Assessment of Optical Coherence Tomography Findings Based on COVID-19 Status and Demographics

ABSTRACT

Purpose: The full scope of ophthalmic manifestations of coronavirus disease 2019 (COVID-19) has yet to be appreciated. We used optical coherence tomography (OCT) to compare subjects with a history of COVID-19 disease and those without evidence of past disease across qualitative and quantitative metrics. Methods: Subjects diagnosed by reverse-transcriptase polymerase chain reaction with COVID-19 or presence of SARS-CoV-2 antibodies (N=25) and those with no history or antibody evidence of disease (N=25) were prospectively assessed using a Zeiss Cirrus HD OCT Model 5000. Retinal nerve fiber layer (RNFL), macular ganglion cell complex (GCC), and foveal thickness were tabulated. Retinal structural findings were evaluated by a retina specialist. Results were stratified by age, race, ethnicity, gender, and presence of comorbidities (diabetes and hypertension). Student's t-test, linear and logistic regression, univariate analysis with COVID+ subjects, and multivariate analysis with all subjects were performed. Significance was set at p<0.05. Results: COVID+ subjects did not show significant differences compared to COVID- subjects across any parameters. There were significant differences across demographic groups. Univariate analysis showed that COVID+ Asians had thinner RNFL (p=0.014, right;p=0.018, left) and GCC (p=0.041, right;p=0.051, left) than COVID+ Blacks and Whites. COVID+ Hispanics had decreased foveal thickness compared to COVID+ non-Hispanics (p=0.019, right;p=0.004, left). Multivariate analysis confirmed that Blacks (p=0.015, left) and Whites (p=0.010, left) had thicker GCC than Asians and that Hispanics had decreased foveal thickness (p=0.041, left) compared to non-Hispanics. The middle age group had thinner GCC (p=0.022, right;p=0.024, left) than the youngest age group. While COVID+ Blacks were more likely to have retinal structural changes than COVID+ subjects of other races with a trend toward significance (OR=5.00, p=0.084), multivariate analysis did not confirm this disparity. Conclusions: Analysis of this cohort did not reveal significant differences between COVID+ and COVID- individuals. However, comparison of demographic parameters did show significant differences across age, race, and ethnicity. The reasons for these disparities are obscure. Further studies with a greater number of subjects may reveal differences based on COVID-19 status.