Bypareddy Ravi, Rathod B L Sujatha, Shilpa Y D, Hithashree H R, Nagaraj Kalpana Badami, Hemalatha B C, Basumatary Jessica, Bekal Deeksha, Niranjan R, Anusha P G
Department of Vitreo-Retina, Regional Institute of Ophthalmology, Minto Ophthalmic Hospital, BMCRI, Bengaluru, Karnataka, India.
Indian J Ophthalmol. 2021 May;69(5):1271-1274. doi: 10.4103/ijo.IJO_3227_20.
The aim of this work was to study and document retinal changes in coronavirus disease-2019 (COVID-19) positive patients with nonsevere disease using a nonmydriatic handheld fundus camera.
A cross-sectional observational study was conducted on patients affected by COVID-19 who were admitted at our center. Our study included patients with no, mild, and moderate symptoms (nonsevere cases). Intensive care unit (ICU)-admitted patients were excluded considering the difficulty in procuring the fundus image by the handheld camera due to patients positioning. Patients with systemic conditions (diabetes, hypertension, and severe anemia) known to cause retinopathy were also excluded. Bedside anterior segment examination, fundus examination using indirect ophthalmoscopy and fundus imaging of each patient using a nonmydriatic handheld fundus camera was done by a trained ophthalmologist posted for COVID duty.
In a cohort of 138 patients, 94 (68.1%) were men and 44 (31.9%) were women. A total of 276 eyes were evaluated. The mean age of the patients was 38.51 ± 14.4 years. Anterior segment evaluation showed no abnormality in any of the eyes. On fundus screening using nonmydriatic handheld camera, a single streak of superficial retinal hemorrhage was noted at the posterior pole of the fundus in the left eye of one patient (0.72%), which was away from fovea. Laboratory tests revealed low hemoglobin (between 10 and 10.9 g/dL falling under mild Anemia) in 12 patients, elevated total leucocyte count in 6 patients, raised LDH in majority of patients (323 ± 101 Units/L) and elevated CRP (14.6 ± 30.99 mg/L). Rest of the lab parameters were within the normal range.
In our study, COVID patients with mild-to-moderate symptoms did not show any inflammatory/infective or vaso-occlusive lesions in the retina attributable to COVID-19 infection, except one patient who had a single streak hemorrhage in the macula away from fovea, probably incidental.
本研究旨在使用非散瞳手持式眼底相机，研究并记录非重症新型冠状病毒肺炎（COVID-19）阳性患者的视网膜变化。
对我院收治的COVID-19患者进行横断面观察性研究。我们的研究纳入了无症状、轻症和中症患者（非重症病例）。由于手持相机获取眼底图像时患者体位的原因，入住重症监护病房（ICU）的患者被排除。已知会导致视网膜病变的全身性疾病（糖尿病、高血压和重度贫血）患者也被排除。由一名负责COVID相关工作的训练有素的眼科医生对每位患者进行床边眼前节检查、使用间接检眼镜进行眼底检查以及使用非散瞳手持式眼底相机进行眼底成像。
在138例患者队列中，男性94例（68.1%），女性44例（31.9%）。共评估了276只眼。患者的平均年龄为38.51±14.4岁。眼前节评估显示所有眼睛均无异常。使用非散瞳手持式相机进行眼底筛查时，一名患者（0.72%）的左眼眼底后极部发现一条表浅视网膜出血条纹，远离黄斑中心凹。实验室检查显示，12例患者血红蛋白低（10至10.9 g/dL，属于轻度贫血），6例患者白细胞总数升高，大多数患者乳酸脱氢酶升高（323±101单位/L），C反应蛋白升高（14.6±30.99 mg/L）。其余实验室参数均在正常范围内。
在我们的研究中，除一名患者黄斑区远离中心凹处有一条出血条纹（可能为偶然情况）外，轻至中度症状的COVID患者未显示出任何因COVID-19感染导致的视网膜炎症/感染或血管闭塞性病变。
