Singapore National Eye Centre, Singapore.
Singapore Eye Research Institute, Singapore.
Br J Ophthalmol. 2022 Sep;106(9):1308-1312. doi: 10.1136/bjophthalmol-2020-318236. Epub 2021 Mar 19.
BACKGROUND/AIMS: To explore if retinal findings are associated with COVID-19 infection.
In this prospective cross-sectional study, we recruited participants positive for COVID-19 by nasopharyngeal swab, with no medical history. Subjects underwent retinal imaging with an automated imaging device (3D OCT-1 Maestro, Topcon, Tokyo, Japan) to obtain colour fundus photographs (CFP) and optical coherence tomographic (OCT) scans of the macula. Data on personal biodata, medical history and vital signs were collected from electronic medical records.
108 patients were recruited. Mean age was 36.0±5.4 years. 41 (38.0%) had symptoms of acute respiratory infection (ARI) at presentation. Of 216 eyes, 25 (11.6%) had retinal signs-eight (3.7%) with microhaemorrhages, six (2.8%) with retinal vascular tortuosity and two (0.93%) with cotton wool spots (CWS). 11 eyes (5.1%) had hyper-reflective plaques in the ganglion cell-inner plexiform layer layer on OCT, of which two also had retinal signs visible on CFP (CWS and microhaemorrhage, respectively). There was no significant difference in the prevalence of retinal signs in symptomatic versus asymptomatic patients (12 (15.0%) vs 13 (9.6%), p=0.227). Patients with retinal signs were significantly more likely to have transiently elevated blood pressure than those without (p=0.03).
One in nine had retinal microvascular signs on ocular imaging. These signs were observed even in asymptomatic patients with normal vital signs. These retinal microvascular signs may be related to underlying cardiovascular and thrombotic alternations associated with COVID-19 infection.
背景/目的：探讨视网膜病变是否与 COVID-19 感染有关。
本前瞻性横断面研究纳入了经鼻咽拭子检测 COVID-19 阳性、无既往病史的患者。所有患者均使用自动成像设备（3D OCT-1 Maestro，Topcon，东京，日本）进行视网膜成像，以获得眼底彩色照片（CFP）和黄斑 OCT 扫描。从电子病历中收集个人基本数据、病史和生命体征数据。
共纳入 108 例患者，平均年龄为 36.0±5.4 岁，41 例（38.0%）在就诊时有急性呼吸道感染（ARI）症状。216 只眼中有 25 只（11.6%）存在视网膜病变迹象，其中 8 只（3.7%）有微出血，6 只（2.8%）有视网膜血管迂曲，2 只（0.93%）有棉絮斑（CWS）。11 只眼（5.1%）OCT 上在神经节细胞-内丛状层有高反射斑块，其中 2 只眼在 CFP 上也可见视网膜病变迹象（分别为 CWS 和微出血）。有症状和无症状患者视网膜病变的发生率无显著差异（12 只眼（15.0%）vs. 13 只眼（9.6%），p=0.227）。有视网膜病变迹象的患者血压一过性升高的可能性显著高于无视网膜病变迹象的患者（p=0.03）。
九分之一的患者眼部影像学检查可见视网膜微血管病变迹象。这些迹象甚至在生命体征正常的无症状患者中也有发现。这些视网膜微血管病变可能与 COVID-19 感染相关的潜在心血管和血栓改变有关。
