Optic nerve and macular optical coherence tomography in recovered COVID-19 patients

Abstract

Purpose: To investigate the peripapillary retinal nerve fiber layer thickness (RNFLT), macular RNFLT, ganglion cell layer (GCL), and inner plexiform layer (IPL) thickness in recovered COVID-19 patients compared to controls. Methods: Patients previously diagnosed with COVID-19 were included, while healthy patients formed the historic control group. All patients underwent an ophthalmological examination, including macular and optic nerve optical coherence tomography. In the case group, socio-demographic data, medical history, and neurological symptoms were collected. Results: One hundred sixty patients were included; 90 recovered COVID-19 patients and 70 controls. COVID-19 patients presented increases in global RNFLT (mean difference 4.3; CI95% 0.8 to 7.7), nasal superior (mean difference 6.9; CI95% 0.4 to 13.4), and nasal inferior (mean difference 10.2; CI95% 2.4 to 18.1) sectors of peripapillary RNFLT. Macular RNFL showed decreases in COVID-19 patients in volume (mean difference −0.05; CI95% −0.08 to −0.02), superior inner (mean difference −1.4; CI95% −2.5 to −0.4), nasal inner (mean difference −1.1; CI95% −1.8 to −0.3), and nasal outer (mean difference −4.7; CI95% −7.0 to −2.4) quadrants. COVID-19 patients presented increased GCL thickness in volume (mean difference 0.04; CI95% 0.01 to 0.07), superior outer (mean difference 2.1; CI95% 0.8 to 3.3), nasal outer (mean difference 2.5; CI95% 1.1 to 4.0), and inferior outer (mean difference1.2; CI95% 0.1 to 2.4) quadrants. COVID-19 patients with anosmia and ageusia presented an increase in peripapillary RNFLT and macular GCL compared to patients without these symptoms. Conclusions: SARS-CoV-2 may affect the optic nerve and cause changes in the retinal layers once the infection has resolved.

Retinal nerve fibre layer and ganglion cell layer changes in children who recovered from COVID-19: a cohort study

“…In addition, patients who recovered from COVID-19 presented increased GCL thickness in volume, superior outer, nasal outer and inferior outer quadrants. 24 These results were closely related to the presence of nervous system symptoms, which we did not find in the current study. This is probably because children present a milder form of the disease, and symptoms are vague and are more difficult to determine in the paediatric population.…”

Retinal OCT Findings in Patients after COVID Infection

“…Additionally, Savastano et al noticed a reduced perfusion density of the radial peripapillary capillary plexus in recovered COVID-19 patients compared to that in a control group [ 25 ]. Moreover, in a study performed on 90 recovered COVID-19 patients, the authors described an increase in peripapillary RNFLT and macular GCC compared to controls, suggesting that the virus may also affect the optic nerve [ 10 ]. Despite these reports of the retinal capillary microvasculature changes due to SARS-CoV-2 infection, in our study, we did not confirm any differences between the study and control groups in terms of superficial vessel plexus density, FAZ area, central macular thickness, or RNFL thickness.…”

“…For several years, it has been possible to visualize retinal and choroidal vasculature, without the use of contrast, due to the development of OCT angiography [ 6 , 7 ]. Recently, scientific reports have been published describing abnormalities such as an increase in RNFLT, retinal vessel enlargement, and lower vessel density of the superficial and deep retinal capillary plexus in patients after SARS-CoV-2 infection compared to a control group [ 4 , 8 , 9 , 10 ]. This study aimed to assess the presence of possible ophthalmological complications after symptomatic coronavirus disease 2019 by appraising the morphology and morphometry of the optic nerve, retina, and retinal vessels using optical coherence tomography in a group of post-COVID-19 subjects.…”

The effect of COVID-19 infection on retinal nerve fiber layer and ganglion cell complex layer thicknesses

“…They did not detect a difference with postcovid patients without anosmia and headache. They stated that anosmia and headache are associated with neurological involvement and that the early period of viral infection causing neuroinflammation caused an increase in RNFL and GCL [14]. In our study, we did not separate the patients into those with and without neurological findings.…”

“…In their study, Burgos-Blasco et al [14] found that patients who had COVID-19 infection with anosmia and headache during their disease period increased the thickness of the peripapillary RNFL and GC-IPL thicknesses in the early period compared to normal healthy individuals. They did not detect a difference with postcovid patients without anosmia and headache.…”