Retinal tissue and microvasculature loss in COVID-19 infection

Kalaw, Fritz Gerald P.; Warter, Alexandra; Cavichini, Melina; Knight, Darren; Li, Alexandria; Deussen, Daniel N.; Galang, Carlo; Heinke, Anna; Mendoza, Verónica; Borooah, Shyamanga; Baxter, Sally L.; Bartsch, Dirk-Uwe; Cheng, Lingyun; Freeman, William R.

doi:10.1038/s41598-023-31835-x

Cited by 3 publications

(3 citation statements)

References 41 publications

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“…( 22 ) found a significantly lower retinal volume of the outer third of the macula for severe COVID-19 patients. However, changes in the volume of the entire ETDRS grid for mild cases have not been reported, making them unavailable for comparison with our CV results ( 22 ). Temporal GCIPL thinning was also revealed by Seker et al ( 38 ) in patients shortly after recovering from COVID-19 and no difference in GCIPL thickness was obtained at a 12-month follow-up.…”

Section: Discussionmentioning

confidence: 95%

“…As to retinal volume, Kalaw et al. ( 22 ) found a significantly lower retinal volume of the outer third of the macula for severe COVID-19 patients. However, changes in the volume of the entire ETDRS grid for mild cases have not been reported, making them unavailable for comparison with our CV results ( 22 ).…”

Section: Discussionmentioning

confidence: 98%

“…The impact of SARS-CoV-2 on retinal microvasculature still stands to be controversial. Some studies showed significant reduction in VD, increase in FAZ and CMT ( 19 , 20 ), and thinning in GCIPL ( 14 , 21 ) compared to healthy controls, indicating potential long-term consequences of the disease ( 22 ). Conversely, other studies found no notable differences in VD or mean FAZ measurements, similar to our results observed at the second follow-up ( 15 , 23 ).…”

Section: Discussionmentioning

confidence: 99%

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New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study

Zhang,

Cheng,

Chen

et al. 2024

Front. Immunol.

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PurposeTo investigate the longitudinal alterations of retinal microvasculature in patients with primary coronavirus disease 2019 (COVID-19) infection.MethodsA cohort of participants, who had never been infected with COVID-19, was recruited between December 2022 and May 2023 at Peking Union Medical College Hospital in Beijing, China. Participants underwent comprehensive ophthalmologic examinations and fundus imaging, which included color fundus photography, autofluorescence photography, swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA). If participants were infected with COVID-19 during the study, follow-ups with consistent imaging modality were conducted within one week and two months after recovery from the infection.Results31 patients (61 eyes), with a mean age of 31.0 ± 7.2 years old, were eligible for this study. All participants contracted mild COVID-19 infection within one month of baseline data collection. The average period was 10.9 ± 2.0 days post-infection for the first follow-up and 61.0 ± 3.5 days for the second follow-up. No clinical retinal microvasculopathy features were observed during the follow-ups. However, SS-OCTA analysis showed a significant increase in macular vessel density (MVD) from 60.76 ± 2.88% at baseline to 61.59 ± 3.72%(p=0.015) at the first follow-up, which subsequently returned to the baseline level of 60.23 ± 3.33% (p=0.162) at the two-month follow-up. The foveal avascular zone (FAZ) remained stable during the follow-ups with areas of 0.339 ± 0.097mm2, 0.342 ± 0.093mm2, and 0.344 ± 0.098mm2 at the baseline, first follow-up (p=0.09) and second follow-up (p=0.052), respectively. Central macular thickness, cube volume and ganglion cell-inner plexiform layer showed a transient decrease at the first follow-up(p<0.001, p=0.039, p=0.002, respectively), and increased to baseline level at the two-month follow-up(p=0.401, p=0.368, p=0.438, respectively).ConclusionMild COVID-19 infection may temporarily and reversibly impact retinal microvasculature, characterized by a transient increase in retinal blood flow during the early recovery phase, which returns to the pre-infection level two months post-infection.

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Section: Discussionmentioning

confidence: 95%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

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New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study

Zhang,

Cheng,

Chen

et al. 2024

Front. Immunol.

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Comprehensive Assessment of Eyes in Kidney Transplant Recipients after Recovering from COVID-19

Ślizień,

Sulecka,

Tylicki

et al. 2023

Life

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Introduction: Patients after organ transplantation with COVID-19 have a higher risk of morbidity and mortality than patients in the general population. There are single studies that assess the eyes of COVID-19 patients, but there are no such studies on organ transplant recipients. The purpose of this study was to comprehensively examine the eyes of kidney transplant recipients (KTR) after recovery from mild to moderate SARS-CoV-2 infection. Methods: A total of 40 KTR after COVID-19 and 20 KTR without clinical and immunological symptoms of SARS-CoV-2 infection as a control group was qualified for the cross-sectional study. A total of 76 eyes from 38 KTR on an average of 7 weeks after COVID-19 and 36 eyes from 18 KTR from the control group were studied. The participants underwent an ophthalmological examination, and the retinal and choroid vessels and nerves were assessed by optical coherence tomography angiography. Results: We found a lower vessel density (VD) in the deep capillary plexus in the central part of the retina (VD deep central) of the study group. Women had significantly lower VD deep central in the study group (15.51 vs. 18.91, p < 0.001). Multivariate linear regression analysis confirmed an independent, negative impact of COVID-19 (p < 0.001) and female gender (p = 0.001) on VD deep central. Conclusion: The results of our study confirmed that changes in microcirculation induced by SARS-CoV-2 infection may affect the retinal vessels in KTR. Mild to moderate COVID-19 in KTR resulted in a significant reduction in VD deep central of the retina, with these changes being more common in females.

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Posterior Segment Ocular Findings in Critically Ill Patients with COVID

María Romero Castro,

González Cannata,

Sánchez Tlapalcoyoatl

2024

New COVID-19 Variants - Diagnosis and Management in the Post-Pandemic Era

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To describe ophthalmological fundoscopic findings in patients with COVID-19 admitted to the intensive care unit (ICU) of the largest third-level referral center for COVID-19 in Mexico City. In this cross-sectional single-center study, consecutive patients admitted to the ICU with a diagnosis of COVID-19 underwent fundus examination with an indirect ophthalmoscope. Clinical photographs were taken using a posterior-pole camera. We explored the association between ocular manifestations and demographic characteristics, inflammatory markers, hemodynamic factors, and comorbidities. Of 117 patients examined, 74 were male; the median age was 54 years (range: 45–63 years). Forty-two patients had ophthalmological manifestations (unilateral in 23 and bilateral in 19), and 10 of these patients had more than one ophthalmological manifestation. Ocular findings were papillitis (n = 13), cotton-wool spots (n = 12), retinal hemorrhages (n = 5), retinal nerve fiber layer edema (n = 8), macular whitening (n = 5), retinal vascular tortuosity (n = 4), papillophlebitis (n = 3), central retinal vein occlusion (n = 1), and branch retinal vein occlusion (n = 1). Ocular fundus manifestations were not associated with demographic characteristics, inflammatory markers, hemodynamic factors, or comorbidities. Over one-third of patients with severe COVID-19 had ophthalmological manifestations. The most frequent fundoscopic findings were optic nerve inflammation, microvasculature occlusion, and major vascular occlusions. We recommend long-term follow-up to prevent permanent ocular sequelae.

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Retinal tissue and microvasculature loss in COVID-19 infection

Cited by 3 publications

References 41 publications

New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study

New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study

Comprehensive Assessment of Eyes in Kidney Transplant Recipients after Recovering from COVID-19

Posterior Segment Ocular Findings in Critically Ill Patients with COVID

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