Ophthalmology Unit, Neurosciences, Mental Health, and Sense Organs (NESMOS) Department, Sapienza University of Rome, Rome, Italy.
Faculty of Medicine and Psychology, St. Andrea Hospital, Via di Grottarossa 1035/1039, 00189, Rome, Italy.
Int Ophthalmol. 2022 Nov;42(11):3601-3610. doi: 10.1007/s10792-022-02338-x. Epub 2022 May 11.
The role of the human eye in severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) is still under investigation. The pathophysiology of the ocular findings is arduous when dealing with critically ill Covid-19 patients with comorbidities. Multiorgan involvement and the effects of inflammation, infection and systemic treatment on the retina are complex, and comparison of studies is difficult. Most studies in human patients have investigated the anterior segment, whereas few reports deal with the posterior segment of the eye. The present review aims to evaluate the retinal manifestations and imaging features in COVID-19 patients.
Studies on the retinal manifestations and retinal imaging in COVID-19 patients published through June 2021 were reviewed. We included cross-sectional and case-control studies, case series, case reports and correspondence in the analysis.
Flame-shaped hemorrhages, cotton wool spots, augmented diameter and tortuosity of retinal vessels were found on funduscopic examination. Peripapillary, macular retinal nerve fiber layer and ganglion cell layer thickness alterations were reported on spectral domain optical coherence tomography. Reduced vessel density of the superficial and deep retinal capillary plexus on optical coherence tomography angiography was reported.
Retinal complications may arise in COVID-19 patients. Although no consensus on presentation is currently available, retinal funduscopy and imaging has shown neuronal and vascular alterations. Systemic neurological complications and microangiopathy are associated with SARS-COV-2; thus, as the retina has a neuronal and vascular component, funduscopy and retinal imaging on COVID-19 patients can provide further insight to SARS-COV-2 disease and the follow-up of patients.
人类眼睛在严重急性呼吸综合征冠状病毒 2（SARS-CoV-2）中的作用仍在研究中。当处理患有合并症的重症 COVID-19 患者时，眼部发现的病理生理学非常复杂。多器官受累以及炎症、感染和全身治疗对视网膜的影响很复杂，并且研究之间的比较也很困难。大多数在人类患者中的研究都调查了前段，而很少有报道涉及眼睛的后段。本综述旨在评估 COVID-19 患者的视网膜表现和影像学特征。
通过 2021 年 6 月，我们对 COVID-19 患者视网膜表现和视网膜成像的研究进行了回顾。我们将横断面和病例对照研究、病例系列、病例报告和通信纳入分析。
眼底检查发现火焰状出血、棉絮斑、视网膜血管直径增宽和迂曲。频域光相干断层扫描报告了视盘周围、黄斑视网膜神经纤维层和节细胞层厚度改变。光学相干断层扫描血管造影显示浅层和深层视网膜毛细血管丛的血管密度降低。
COVID-19 患者可能会出现视网膜并发症。尽管目前尚无关于表现的共识，但视网膜眼底检查和影像学检查显示了神经元和血管改变。全身神经系统并发症和微血管病与 SARS-CoV-2 相关；因此，由于视网膜具有神经元和血管成分，对 COVID-19 患者进行眼底检查和视网膜成像可以进一步了解 SARS-CoV-2 疾病和患者的随访情况。
