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定量评估 COVID-19 患者的视网膜变化。

Quantitative assessment of retinal changes in COVID-19 patients.

机构信息

Ophthalmology Department, Adıyaman University Training and Research Hospital, Adıyaman, Turkey.

Ophthalmology Department, Ulucanlar Eye Training and Research Hospital, Ankara, Turkey.

出版信息

Clin Exp Optom. 2021 Aug;104(6):717-722. doi: 10.1080/08164622.2021.1916389. Epub 2021 May 20.

Abstract

CLINICAL RELEVANCE

The SARS-COV 2 virus, which is responsible for the COVID-19 pandemic, acts on the angiotensin converting enzyme 2 (ACE-2) receptor in the host cell. Ocular effects may occur because of the ACE-2 receptor in the retina.

BACKGROUND

To investigate the impact of COVID-19 on the retinal layers and optic disc parameters in previously confirmed COVID-19 patients using spectral domain optical coherence tomography (SD-OCT).

METHODS

This study included 60 eyes of 60 subjects; 35 of them were in the COVID-19 group and the remaining 25 were in the control group. Patients with the diagnosis of COVID-19 that had a negative result after treatment were included in the study. Macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements, each retinal layer thickness of all participants were done 14-30 days after COVID-19 symptom onset, following the negative result of real time reverse transcriptase-polymerase chain reaction test using SD-OCT.

RESULTS

The mean value of central macular thickness was significantly higher in the COVID-19 group than the control group (p = 0.02). The mean values of the ganglion cell layer and inner nuclear layer thickness in the COVID-19 group were significantly thinner than control group (p = 0.04 and p = 0.04, respectively). Even though mean RNFL thickness measurements in all sections in the COVID-19 group was thinner than controls, there were no significant differences between groups (p > 0.05 for all).

CONCLUSION

In the early recovery phase, changes in the macula, ganglion cell layer and inner nuclear layer could be seen. These patients should be followed up closely for the recognition of new pathologies that could be seen in the late recovery phase.

摘要

临床相关性

导致 COVID-19 大流行的 SARS-CoV-2 病毒在宿主细胞中作用于血管紧张素转换酶 2(ACE-2)受体。眼部效应可能是由于视网膜中的 ACE-2 受体引起的。

背景

使用谱域光相干断层扫描(SD-OCT)研究先前确诊 COVID-19 患者中 COVID-19 对视网膜层和视盘参数的影响。

方法

本研究纳入了 60 名患者的 60 只眼;其中 35 只眼为 COVID-19 组,其余 25 只眼为对照组。纳入研究的患者均为 COVID-19 诊断,经治疗后结果为阴性。在 COVID-19 症状出现后 14-30 天,对所有患者进行黄斑和视盘周围视网膜神经纤维层(RNFL)厚度测量,以及所有参与者的各层视网膜厚度测量,使用 SD-OCT 进行实时逆转录聚合酶链反应检测,结果为阴性。

结果

COVID-19 组的中央黄斑厚度平均值明显高于对照组(p=0.02)。COVID-19 组的神经节细胞层和内核层厚度平均值明显薄于对照组(分别为 p=0.04 和 p=0.04)。尽管 COVID-19 组各节段的平均 RNFL 厚度测量值均小于对照组,但两组间无显著差异(p>0.05)。

结论

在早期恢复期,可以看到黄斑、神经节细胞层和内核层的变化。这些患者应密切随访,以识别在晚期恢复期可能出现的新病变。

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