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严重 COVID-19 患者的视网膜血管直径和脉络膜厚度变化:严重 COVID-19 患者的视网膜参数变化。

Change in retinal vessel diameter and choroidal thickness in patients with severe COVID-19: Change In Retinal Parameters In Patients With Severe COVID-19.

机构信息

Kayseri City Hospital, Department of Ophthalmology, Kayseri, Turkey.

Kayseri City Hospital, Department of Ophthalmology, Kayseri, Turkey.

出版信息

Photodiagnosis Photodyn Ther. 2022 Mar;37:102674. doi: 10.1016/j.pdpdt.2021.102674. Epub 2021 Dec 5.

Abstract

PURPOSE

To compare the differences in retinal vascular structure and choroidal thickness between the active disease and post-recovery periods in COVID-19 patients and healthy controls.

MATERIAL AND METHODS

This prospective, cross-sectional study included 30 eyes from 30 patients with severe COVID-19 and 30 eyes of 30 sex-matched healthy controls. Central macular thickness (CMT), subfoveal choroidal thickness (CT) and retinal vascular changes of patients were measured after positive polymerase chain reaction (PCR) (where the patient had COVID-19-related symptoms) and then three months after two negative PCRs. Laboratory parameters, including C-reactive protein and d-dimer levels, were also recorded.

RESULTS

The mean age of the patients was 47.90 ± 9.06 years in patients group, 49.07 ± 8.41 years in control goups (p = 0.467). In terms of choroidal thicknesses subfoveal, nasal and temporal region were significantly higher in the active disease period than control group (p = 0.019, p = 0.036, p = 0.003, respectively). When the after recovery period was compared with the control group in terms of choroidal thickness, although the choroidal thickness was higher in all regions, this difference was not found statistically significant. There was no statistically significant difference in CMT between groups (p = 0.506).The mean venous and arterial wall thicknesses were significantly higher in the active period than after recovery (p = 0.023, p = 0.013, respectively) but there were no differences between after recovery and control groups in the pairwise comparison (p = 0.851, p = 0.715, respectively).

CONCLUSION

In patients with severe COVID-19, there are changes in thickness of the choroid and retinal vessel walls. While vascular wall thickness increases due to inflammation, the absence of lumen changes may be associated with hemodynamic variables.

摘要

目的

比较 COVID-19 患者活动期和恢复期的视网膜血管结构和脉络膜厚度差异。

材料和方法

本前瞻性、横断面研究纳入了 30 例严重 COVID-19 患者的 30 只眼和 30 例性别匹配的健康对照者的 30 只眼。在聚合酶链反应(PCR)阳性(患者有 COVID-19 相关症状)后,以及两次 PCR 阴性后三个月,测量患者的中央黄斑厚度(CMT)、中心凹下脉络膜厚度(CT)和视网膜血管变化。还记录了实验室参数,包括 C 反应蛋白和 D-二聚体水平。

结果

患者组的平均年龄为 47.90±9.06 岁,对照组为 49.07±8.41 岁(p=0.467)。在脉络膜厚度方面,活动期的下、鼻和颞侧区域均显著高于对照组(分别为 p=0.019、p=0.036、p=0.003)。与对照组相比,恢复期的脉络膜厚度虽然在所有区域均较高,但差异无统计学意义。组间 CMT 无统计学差异(p=0.506)。活动期静脉和动脉壁厚度明显高于恢复期(分别为 p=0.023、p=0.013),但在两两比较中,恢复期与对照组之间无差异(分别为 p=0.851、p=0.715)。

结论

在严重 COVID-19 患者中,存在脉络膜和视网膜血管壁厚度的变化。由于炎症导致血管壁厚度增加,而管腔无变化可能与血流动力学变量有关。

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