Retinal nerve fiber layer thickness and peripapillary vasculature of post-COVID-19 patients with and without olfactory/gustatory dysfunction symptoms.

PURPOSE: We aimed to compare retinal nerve fiber layer (RNFL) thickness and peripapillary vessel density values between COVID-19 patients with or without olfactory/gustatory dysfunction symptoms and healthy controls. MATERIALS AND METHODS: We evaluated RNFL and radial peripapillary capillary vessel density (RPC-VD) values of 41 patients who had COVID-19 history and age- and gender-matched control group including 31 healthy individuals with optical coherence tomography angiography. First, post-COVID-19 group's and control group's RNFL and RPC-VD values were compared, then post-COVID-19 patients were divided into subgroups according to the presence (subgroup-A) and absence (subgroup-B) of olfactory/gustatory dysfunction symptoms, and same parameters were analyzed for subgroups. RESULTS: Forty-one eyes of 41 post-COVID-19 patients and 31 eyes of 31 age- and gender-matched healthy controls were included in this cross-sectional study. In RNFL analysis, inferior sector thickness was found significantly lower in post-COVID-19 patients by comparison with control group (P = 0.041). In subgroup analyses, COVID-19 patients who first presented with olfactory/gustatory dysfunction symptoms had higher peripapillary and whole image optic disc capillary density (P = 0.011 and P = 0.002) compared to those who had not had these symptoms. CONCLUSION: Lower RPC-VD and RNFL thickness were detected in COVID-19 patients compared to healthy controls. Higher Disc-VD values were found in COVID-19 patients with chemosensorial dysfunction (CSD) symptoms compared to those who had not had these symptoms probably due to milder disease course in COVID-19 with CSD. Sectorial RNFL attenuation in COVID-19 might have occurred secondary to peripapillary capillary circulation defect.

Central retinal vein occlusion and occlusive vasculopathy at macula in a patient with recent COVID-19 infection.

We described a post-COVID-19 patient who presented with central retinal vein occlusion and macular ischemia. A 50-year-old male presented with decreased vision for a month in his right eye (RE). The patient had no systemic risk factors for vascular disease but recent COVID-19 infection. Fundus examination revealed dense intraretinal dot hemorrhages especially at macula and ischemia-related retinal whitening in the posterior pole in RE. Expanding of foveal avascular zone was also detected in optical coherence tomography angiography (OCTA) sections. After systemic steroid therapy, subretinal fluid resolved but visual acuity did not increase. Depending on the fundus fluorescein angiography and OCTA findings, clinical picture was compatible with previous central retinal vein occlusion with superimposed occlusive vasculopathy at macula. COVID-19 patients with visual problems must be considered with care in regard to thrombotic retinal diseases.