Department of Ophthalmology, University Medical Centre Ljubljana, Grablovičeva 46, 1000, Ljubljana, Slovenia.
Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
Graefes Arch Clin Exp Ophthalmol. 2023 Apr;261(4):1115-1125. doi: 10.1007/s00417-022-05887-0. Epub 2022 Nov 5.
To quantify retinal microvascular findings in the acute phase of COVID-19 using multimodal imaging and compare them with healthy, age-matched controls.
Hospitalized patients in the acute phase of COVID-19 without known systemic comorbidities (n = 75) and healthy controls (n = 101) aged 18-65 were enrolled in this prospective cross-sectional study. The retinal microcirculation and microvasculature impairments were assessed using fundus photography, swept-source optical coherence tomography, and swept-source optical coherence tomography angiography in the COVID-19 unit and compared with healthy, age-matched controls.
Retinal findings were predominately observed in patients with severe disease (P = 0.006). Patients with severe disease were shown to have increased both mean vein diameter (Coef. = 19.28, 95% CI: 7.34-31.23, P = 0.002) and mean artery diameter (Coef. = 11.07, 95% CI: 0.84-21.67, P = 0.044). Neither blood vessel diameters were correlated with any confounding variables (age, sex, treatment with oxygen, LDH, or ferritin). Patients with severe COVID-19 were shown to have significantly increased retinal nerve fiber layer thickness in the superior and inferior quadrants both in the inner (S: P = 0.046; I: P = 0.016) and outer (S: P = 0.026; I: P = 0.014) ring and significantly increased GCL thickness in the outer temporal quadrant (P = 0.038). There were no statistically significant differences in vessel density or the foveal avascular zone area between the groups.
The severity of COVID-19 was significantly correlated with the presence of retinal microangiopathy, which could become a biomarker of angiopathy in patients with COVID-19.
使用多模态成像技术定量检测 COVID-19 急性期的视网膜微血管病变，并将其与健康、年龄匹配的对照进行比较。
本前瞻性横断面研究纳入了 75 例无已知系统性合并症的 COVID-19 急性期住院患者和 101 例健康对照（年龄 18-65 岁）。在 COVID-19 病房使用眼底照相、扫频源光学相干断层扫描和扫频源光学相干断层扫描血管造影评估视网膜微循环和微血管损伤，并与健康、年龄匹配的对照组进行比较。
视网膜病变主要见于重症患者（P=0.006）。重症患者的平均静脉直径（Coef. = 19.28，95%CI：7.34-31.23，P=0.002）和平均动脉直径（Coef. = 11.07，95%CI：0.84-21.67，P=0.044）均增加。血管直径均与任何混杂变量（年龄、性别、氧疗、LDH 或铁蛋白）无关。重症 COVID-19 患者的上、下象限的视网膜神经纤维层厚度在内环（S：P=0.046；I：P=0.016）和外环（S：P=0.026；I：P=0.014）均显著增加，外颞象限的 GCL 厚度也显著增加（P=0.038）。两组间血管密度或无血管区面积无统计学差异。
COVID-19 的严重程度与视网膜微血管病变的存在显著相关，这可能成为 COVID-19 患者血管病变的生物标志物。
