Optic Nerve Head Vessel Density Assessment in Recovered COVID-19 Patients: A Prospective Study Using Optical Coherence Tomography Angiography

Abstract

Precis: Vascular diseases have been linked to alterations in optic nerve head perfusion. Purpose: The main objective was to investigate the changes in peripapillary vessel density (VD) in post coronavirus disease (COVID-19) patients. Methods: In this prospective pilot exploratory study, patients with COVID-19 that were attended in the Emergency Department of Hospital Clinico San Carlos (Madrid) were included. All patients underwent optic nerve head optical coherence tomography angiography using the Cirrus HD-OCT 500 with AngioPlex OCTA (Zeiss, Dublin, CA) 4 and 12 weeks after diagnosis by positive reverse transcriptase-polymerase chain reaction test from nasopharyngeal swab at the Emergency Department. Sociodemographic data, medical history, disease severity, and laboratory work-up were collected. Results: One hundred and eighty eyes of 90 patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection were included. None of the patients reported visual changes. Severe patients were older, more frequently hispanic, dyslipidemic, and presented lower lymphocytes counts, as well as increased ferritin, D-dimer, fibrinogen, and international normalized ratio levels. No changes in optic nerve head vascularization were observed when both visits were compared. No correlation was found between VD and clinical parameters, disease severity and laboratory work-up. Conclusions: Changes to peripapillary VD were not observed in patients with COVID-19 in the early months following diagnosis.

One-Year Changes in Optic Nerve Head Parameters in Recovered COVID-19 Patients

“…0.05, not shown). Regarding patients' medical history data, DM was associated with VD and RNFL (as in previous study, not shown) (9).…”

“…No correlation was noted between VD, FI, or RNFL thickness at the 12-month visit and SARS-CoV-2 parameters, which included clinical parameters, disease severity, and blood test (all P > 0.05, not shown). Regarding patients' medical history data, DM was associated with VD and RNFL (as in previous study, not shown) (9).…”

“…Using OCTA, Savastano et al reported a lower peripapillary vessel density (VD) in post–COVID-19 patients one month after hospital discharge compared with healthy subjects (8). Our previous study could not detect differences in peripapillary vascularization of patients with COVID-19 compared with healthy individuals, probably because of the smaller sample of the latter (9). In addition, no differences were found in peripapillary vascularization 1 and 3 months after SARS-CoV-2 infection (9).…”

“…Our previous study could not detect differences in peripapillary vascularization of patients with COVID-19 compared with healthy individuals, probably because of the smaller sample of the latter (9). In addition, no differences were found in peripapillary vascularization 1 and 3 months after SARS-CoV-2 infection (9). Therefore, if an increase in RNFL thickness along with a decrease in vascularization does in fact occur, these could represent a long-term sequela of the virus.…”

Optical Coherence Tomography Angiography Assessment of the Optic Nerve Head in Patients Hospitalized Due to COVID-19 Bilateral Pneumonia

“…Patients with COVID-19 were not assessed during the acute phase of the disease during hospitalization, and the healthy control group was relatively small. In addition, the study did not include patients with severe illness, some of whom may have died of the disease [ 28 ].…”