nerve fiber area (P = 0.0001), nerve fiber density (P = 0.0009), nerve fiber length (P < 0.0001), and total nerve branch density (P = 0.002) values were observed in patients after COVID-19 compared to healthy controls. VD of the temporal SCP was significantly different between the two groups (P = 0.019). No other SCP and DCP vessel density parameter differed significantly between the two groups. CONCLUSIONS: Our results suggest that peripheral neurodegenerative changes may occur even after mild or asymptomatic SARS-CoV-2 infection. No relevant microvascular changes were seen with OCT angiography and structural OCT parameters did not show any signs of optic neuropathy in post-COVID patients. In vivo confocal microscopy seems to be an important tool in monitoring peripheral neuropathy in patients after COVID-19.


Subject(s)
COVID-19 , Retinal Vessels , COVID-19/complications , COVID-19/diagnosis , Fluorescein Angiography/methods , Humans , SARS-CoV-2 , Tomography, Optical Coherence/methods
9.
Arq Bras Oftalmol ; 85(2): 158-165, 2022.
Article in English | MEDLINE | ID: covidwho-1744710

ABSTRACT

PURPOSE: The primary purpose of this study was to assess vascular retinal findings temporally related to COVID-19 vaccination. With greater information regarding all possible future adverse events, we hope to understand the real dimension and relevance of what was presented. METHODS: Eleven patients with visual complaints after COVID-19 vaccination were enrolled. Data on the following were included: age, sex, vaccine, time of symptom onset, systemic findings, medical history, best-corrected visual acuity, and ocular findings by slit-lamp biomicroscopy as well as multimodal retinal imaging (color fundus, red-free photography, spectral-domain optical coherence tomography, optical coherence tomography angiography, and fluorescein-angiography). Inclusion criteria were the presence of ophthalmologic signs within 30 days after the first or second dose of any COVID-19 vaccine. RESULTS: Of 11 patients, five had arterial occlusion (45.4%), four had venous occlusion (36.4%), and two (18.2%) had nonspecific vascular alterations suggestive of retinal ischemia such as cotton-wool spots. The mean age was 57 (SD = 16; range: 27-84) years. The mean time of symptoms onset was 10 (SD = 5.4; range: 3-16) days. Nine patients were female (81.8%). Systemic risk factors were observed in 36.4% of patients. Two patients had both neurological and visual symptoms, with arterial occlusion. Overall, 36.4% patients had COVID-19 in the previous year. Seven patients (63.6%) received ChAdOx1 nCoV-19 (AZD1222) vaccine. CONCLUSIONS: Our data suggest that retinal events temporally related to COVID-19 vaccination are possible but are very rare. The relationship of these events with post-COVID-19 vaccination warrants further attention to derive a meaningful conclusion.


Subject(s)
COVID-19 , Vaccines , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Female , Fluorescein Angiography/methods , Humans , Male , Middle Aged , Tomography, Optical Coherence/methods , Vaccination/adverse effects
10.
Am J Ophthalmol ; 235: 111-119, 2022 03.
Article in English | MEDLINE | ID: covidwho-1709798

ABSTRACT

PURPOSE: To analyze the outcomes of using an internal limiting membrane (ILM) flap and the conventional ILM peel technique for small- or medium-sized full-thickness macular hole (FTMH) repair. DESIGN: Retrospective, interventional case series. METHODS: Eyes with an FTMH ≤400 µm that underwent vitrectomy with a single-layer inverted ILM flap (flap group, 55 eyes) or an ILM peel (peel group, 62 eyes) were enrolled. Best-corrected visual acuity (BCVA) and optical coherence tomography (OCT) measurements were obtained preoperatively and at 1, 3, 6, and 12 months postoperatively. RESULTS: Primary hole closure was achieved in 54 (98%) and 60 (97%) eyes in the flap and peel groups, respectively. The preoperative and postoperative 12-month BCVA values were comparable between the groups but were significantly better in the flap than in the peel group at 1 month (mean ± SD logMAR: 0.83 ± 0.43 vs 1.14 ± 0.50; P = .001), 3 months (0.58 ± 0.33 vs 0.82 ± 0.43; P = .002), and 6 months (0.56 ± 0.32 vs. 0.72 ± 0.48; P = .028). In the flap group, foveal gliosis was less common than in the peel group at 1 month (P = .030), and restored external limiting membrane and interdigitation zone was more common at 3 months (P = .046 and P < .001, respectively). CONCLUSIONS: The single-layer ILM flap and conventional ILM peel techniques both closed FTMHs and improved vision. ILM flaps were associated with better visual outcomes up to 6 months postoperatively and should be considered in FTMHs ≤400 µm.


