Maria Cristina Savastano1,2, Gloria Gambini1,2, Grazia Maria Cozzupoli1,2, Emanuele Crincoli3,4, Alfonso Savastano1,2, Umberto De Vico1,2, Carola Culiersi1,2, Benedetto Falsini1,2, Francesco Martelli5, Angelo Maria Minnella1,2, Francesco Landi2,6, Francesco Cosimo Pagano2,6, Stanislao Rizzo1,2,7. 1. Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy. 2. Catholic University of "Sacro Cuore", Largo A. Gemelli 8, 00198, Rome, Italy. 3. Ophthalmology Unit, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy. emanuelecrincoli1@gmail.com. 4. Catholic University of "Sacro Cuore", Largo A. Gemelli 8, 00198, Rome, Italy. emanuelecrincoli1@gmail.com. 5. Department of Cardiovascular and Endocrine-Metabolic Diseases, and Ageing, "Istituto Superiore di Sanità", Rome, Italy. 6. Department of Geriatrics, Neurosciences and Orthopedics, "Fondazione Policlinico Universitario A. Gemelli IRCCS", Rome, Italy. 7. "Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze", Pisa, Italy.
Abstract
BACKGROUND: Systemic vascular involvement in COVID-19 has been identified in several patients: not only endothelial derangement and increased permeability are reported to be early hallmarks of organ damage in patients with COVID-19 but are also the most important cause of worsening of clinical conditions in severe cases of SARS-CoV-2 infection. There are several reasons to hypothesize that the eye, and the retina in particular, could be a target of organ damage in SARS-CoV-2 infection. METHODS: This cohort observational study analyzes OCT angiography and structural OCT of 70 post-COVID-19 patients evaluated at 1-month hospital discharge and 22 healthy control subjects. Primary outcomes were macular vessel density (VD) and vessel perfusion (VP); structural OCT features were evaluated as secondary outcomes. In addition, patients and healthy volunteers were evaluated for best corrected visual acuity, slit lamp photograph, and fundus photo image. RESULTS: VD and VP in 3 × 3 and 6 × 6 mm scans for SCP and DCP showed no significant differences between the groups. Similarly, CMT and GCL did not reveal significant differences between post-COVID-19 and healthy patients. Nine patients (12.9%) featured retinal cotton wool spots and 10 patients had vitreous fibrillary degeneration. The prevalence of epiretinal membrane and macular hole was similar in the two groups. One case of extra papillary focal retinal hemorrhage was reported in the post-COVID-19 group. CONCLUSIONS: Macula and perimacular vessel density and perfusion resulted unaltered in mild post-COVID-19 patients at 1-month hospital discharge, suggesting no or minimal retinal vascular involvement by SARS-CoV-2.
BACKGROUND: Systemic vascular involvement in COVID-19 has been identified in several patients: not only endothelial derangement and increased permeability are reported to be early hallmarks of organ damage in patients with COVID-19 but are also the most important cause of worsening of clinical conditions in severe cases of SARS-CoV-2 infection. There are several reasons to hypothesize that the eye, and the retina in particular, could be a target of organ damage in SARS-CoV-2 infection. METHODS: This cohort observational study analyzes OCT angiography and structural OCT of 70 post-COVID-19patients evaluated at 1-month hospital discharge and 22 healthy control subjects. Primary outcomes were macular vessel density (VD) and vessel perfusion (VP); structural OCT features were evaluated as secondary outcomes. In addition, patients and healthy volunteers were evaluated for best corrected visual acuity, slit lamp photograph, and fundus photo image. RESULTS: VD and VP in 3 × 3 and 6 × 6 mm scans for SCP and DCP showed no significant differences between the groups. Similarly, CMT and GCL did not reveal significant differences between post-COVID-19 and healthy patients. Nine patients (12.9%) featured retinal cotton wool spots and 10 patients had vitreous fibrillary degeneration. The prevalence of epiretinal membrane and macular hole was similar in the two groups. One case of extra papillary focal retinal hemorrhage was reported in the post-COVID-19 group. CONCLUSIONS: Macula and perimacular vessel density and perfusion resulted unaltered in mild post-COVID-19patients at 1-month hospital discharge, suggesting no or minimal retinal vascular involvement by SARS-CoV-2.
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