Sd-oct assessment of macular and optic nerve alterations in patients recovered from covid-19

Abstract

Objective: To quantify microstructutal alterations in the macula and peripapillary retinal nerve fibre layer (RNFL) in patients recovered from coronavirus disease 2019 (COVID-19) using spectral domain optic coherence tomography (SD-OCT).Design: Retrospective, observational.Participants: This comparative, cross-sectional study included patients who recovered from COVID-19 (Group 1) and age- and sex-matched normal controls (Group 2).Methods: A comprehensive ophthalmic examination, including best-corrected visual acuity and biomicroscopic anterior and posterior segment examination was performed. SD-OCT analysis of the macula and peripapillary RNFL was obtained for each participant. In addition, patient demographics and comorbidities were recorded.Results: 238 eyes of 122 subjects (Group 1: n = 63; Group 2: n = 59) were included. The incidence of coexisting comorbidity was higher in Group 1 (n = 26/63, 41.3%) compared with Group 2 (n = 12/59, 20.3%) (p = 0.013). The central foveal thickness (CFT) was significantly higher in Group 1 (271.0 +/- 26.8 mu m) than Group 2 (263.2 +/- 22.0 mu m) (p = 0.015). The average outer nuclear layer (ONL) thickness at central fovea in Group 1 (85.4 +/- 13.3 mm) was significantly thicker than that in Group 2 (81.4 +/- 15.2 mu m) (p = 0.035). The mean peripapillary RNFL thickness of Group 1 (102.6 +/- 8.8 mu m) and Group 2 (100.9 +/- 8.3 mu m) were similar (p = 0.145). The mean choroidal thickness of groups at the fovea and at 1500 mu m nasal and temporal to the fovea were not significantly different (p> 0.05 for all).Conclusion: Significant thickness alterations in individual retinal layers and CFT was detected in post-COVID-19 patients. The increase in CFT and ONL thickness might be attributed to direct infection or viral-induced inflammatory response of retina.