Subject(s)
Retinal Perforations , Basement Membrane/surgery , Humans , Retinal Perforations/diagnosis , Retinal Perforations/surgery , Retrospective Studies , Tomography, Optical Coherence/methods , Visual Acuity , Vitrectomy/methods
11.
Ophthalmologica ; 245(4): 385-392, 2022.
Article in English | MEDLINE | ID: covidwho-1673576

ABSTRACT

INTRODUCTION: The increasing high prevalence of neovascular age-related macular degeneration (nvAMD) in the aging population combined with the need for frequent monitoring and treatment for many years, especially in the COVID-19 era, raises the need to establish an effective, reliable, and safe follow-up and treatment model. This study evaluates the difference in treatment decisions comparing between the gold standard face-to-face clinical examination and virtual evaluation approach based only on visual acuity (VA) and optical coherence tomography (OCT) scans without clinical fundoscopic examination in nvAMD patients. METHODS: A single-center retrospective cohort study was conducted that compared an original "face-to-face" visit treatment decision regarding the need for anti-vascular endothelial growth factor drug, interval, and treatment regimen based on routine VA, spectral domain OCT imaging, and dilated fundus examination to two "virtual" treatment decisions based on evaluation of OCT scans and previous medical records before and after revealing VA data on the same nvAMD patients eyes. RESULTS: About 169 eyes of 114 patients were included in the study. Forty-nine patients (43%) suffered from bilateral nvAMD and had both eyes included in the study. Agreement between the "face-to-face visit treatment decision" and "virtual treatment decision" was noted in 74.6% and 71.6% eyes before and after revealing the patient's VA in the study visit, respectively. CONCLUSIONS: Virtual evaluation results in similar treatment decisions for nvAMD patients compared to standard face-to-face clinical examination.


Subject(s)
COVID-19 , Macular Degeneration , Wet Macular Degeneration , Aged , Angiogenesis Inhibitors/therapeutic use , COVID-19/epidemiology , Humans , Intravitreal Injections , Macular Degeneration/drug therapy , Ranibizumab/therapeutic use , Retrospective Studies , Tomography, Optical Coherence/methods , Visual Acuity , Wet Macular Degeneration/diagnosis , Wet Macular Degeneration/drug therapy
12.
Photodiagnosis Photodyn Ther ; 38: 102742, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1661891

ABSTRACT

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus that is responsible for the current coronavirus disease pandemic and the vaccines currently developed are administered to prevent this infection. CoronaVac is a vaccine produced by the inactivated virus method. Ocular side effects such as anterior uveitis, optic neuritis, vision loss, episcleritis, allergic reaction and paracentral acute middle maculopathy have been reported after receiving CoronaVac vaccine. We assume that with this study, we can identify potential changes in posterior segment structures and posterior segment vascular density of people who received CoronaVac vaccine with optical coherence tomography angiography (OCTA) device. MATERIAL METHOD: Forty healthcare professionals who applied to the Health Sciences University Antalya Training and Research Hospital Ophthalmology Clinic for routine eye control were included in the study. The subjects who do not have any systemic condition and would be administered CoronaVac vaccine were chosen to assess. OCTA images of the patients before and within 1 week after vaccination were captured, then retinal and optic disc vascular values, foveal avascular zone (FAZ), choriocapillary blood flow (CBF), subfoveal choroidal thickness (SCT) and retinal thickness were analyzed and compared. RESULTS: Two of the 40 patients had burning and stinging in the eye (5%), two of the 40 patients had redness (5%) and itching (5%) in the eye. 36 patients did not have any ocular symptoms.No statistically significant difference was found in the retinal and optic disc vascular density values, FAZ, CBF, SCT and retinal thickness values ​​of the patients before and after vaccination. CONCLUSION: This is among the first studies in the literature to evaluate the changes in retinal and optic disc vascular values ​​in people who received CoronaVac vaccine. In this study, we observed that CoronaVac vaccine did not effect retinal and optic disc vascular density significantly.


