D'Aloisio Rossella, Ruggeri Maria Ludovica, D'Onofrio Giada, Formenti Federico, Gironi Matteo, Di Nicola Marta, Porreca Annamaria, Toto Lisa, Mastropasqua Rodolfo
Ophthalmology Clinic, Department of Medicine and Science of Ageing, D'Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
Department of Medical, Oral and Biotechnological Sciences, Laboratory of Biostatistics, D'Annunzio University of Chieti-Pescara, Via dei Vestini 31, 66100 Chieti, Italy.
Diagnostics (Basel). 2023 Mar 15;13(6):1114. doi: 10.3390/diagnostics13061114.
The purpose of this study was to analyze choroidal and retinal vascular alterations of both the macula and midperiphery areas in patients hospitalized for COVID-19 infection complicated with pneumonia within 30 days from discharge.
A total of 46 eyes of 23 subjects with a history of symptomatic COVID-19 infection and recent hospitalization for pneumonia were enrolled in this observational study. Patients had not been previously vaccinated against COVID-19. A group of patients homogenous for age and sex was enrolled as controls. Microvascular retinal and choroidal features of the enrolled patients were studied with widefield optical coherence tomography angiography (OCT-A). Perfusion parameters in terms of the vessel density (VD) of the superficial capillary plexus (SCP) and deep capillary plexus (DCP) and the choroidal vascularity index (CVI) on enhanced depth imaging (EDI) mode OCT scans were analyzed.
Our cohort of patients showed a trend of reduction in VD, significantly in the SCP VD of the superior and inferior midperiphery sectors, whereas the CVI did not show significant differences between the cases and controls. Moreover, a positive correlation between CVI and vessel density in the deep capillary plexus in the macular area (VD-DCP-MAC) was found.
The systemic disease due to COVID-19 can also involve the retina and choroid with multiple mechanisms: ischemic and inflammatory. Our study showed changes in perfusion occurring in the eyes of patients with a recent hospitalization for COVID-19 complicated with pneumonia and without any possible ocular effect due to the vaccines. There is still the need to better comprise how long COVID-19 actually affects vascular changes in the eye.
本研究旨在分析在出院后30天内因COVID-19感染合并肺炎住院的患者黄斑区和中周边区域的脉络膜及视网膜血管改变。
本观察性研究纳入了23例有症状COVID-19感染病史且近期因肺炎住院的患者的46只眼。患者此前未接种过COVID-19疫苗。纳入一组年龄和性别匹配的患者作为对照。采用广角光学相干断层扫描血管造影（OCT-A）研究纳入患者的视网膜和脉络膜微血管特征。分析增强深度成像（EDI）模式OCT扫描中浅表毛细血管丛（SCP）和深部毛细血管丛（DCP）的血管密度（VD）以及脉络膜血管指数（CVI）等灌注参数。
我们的患者队列显示出VD降低的趋势，尤其是在上下中周边区域的SCP VD显著降低，而病例组和对照组之间的CVI没有显著差异。此外，还发现黄斑区深部毛细血管丛中的CVI与血管密度（VD-DCP-MAC）之间存在正相关。
COVID-19所致的全身性疾病也可通过多种机制累及视网膜和脉络膜：缺血性和炎症性。我们的研究显示，近期因COVID-19合并肺炎住院且无疫苗可能导致的任何眼部影响的患者眼部出现了灌注变化。仍有必要更好地了解COVID-19实际影响眼部血管变化的时长。
