基于光学相干断层扫描研究的新冠病毒肺炎双侧肺炎患者氧饱和度降低对视网膜微血管形成的影响
The Effect of Reduced Oxygen Saturation on Retinal Microvascularization in COVID-19 Patients with Bilateral Pneumonia Based on Optical Coherence Tomography Study.
作者信息
Kal Magdalena, Winiarczyk Mateusz, Mackiewicz Jerzy, Odrobina Dominik, Cieśla Elżbieta, Płatkowska-Adamska Bernadetta, Biskup Michał, Pabjan Paweł, Zarębska-Michaluk Dorota
机构信息
Collegium Medicum of Jan Kochanowski University in Kielce, 25-369 Kielce, Poland.
Ophthalmic Clinic of the Voivodeship Hospital in Kielce, 25-736 Kielce, Poland.
出版信息
J Pers Med. 2022 Nov 2;12(11):1824. doi: 10.3390/jpm12111824.
The aim of the study was to evaluate changes in the retinal thickness and microvasculature based on optical coherence tomography (OCT) depending on baseline oxygen saturation (SpO2) in patients hospitalized due to COVID-19 bilateral pneumonia. The prospective study was carried out among 62 patients with COVID-19 pneumonia who underwent ophthalmic examination after hospital discharge. They were divided into three groups depending on the oxygen saturation (SpO2) on admission: ≤90% (group 1), >90% and ≤95% (group 2), and >95% (group 3). The following parameters were assessed in the ophthalmological examination and correlated with the baseline SpO2: ganglion cell layer (GCL), the retinal nerve fiber layer (RNFL) in the macular area, RNFL in the peripapillary area, the foveal avascular zone (FAZ) in superficial capillary plexus (SCP) and deep capillary plexus (DCP), vessel density (VD) in SCP, in DCP, and in the choriocapillaris plexus (CC). Baseline saturation ≤90% in COVID-19 patients caused a decrease of VD in some areas of SCP and DCP and an increase in FAZ area in SCP and DCP. In the group of patients with SpO2 ≤ 90% statistically significant thinning of the retina in the inner superior ring (ISR) (p = 0.029), the inner temporal ring (ITR) (p = 0.34), the outer superior ring (OSR) (p = 0.012), and the outer temporal ring (OTR) (p= 0.004)] was observed. The statistically significant thickening of RNFL optic disc and thinning of RNFL retina in some macular areas in patients with SpO2 ≤ 90% were reported. The size of FAZ area in SCP and vessel density were significantly greater in some areas of SCP, DCP, and CC in patients with SpO2 ≤ 90% (p = 0.025). Baseline oxygen saturation ≤90% has been found to influence the ocular parameters of OCT in COVID-19 patients. We noticed a widened FAZ zone in SCP and increased VD in some regions of the retina and choroid as a response to systemic hypoxia.
本研究的目的是评估因 COVID-19 双侧肺炎住院的患者，基于光学相干断层扫描（OCT），根据基线氧饱和度（SpO2），视网膜厚度和微血管系统的变化。这项前瞻性研究在 62 例 COVID-19 肺炎患者出院后进行了眼科检查。根据入院时的氧饱和度（SpO2）将他们分为三组：≤90%（第 1 组），>90%且≤95%（第 2 组），以及>95%（第 3 组）。在眼科检查中评估了以下参数，并与基线 SpO2 相关：神经节细胞层（GCL）、黄斑区视网膜神经纤维层（RNFL）、视乳头周围区域的 RNFL、浅表毛细血管丛（SCP）和深层毛细血管丛（DCP）中的黄斑无血管区（FAZ）、SCP、DCP 和脉络膜毛细血管丛（CC）中的血管密度（VD）。COVID-19 患者基线饱和度≤90%导致 SCP 和 DCP 的某些区域 VD 降低，以及 SCP 和 DCP 中 FAZ 面积增加。在 SpO2≤90%的患者组中，观察到内上环（ISR）（p = 0.029）、内颞环（ITR）（p = 0.34）、外上环（OSR）（p = 0.012）和外颞环（OTR）（p = 0.004）的视网膜有统计学意义的变薄。报告了 SpO2≤90%的患者中，视盘 RNFL 有统计学意义的增厚以及某些黄斑区域视网膜 RNFL 变薄。SpO2≤90%的患者中，SCP、DCP 和 CC 的某些区域 SCP 中 FAZ 面积大小和血管密度显著更大（p = 0.025）。已发现基线氧饱和度≤90%会影响 COVID-19 患者的 OCT 眼部参数。我们注意到，作为对全身缺氧的反应，SCP 中 FAZ 区变宽，视网膜和脉络膜某些区域的 VD 增加。
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