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儿科 COVID-19 中的视网膜微血管和血流灌注障碍:一项病例对照光学相干断层扫描血管造影研究。

Retinal microvascular and perfusional disruption in paediatric COVID-19: A case-control optical coherence tomography angiography study.

机构信息

Celal Bayar University, Hafsa Sultan Hospital, Department of Pediatrics, Manisa, Turkey.

İzmir Katip Çelebi University Atatürk Educating and Research Hospital, Department of Ophthalmology, 35200 İzmir, Turkey.

出版信息

Photodiagnosis Photodyn Ther. 2021 Dec;36:102577. doi: 10.1016/j.pdpdt.2021.102577. Epub 2021 Oct 11.

DOI:10.1016/j.pdpdt.2021.102577
PMID:34648992
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8503975/
Abstract

PURPOSE

To investigate the short-term effect of coronavirus 2019 (COVID-19) on the retinal capillary network and choroid in children.

MATERIALS AND METHODS

This prospective, cross-sectional, case-control study included 19 recovered COVID-19 pediatric patients and 20 healthy children. Macular thickness, choroidal thickness, vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) values were obtained. Central vessel and perfusion densities were measured at the central 6-mm area, and the values were compared among three subgroups according to location.

RESULTS

The mean ages of patients and controls were 12. 42 ± 3.3 years and 13.35 ± 1.2 years, respectively. Significant differences were observed between the two groups in terms of inner, outer, and full VD, as well as inner and full PD. No significant differences in center VD and PD were observed between groups. Although it was not evident in analysis of choroidal values, inflammatory sites were thickened. FAZ area significantly differed between groups (p < 0.05).

CONCLUSIONS

Retinal microvascularity was impaired in the acute phase of disease in recovered COVID-19 patients aged 10-15 years. However, the microvascularity impairment was subclinical. The choroid was thickened because of inflammation during the acute phase of disease. pediatric COVID-19 patients should undergo follow up via optical coherence tomography angiography to detect subclinical and asymptomatic retinal changes. Long-term follow-up studies are needed to validate these findings.

摘要

目的

研究 2019 年冠状病毒病(COVID-19)对儿童视网膜毛细血管网络和脉络膜的短期影响。

材料与方法

本前瞻性、横断面、病例对照研究纳入了 19 例已康复的 COVID-19 儿科患者和 20 名健康儿童。测量了黄斑厚度、脉络膜厚度、血管密度(VD)、灌注密度(PD)和中心无血管区(FAZ)值。在中央 6mm 区域测量中央血管和灌注密度,并根据位置将值分为三组进行比较。

结果

患者和对照组的平均年龄分别为 12.42±3.3 岁和 13.35±1.2 岁。两组间内层、外层和全层 VD 以及内层和全层 PD 存在显著差异。两组间中心 VD 和 PD 无显著差异。虽然分析脉络膜值时不明显,但炎症部位增厚。FAZ 面积在两组间有显著差异(p<0.05)。

结论

已康复的 10-15 岁 COVID-19 患者在疾病的急性期存在视网膜微血管功能障碍,但这种微血管功能障碍是亚临床的。由于疾病急性期的炎症,脉络膜增厚。儿科 COVID-19 患者应通过光相干断层扫描血管造影进行随访,以检测亚临床和无症状的视网膜变化。需要进行长期随访研究来验证这些发现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af10/8503975/cc1cb608c81f/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af10/8503975/903afb0854d3/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af10/8503975/cc1cb608c81f/gr2_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af10/8503975/903afb0854d3/gr1_lrg.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af10/8503975/cc1cb608c81f/gr2_lrg.jpg

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Reduced retinal vessel density in COVID-19 patients and elevated D-dimer levels during the acute phase of the infection.感染 COVID-19 的患者视网膜血管密度降低,感染急性期 D-二聚体水平升高。
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