Assessment of the optic nerve, macular, and retinal vascular effects of COVID-19

Uğurlu, Adem; Ağcayazi, Sümeyye Burcu; İçel, Erel; Budakoglu, Ozlem; Ünver, Edhem; Barkay, Orçun; Karakeçili, Faruk; Bayrakceken, Kemal

doi:10.1016/j.jcjo.2022.06.016

Cited by 4 publications

(2 citation statements)

References 27 publications

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“…A comprehensive retrospective case-control study involving 2,351 patients revealed a notable increase in immune-mediated ocular conditions like uveitis and optic neuritis, potentially linked to COVID-19 ( 2 ). Concurrently, an observational cross-sectional study indicated that patients with neurological symptoms of COVID-19 exhibited a decrease in the thickness of the retinal nerve fiber layer and ganglion cell complex, as well as a reduced vessel density ( 22 ). In contrast, other research indicated an elevation in the thickness of the retinal nerve fiber layer, implying potential inflammation of the optic nerve or temporary alterations during acute COVID-19 infection ( 23 ).…”

Section: Discussionmentioning

confidence: 99%

Causal effect of COVID-19 on optic nerve and visual pathway disorders: genetic evidence of lung-brain axis

Cao,

Li,

Cai

et al. 2024

Front. Immunol.

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PurposeTo investigate the potential causal association between COVID-19 exposure and optic nerve and visual pathway disorders through a two-sample bidirectional Mendelian randomization (MR) analysis, and to provide empirical support for the lung-brain axis.MethodsThis MR analysis utilized publicly accessible summary-level data from genome-wide association studies on COVID-19 (n=158,783) and optic nerve and visual pathway diseases (n=412,181), primarily involving individuals of European descent. The random-effect inverse-variance weighted estimation was applied as the main analytical approach, complemented by MR-Egger, weighted median, and weighted mode methods. The heterogeneity and pleiotropy of the instrumental variables were assessed using Cochran’s Q test, leave-one-out sensitivity analysis, MR-Egger intercept test, MR-PRESSO, and funnel plot evaluations.ResultsIn the forward analysis, the inverse-variance weighted method identified a significant causal effect of COVID-19 on optic nerve and visual pathway disorders (odds ratio = 1.697, 95% confidence interval: 1.086–2.652, p = 0.020). Directionally consistent results were also observed with MR-Egger regression, weighted median, and weighted mode approaches. Conversely, the reverse analysis revealed no causal effects of optic nerve and visual pathway disorders on COVID-19 susceptibility.ConclusionOur findings suggest that COVID-19 exposure may increase the risk of developing optic nerve and visual pathway disorders, supporting the lung-brain axis hypothesis. These results underscore the importance of vigilant monitoring of the visual system in patients recovering from COVID-19 and suggest potential avenues for future therapeutic strategies.

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Section: Discussionmentioning

confidence: 99%

Causal effect of COVID-19 on optic nerve and visual pathway disorders: genetic evidence of lung-brain axis

Cao,

Li,

Cai

et al. 2024

Front. Immunol.

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“…Mavi et al found statistically significant changes with higher central foveal, mean outer nuclear layer, and mean peri-papillary RNFL thickness in the post COVID-19 patients compared to normal [85]. Ugurlu et al also examined SD-OCTs of 129 patients with COVID-19 infection 29 to 45 days following a positive PCR test, with findings of a statistically thinner macular RNFL and GCL layer in COVID-19 patients with neurological symptoms during the acute infection compared to those with non-neurological symptoms, no symptoms/pauci-symptoms, and control subject [86]. Interestingly, Taskiran-Sag et al studied 40 patients 113 ± 62 (SD) days after recovering from acute COVID-19 infection.…”

Section: Discussionmentioning

confidence: 99%

Retinal Microvasculature Image Analysis Using Optical Coherence Tomography Angiography in Patients with Post-COVID-19 Syndrome

Noor,

McGrath,

Drira

et al. 2023

J. Imaging

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Several optical coherence tomography angiography (OCT-A) studies have demonstrated retinal microvascular changes in patients post-SARS-CoV-2 infection, reflecting retinal-systemic microvasculature homology. Post-COVID-19 syndrome (PCS) entails persistent symptoms following SARS-CoV-2 infection. In this study, we investigated the retinal microvasculature in PCS patients using OCT-angiography and analysed the macular retinal nerve fibre layer (RNFL) and ganglion cell layer (GCL) thickness via spectral domain-OCT (SD-OCT). Conducted at the Manchester Royal Eye Hospital, UK, this cross-sectional study compared 40 PCS participants with 40 healthy controls, who underwent ophthalmic assessments, SD-OCT, and OCT-A imaging. OCT-A images from the superficial capillary plexus (SCP) were analysed using an in-house specialised software, OCT-A vascular image analysis (OCTAVIA), measuring the mean large vessel and capillary intensity, vessel density, ischaemia areas, and foveal avascular zone (FAZ) area and circularity. RNFL and GCL thickness was measured using the OCT machine’s software. Retinal evaluations occurred at an average of 15.2 ± 6.9 months post SARS-CoV-2 infection in PCS participants. Our findings revealed no significant differences between the PCS and control groups in the OCT-A parameters or RNFL and GCL thicknesses, indicating that no long-term damage ensued in the vascular bed or retinal layers within our cohort, providing a degree of reassurance for PCS patients.

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Nongranulomatous Inflammation: Uveitis, Endophthalmitis, Panophthalmitis, and Sequelae

Yanoff,

Sassani

2025

Ocular Pathology

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Assessment of the optic nerve, macular, and retinal vascular effects of COVID-19

Cited by 4 publications

References 27 publications

Causal effect of COVID-19 on optic nerve and visual pathway disorders: genetic evidence of lung-brain axis

Causal effect of COVID-19 on optic nerve and visual pathway disorders: genetic evidence of lung-brain axis

Retinal Microvasculature Image Analysis Using Optical Coherence Tomography Angiography in Patients with Post-COVID-19 Syndrome

Nongranulomatous Inflammation: Uveitis, Endophthalmitis, Panophthalmitis, and Sequelae

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