Ghosn Nagilton Bou, Balbino Marcos, Raiza Ana Carolina Pasquini, Vicentini Otani Camila Sayuri, Fernandes Victoria Moreira, Lotto Takahashi Vitor Kazuo, Seixas Beatriz Silveira, Guimarães Laura Vanalli, Dias Mario Luiz Paulo, Seixas Regina Cele Silveira
Grupo OPTY - HCLOE Oftalmologia Especializada, São Paulo, Brazil.
Centro Universitário São Camilo, Rua Cipriano Barata, 1869- ap. 93, São Paulo, SP, Brazil.
BMC Ophthalmol. 2025 Aug 11;25(1):451. doi: 10.1186/s12886-025-04177-7.
SARS-CoV-2 is associated with systemic inflammation, vascular dysfunction, and potential ocular involvement. While structural retinal changes have been observed in some patients, the long-term impact of COVID-19 on macular architecture remains unclear, §particularly in unvaccinated populations.
To evaluate differences in central macular thickness (CMT) between post-COVID-19 patients and healthy individuals using optical coherence tomography (OCT), with age-stratified analysis.
A prospective case-control study conducted at a specialized ophthalmology center in Brazil during the early vaccination phase. A total of 76 unvaccinated participants were included: 29 patients with prior COVID-19 (58 eyes) and 47 healthy controls (94 eyes). OCT was performed at least 14 days after PCR-confirmed infection.
The overall mean CMT was 246.93 ± 23.30 μm. No significant difference was found between the COVID-19 and control groups (242.54 ± 19.76 μm vs. 249.63 ± 25.06 μm; = 0.10). However, among participants aged ≥ 42 years, post-COVID-19 patients had significantly lower CMT compared to age-matched controls (241.00 ± 21.90 μm vs. 256.85 ± 28.58 μm; = 0.04). No significant difference was observed in the < 42 years group. OCT angiography revealed no qualitative vascular abnormalities in either group.
Our findings suggest that SARS-CoV-2 infection may be associated with subtle retinal thinning in older adults, even in the absence of acute symptoms or visual complaints. These results highlight the importance of age-stratified analysis and support further investigation into the long-term ocular effects of COVID-19.
严重急性呼吸综合征冠状病毒2（SARS-CoV-2）与全身炎症、血管功能障碍及潜在的眼部受累有关。虽然在一些患者中观察到了视网膜结构变化，但新冠病毒病（COVID-19）对黄斑结构的长期影响仍不清楚，尤其是在未接种疫苗的人群中。
使用光学相干断层扫描（OCT）评估COVID-19康复患者与健康个体之间中心黄斑厚度（CMT）的差异，并进行年龄分层分析。
在巴西一个专业眼科中心的早期疫苗接种阶段进行的一项前瞻性病例对照研究。共纳入76名未接种疫苗的参与者：29例曾感染COVID-19的患者（58只眼）和47名健康对照者（94只眼）。在PCR确诊感染后至少14天进行OCT检查。
总体平均CMT为246.93±23.30μm。COVID-19组与对照组之间未发现显著差异（242.54±19.76μm对249.63±25.06μm；P=0.10）。然而，在年龄≥42岁的参与者中，COVID-19康复患者的CMT显著低于年龄匹配的对照组（241.00±21.90μm对256.85±28.58μm；P=0.04）。在年龄<42岁的组中未观察到显著差异。OCT血管造影显示两组均无定性血管异常。
我们的研究结果表明，SARS-CoV-2感染可能与老年人视网膜轻微变薄有关，即使在没有急性症状或视觉主诉的情况下也是如此。这些结果凸显了年龄分层分析的重要性，并支持对COVID-19的长期眼部影响进行进一步研究。
