Ocular repercussions in COVID-19 patients: structural changes of the retina and choroid

Background: Neurotropic capabilities of SARS-COVs allow viruses to reach the central nervous system by hematogenous neuronal dissemination. The human retina, as an extension of the Central Nervous System, may have some neurodegenerative and/or vascular modifications related to COVID-19. Objectives: To evaluate choroidal and inner neural layers in participants previously recovered from COVID-19 compared to the control group using optical coherence tomography. Methods: With a cross-sectional approach, the sample (n = 96), consisting of patients who have recovered from COVID-19 (n = 56) and healthy participants control group (n = 40) were ophthalmologically characterized. The neurodegenerative and vascular histological assessment was performed using SD-OCT and the mean thickness was measured in Early Treatment Diabetic Retinopathy Study (ETDRS) subfields. The retinal nerve fiber layer, Ganglion cell layer, and subfoveal choroidal thickness were obtained through semi-automatic measurement. Results: A total of 40 controls (27 women [67.5%]) and 56 COVID-19 participants (34 women [60.8%]) were included in this first report. There were retinal thickness significant differences in nearly all inner ETDRS subfields: nasal 3 mm (p = .025), I3 (p = .049), and temporal 3 mm (p = .009). Also, a decrease in neural layers was found in the nasal 3 mm (p = .049) and temporal 3 mm (p = .029) during ganglion cell layer assessment. The peripapillary retinal nerve fiber layer thickness was thinner in the COVID-19 group in superior temporal (p = .019), nasal (p = .002), inferior temporal (p = .046), and global (p = .014). Concerning the subfoveal choroidal measurement, an increase was observed in the COVID-19 group (p = .002). Conclusion: Participants who had recovered from COVID-19 showed a non-glaucomatous neuropathy trend pattern. We found differences closer to the classic description of the “bow-tie” observed in other neurological as compressive neuropathies at the chiasma location. OCT assessment also showed an increase in choroidal thickness as a result of vascular changes.

Description

This project was partially supported by an IDI&CA grant [IPL/2020/OCLOVID-19_ESTeSL] by H&TRC- Health & Technology Research Center, ESTeSL- Escola Superior de Tecnologia da Saúde, Instituto Politécnico de Lisboa.

Keywords

Ophthalmology COVID-19 Choroid Ganglion cell layer OCT Retina thickness Retinal nerve fiber layer IPL/2020/OCLOVID-19_ESTeSL

URI

http://hdl.handle.net/10400.21/16662

Citation

Poças IM, Lino P, Silva C, Mendonça P, Cunha JC, Camacho P, et al. Ocular repercussions in COVID-19 patients: structural changes of the retina and choroid. Strabismus. 2023;31(4):271-80.