A Pediatric COVID-19 Study: Retinal Nerve Fiber Layer, Ganglion Cell Layer, and Alterations in Choroidal Thickness in Swept-Source OCT Measurements

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.

OCT and OCTA evaluation of vascular and morphological structures in the retina in recovered pediatric patients with COVID-19

“…showed that there was no significant difference in RT between the two groups. Akpolat et al [8] . reported that the CT was thinner in children with COVID-19 than in healthy children.…”

“…reported that the pRNFLT and macular GCL thickness was thicker in patients with COVID-19 compared to healthy subjects. Akpolat et al [8] . reported that the pRNFLT was thicker in patients with COVID-19 compared to healthy subjects, while the GCL was thinner.…”

“…More recently, few manuscripts have been reported evaluating retinal and choroidal thickness changes in pediatric patients with COVID-19 by OCT imaging and comparing them with healthy children[ 6 , 8 , 9 ]. Zengin et al [6] .…”

“…The inner retina is a neuronal tissue and can be damaged by SARS-CoV-2 [26] . Retinal nerve fiber and ganglion cell layer thickness changes were evaluated in pediatric patients with COVID-19 by OCT imaging and comparing them with healthy children [8] , [9] . Burgos-Blasco et al [9] .…”

“…Recent studies of eye involvement in pediatric patients with COVID-19 have included limited numbers of patients and have focused primarily on pathologies occurring in the anterior segment of the eye. To the best of our knowledge, there are few studies investigating posterior segment involvement in this age group [5] , [6] , [7] , [8] , [9] , [10] .…”