Retinal findings and vessel caliber measurements in admitted patients with COVID-19

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.