Azar Georges, Abdelmassih Youssef, Bonnin Sophie, Guindolet Damien, Vasseur Vivien, Behar Cohen Francine, Salmon Dominique, Mauget-Faÿsse Martine
Rothschild Foundation Hospital, 75019 Paris, France.
Ophthalmology Department, Cochin Hospital, 75014 Paris, France.
J Clin Med. 2024 Nov 29;13(23):7272. doi: 10.3390/jcm13237272.
: To report ophthalmological and microvascular findings in patients with post-acute COVID-19. : In this prospective, monocentric cohort study, we included patients with post-acute COVID-19 who presented with ophthalmological symptoms. All patients underwent indocyanine green angiography (ICGA), OCT, OCT-angiography, adaptive optics, and GlycoCheck assessments. We included 44 patients, predominantly female (81.8%), with a mean age of 47.5 ± 11.5 years. Key ICGA findings revealed hyperreflective dots in 32 eyes (36.4%) and hemangioma-like lesions in 7 eyes (8.0%). Capillary non-perfusion in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) was observed in 42 eyes (47.7%) and 21 eyes (23.9%), respectively. Eyes with hyperreflective dots exhibited a lower perfused boundary region (PBR), while those with superficial punctate keratitis showed a higher PBR ( = 0.02 and = 0.002, respectively). Eyes with capillary non-perfusion in the SCP displayed lower capillary densities (CD4, CD5, and CD4-6; = 0.001, 0.03, and 0.03, respectively), and eyes with non-perfusion in the DCP had lower CD4 ( = 0.03). A negative correlation was identified between capillary density and the wall-to-lumen ratio. Patients with post-acute COVID-19 demonstrate both retinal and choroidal vascular anomalies. Ocular pathology was associated with reduced capillary density. These injuries appear to stem more from microvascular disruptions than from persistent glycocalyx abnormalities.
报告急性 COVID-19 后患者的眼科和微血管检查结果。：在这项前瞻性、单中心队列研究中，我们纳入了有眼科症状的急性 COVID-19 后患者。所有患者均接受了吲哚菁绿血管造影（ICGA）、光学相干断层扫描（OCT）、OCT 血管造影、自适应光学和糖萼检查评估。我们纳入了 44 例患者，以女性为主（81.8%），平均年龄为 47.5±11.5 岁。ICGA 的主要检查结果显示，32 只眼（36.4%）有高反射点，7 只眼（8.0%）有血管瘤样病变。分别在 42 只眼（47.7%）和 21 只眼（23.9%）观察到浅表毛细血管丛（SCP）和深部毛细血管丛（DCP）的毛细血管无灌注。有高反射点的眼睛表现出较低的灌注边界区域（PBR），而有浅表点状角膜炎的眼睛表现出较高的 PBR（分别为 = 0.02 和 = 0.002）。SCP 有毛细血管无灌注的眼睛显示出较低的毛细血管密度（CD4、CD5 和 CD4 - 6；分别为 = 0.001、0.03 和 0.03），DCP 有毛细血管无灌注的眼睛 CD4 较低（ = 0.03）。毛细血管密度与壁腔比之间存在负相关。急性 COVID-19 后患者表现出视网膜和脉络膜血管异常。眼部病理与毛细血管密度降低有关。这些损伤似乎更多地源于微血管破坏，而非持续的糖萼异常。
