Structural alterations of the choroid evaluated using enhanced depth imaging optical coherence tomography in patients with coronavirus disease

Abstract

To assess choroidal changes using enhanced depth imaging optical coherence tomography in coronavirus disease . Methods: Thirty-two patients with moderate COVID-19 and 34 healthy subjects were included in the study. Choroidal thickness was measured at 3 points as follows: at the subfovea, 1500 mm nasal to the fovea, and 1500 mm temporal to the fovea. The total choroidal area, luminal area, stromal area, and choroidal vascular index were measured with Image-J. All the measurements were performed during the disease and at 4 months after remission. Results: In the patient group, the subfoveal, nasal, and temporal choroidal thicknesses were decreased as compared with those in the controls, but without statistically significant differences (p=0.534, p=0.437, and p=0.077, respectively). The mean total choroidal, stromal, and luminal areas and choroidal vascular index were statistically significantly decreased in the patient group (p<0.001, p=0.001, p=0.001, and p=0.003; respectively). At 4 months after remission, the choroidal structural parameters and choroidal vascular index revealed statistically significant increases as compared with the baseline measurements in the patients with COVID-19 (all p<0.001 and p=0.047, respectively). Conclusion: The choroidal vascular and stromal parameters showed significant transient decreases during the disease course of COVID-19.

Investigation of changes in retinal vascular parameters and choroidal vascular index values during the early recovery period of COVID-19: The COVID-OCTA study

“…They stated that these results were associated with vascular damage, hypercoagulability, and hyperinflammation factors causing ischemia in the choriocapillaris, leading to a decrease in CVI. The authors state that the results at four months after remission are close to the measurements of the control group [34] . A study comparing the group with mild COVID-19 patients and the healthy group found that CVI, LA and TCA significantly decreased in the patient group.…”

“…Similarly, other studies found that the central foveal and choroidal thicknesses decreased in the COVID-19 group, but this decrease did not reach statistical significance [ 33 , 34 ]. On the contrary, Abrishami et al stated that the subfoveal nasal and temporal ChT was measured higher in the active period of the disease [31] .…”

Choroidal and Retinal Vascular Findings in Patients with COVID-19 Complicated with Pneumonia: Widefield Imaging

“…Others showed a decreased CVI during the COVID-19 disease with a reversible fashion some months after discharge, suggesting reversible and multiple mechanisms (ischemic and inflammatory) of COVID-19 on ocular perfusion [ 17 , 46 ].…”

Longitudinal Alterations of Retinal and Choroidal Structure in Patients Recovered from COVID-19

“…In a recent preprint, Kocamis and associates [10] investigated the choroidal alterations in patients with COVID-19 and demonstrated a lower amount of CVI in patients with COVID-19 than healthy control eyes. Despite the apparent difference between the present study results, our results cannot be compared with the mentioned study for several reasons.…”

“…While the validity of these findings has been questioned by attributing the lesions to the normal retinal vessels [8], later studies also confirmed the retinal microvascular changes [4,9]. In addition to retinal manifestations, choroid can also be involved during the disease course [10,11].…”