Subject(s)
COVID-19 , Optic Disk , Photochemotherapy , Vaccines , COVID-19 Vaccines , Humans , Photochemotherapy/methods , Retina , SARS-CoV-2 , Tomography, Optical Coherence/methods
13.
Photodiagnosis Photodyn Ther ; 38: 102726, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1630341

ABSTRACT

PURPOSE: The aim of this study was to evaluate the ocular disorders in COVID-19 patients, two to three months after infection. METHODS: In this cross-sectional, historically controlled study, fifty-one COVID-19 patients were compared with thirty-seven age, and gender-matched healthy individuals. After complete ophthalmological examination, all participants underwent peripapillary and macular optical coherence tomography, and optical coherence tomography angiography (OCTA) measurements (OptoVue Inc, Freemont, CA, USA). RESULTS: The time between the initial onset of symptoms, and ophthalmologic examination was 63.31±15.21 (40-95 days). Ophthalmic examination of all the recovered COVID-19 patients was within normal range. None of the peripapillary and macular OCTA parameters were significantly different between the two groups with pairwise comparisons, but after adjusting for age, gender, axial length, and signal strength index (SSI), recovered COVID-19 eyes showed a significant increase in peripapillary retinal nerve fiber (RNFL) thickness, superficial, and deep macular vessel densities in parafoveal and perifoveal regions compared with healthy control eyes (p<= 0.05). Inner retinal thickness overall is higher in recovered COVID-19 eyes compared to healthy eyes after adjustment. CONCLUSION: Patients with moderate-intensity SARS-CoV-2 pneumonia had altered peripapillary and macular vessel density compared to healthy subjects. Further investigation is warranted to analyze the correlation of these changes with disease severity as well as evolution of these changes over time.


Subject(s)
COVID-19 , Optic Disk , Photochemotherapy , Cross-Sectional Studies , Fluorescein Angiography , Humans , Photochemotherapy/methods , Retinal Vessels/diagnostic imaging , SARS-CoV-2 , Tomography, Optical Coherence/methods
14.
Graefes Arch Clin Exp Ophthalmol ; 260(6): 1907-1914, 2022 Jun.
Article in English | MEDLINE | ID: covidwho-1616128

ABSTRACT

PURPOSE: To assess the impact of COVID-19-related delay in intravitreal injection timing on macular structure and visual acuity (VA) among patients treated for neovascular age-related macular degeneration (nvAMD). METHODS: We reviewed demographic and clinical data and macular ocular computerized tomographic images of 34 patients (48 eyes, group A) who did not follow their injection schedule during the first wave of COVID-19 and compared them to 46 patients (71 eyes, group B) who did. Functional worsening was defined as a loss of at least 0.1 in decimal VA. Anatomic worsening was defined as new or increased subretinal/intraretinal fluids or new hemorrhage. RESULTS: The planned mean ± standard deviation intervals between the intravitreal injections were 5.7 ± 2.7 weeks for group A and 5.5 ± 2.4 weeks for group B (P = 0.60). The actual intervals were 13.6 ± 6.8 (7.9 ± 5.2 weeks' delay) and 5.3 ± 2.4 weeks (no delay), respectively (P < 0.001). The best corrected visual acuity worsened in 23 group A eyes (47.9%) and in 6 group B eyes (8.5%) (odds ratio [OR] 9.97, P < 0.001). Anatomic features indicative of nvAMD worsening were detected in 31 group A eyes (64.6%) and in 16 group B eyes (22.5%) (OR 5.73, P < 0.001). A new macular hemorrhage was observed in 4 group A eyes (8.3%) and in no group B eyes (P = 0.09). CONCLUSION: Delay in timely retinal care during the COVID-19 restrictions period resulted in short-term negative outcomes, including macular bleeding, in nvAMD patients.


Subject(s)
COVID-19 , Macular Degeneration , Wet Macular Degeneration , Angiogenesis Inhibitors , Follow-Up Studies , Humans , Intravitreal Injections , Macular Degeneration/drug therapy , Ranibizumab , Tomography, Optical Coherence/methods , Treatment Outcome , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors , Wet Macular Degeneration/diagnosis , Wet Macular Degeneration/drug therapy
15.
Graefes Arch Clin Exp Ophthalmol ; 260(7): 2201-2208, 2022 Jul.
Article in English | MEDLINE | ID: covidwho-1611404

ABSTRACT

PURPOSE: Determine the anatomical consequences of delaying intravitreal injection (IVI) therapy with anti-vascular endothelial growth factor (anti-VEGF) in patients using treat-and-extend (T&E) protocol. METHODS: Retrospective medical record review of consecutive patients receiving intravitreal anti-VEGF therapy using T&E protocol prior to and during the COVID-19 pandemic. RESULTS: The study included 923 eyes of 691patients; 58.8% (543 eyes), 25% (231 eyes), and 16.2% (149 eyes) had nvAMD, DME, and RVO, respectively. Mean (± SD) patient age was 74.5 ± 11.7 years. Overall, 56.3% of cases had a delay in therapy of ≥ 7 days; specifically, 56.2%, 61.5%, and 49.0% of nvAMD, DME, and RVO cases, respectively, had a delay. The median delay in days, among cases ≥ 7 days late was 21 (IQR 7 to 42) days, with 21(IQR 7 to 45), 22.5(IQR 8 to 42), and 14(IQR 7 to 33.5) days of delay among patients with nvAMD, DME, and RVO, respectively. Delaying therapy by ≥ 7 days resulted in increased CST in 47.5%, 58.5%, and 58.9% of nvAMD, DME, and RVO cases, respectively, with a significant correlation between the length of treatment delay and the increase in CST (Spearman's rho: 0.196; p < 0.001). CONCLUSIONS: Delayed IVI treatment in eyes treated with T&E protocol was associated with increased macular thickness with potential consequences with respect to visual outcome.


Subject(s)
Macular Edema , Retinal Vein Occlusion , Aged , Aged, 80 and over , Angiogenesis Inhibitors , COVID-19 , Humans , Intravitreal Injections , Macular Edema/drug therapy , Middle Aged , Pandemics , Ranibizumab , Retinal Vein Occlusion/drug therapy , Retrospective Studies , Tomography, Optical Coherence/methods , Vascular Endothelial Growth Factor A , Vascular Endothelial Growth Factors , Visual Acuity
20.
Graefes Arch Clin Exp Ophthalmol ; 260(3): 771-779, 2022 Mar.
Article in English | MEDLINE | ID: covidwho-1460330

ABSTRACT

BACKGROUND/AIMS: To quantify the longitudinal changes of the macular microvasculature and the foveal avascular zone (FAZ) parameters in patients recovered from coronavirus disease-2019 (COVID-19) using optical coherence tomography angiography (OCTA) analysis. METHODS: This observational, longitudinal study was performed on patients recovered from COVID-19. The OCTA images were recorded at baseline and after 1 and 3 months at the follow-up examination. Vessel density (VD) of the retinal superficial (SCP) and deep capillary plexus (DCP), as well as the area of the FAZ of patients who had recovered from COVID-19, were measured. RESULTS: In total, 36 eyes of 18 patients (62.2% female) with a mean age of 34.5 ± 7.5 years old were included. Regarding SCP, while the VDs of the whole image, fovea, and parafovea were comparable at different time points, the mean VDs in inferior hemifield, as well as superior and inferior regions of perifovea, underwent significant reductions at month 3, compared to the baseline. In DCP, the mean of VD in the whole image was 54.3 ± 2.7 at the first visit which significantly decreased to 52.1 ± 3.8(P = 0.003) and 51.4 ± 2.7(P = 0.001) after 1 and 3 months, respectively. The VDs in all regions of parafovea and perifovea revealed a significant reduction after 1 and 3 months, compared to the first visit. The mean FAZ area was 0.27 ± 0.08 mm2, 0.26 ± 0.08 mm2, and 0.27 ± 0.08 mm2 at the baseline, month 1, and month 3, respectively (P > 0.05). CONCLUSION: Based on the results, the patients who had recovered from COVID-19 had a progressive decrease of VD at the follow-up visit 3 months after COVID-19 infection.


Subject(s)
COVID-19 , Tomography, Optical Coherence , Adult , Female , Fluorescein Angiography/methods , Humans , Longitudinal Studies , Male , Retinal Vessels/diagnostic imaging , SARS-CoV-2 , Tomography, Optical Coherence/methods
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