×
Home Current Archive Editorial board
News Contact
Review paper

Does SarsCoV-2 infection really cause damage to retinal microcirculation in mild cases of COVID-19?

By
Adisa Pilavdžić Orcid logo ,
Adisa Pilavdžić
Contact Adisa Pilavdžić

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Suzana Pavljašević ,
Suzana Pavljašević

Eye Polyclinic Health Centre , Tuzla , Bosnia and Herzegovina

Amra Nadarević Vodenčarević ,
Amra Nadarević Vodenčarević

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Anis Međedović ,
Anis Međedović

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Meliha Halilbašić ,
Meliha Halilbašić

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Alma Čičkušić ,
Alma Čičkušić

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Nejra Hodžić ,
Nejra Hodžić

Department of Ophthalmology , Plava Medical Group Tuzla , Tuzla , Bosnia and Herzegovina

Sumeja Terzić ,
Sumeja Terzić

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Azra Šmigalović ,
Azra Šmigalović

Eye Polyclinic , Health Centre Kalesija , Kalesija , Bosnia and Herzegovina

Sanela Muhović
Sanela Muhović

Eye Clinic, University Clinical Centre Tuzla , Tuzla , Bosnia and Herzegovina

Abstract

Aim
To evaluate changes of retinal microcirculation in mild cases of recovered COVID-19 patients at least three months after the infection by optical coherence tomography angiography (OCTA) non-invasive method.
Methods
In this prospective cross-sectional study, 50 right eyes of 50 recovered COVID-19 patients were compared with 50 right
eyes of age and gender-matched healthy controls. After the complete ophthalmological examination, all participants underwent OCTA measurements (RTVue XR Avanti, Optovue, Fremont, CA, USA).
Results
The time between the initial onset of symptoms, and ophthalmologic examination was 479.20 ±197.10 (126-754)
days. Findings of ophthalmic examination of all eyes of the recovered COVID-19 patients were within normal range. Significantly reduced superficial (p=0.046) and deep (p=0.044) macular vessel density (VD) in foveal region in the eyes of the recovered COVID-19 patients was found compared with healthy controls. Significantly enlarged foveal avascular zone (FAZ) area and perimeter in the eyes of the recovered COVID-19 patients (p<0.001) were found too.
Conclusion
Recovered COVID-19 patients have impaired retinal microcirculation, which can be a cause of the development of retinal vascular diseases.

References

1
Landecho MF, Yuste G, E S, P Q, J A, AB G-L, et al. COVID-19 retinal microangiopathy as an in vivo biomarker of systemic vascular disease? J Intern Med 2021;289:116–20.
2
Savastano MC, Gambini G, Cozzupoli GM, Crincoli E, Savastano A, Vico U, et al. Retinal capillary involvement in early post-COVID-19 patients: a healthy controlled study. Graefes Arch Clin Exp Ophthalmol 2021;259:2157–65.
3
Zapata MÁ, Banderas García S, Sánchez-Moltalvá A, Falcó A, Otero-Romero S, Arcos G, et al. Retinal microvascular abnormalities in patients after COVID-19 depending on disease severity. Br J Ophthalmol 2022;106:559–63.
4
Kalaw FGP, Warter A, Cavichini M, Knight D, Li A, Deussen D, et al. Retinal tissue and microvasculature loss in COVID-19 infection. Sci Rep 2023;13;(5100).
5
Abrishami M, Emamverdian Z, Shoeibi N, Omidtabrizi A, Daneshvar R, Saeidi Rezvani T, et al. Optical coherence tomography angiography analysis of the retina in patients recovered from COVID 19: a casecontrol study. Can J Ophthalmol 2021;56:24–30.
6
González-Zamora J, Bilbao-Malavé V, Gándara E, Casablanca-Piñera A, Boquera-Ventosa C, Landecho MF, et al. Retinal microvascular impairment in COVID-19 bilateral pneumonia assessed by optical coherence tomography angiography. Biomedicines 2021;9;(247).
7
Hazar L, Karahan M, Vural E, Ava S, Erdem S, Dursun ME, et al. Macular vessel density in patients recovered from COVID 19. Photodiagnosis Photodyn Ther 2021;34;(102267).
8
Cennamo G, Reibaldi M, Montorio D, D’Andrea L, Fallico M, Triassi M. Optical coherence tomography angiography features in post-COVID-19 pneumonia patients: a pilot study. J Ophthalmol 2021;227:182–90.
9
Gül FC, Timurkaan ES. Evaluation of choroidal thickness with OCT in COVID-19 patients with high D-dimer levels. Sci Rep 2022;12;(16826).
10
Kal M, Winiarczyk M, Mackiewicz J, Odrobina D, Cieśla E, Płatkowska-Adamska B, et al. The effect of reduced oxygen saturation on retinal microvascularization in COVID-19 patients with bilateral pneumonia based on optical coherence tomography study. J Pers Med 2022;12;(1824).
11
S BG, D A, B A, F T, X G-S, A S-M, et al. Persistent reduction of retinal microvascular vessel density in patients with moderate and severe COVID-19 disease. BMJ Open Ophthalmol 2022;7:e000867.
12
Chiosi F, Campagna G, Rinaldi M, Manzi G, dell’Omo R, Fiorentino G, et al. Optical coherence tomography angiography analysis of vessel density indices in early post-COVID-19 patients n.d.
13
Abid A, Khan MA, Lee B, White A, Carnt N, Arshad S, et al. Ocular distribution of the renin-angiotensin-aldosterone system in the context of the SARS-CoV-2 pandemic. J Renin Angiotensin Aldosterone Syst 2022;2022;(9970922).
14
Jevnikar K, Meglič A, Lapajne L, Logar M, Vidovič Valentinčič N, Globočnik Petrovič M, et al. The impact of acute COVID-19 on the retinal microvasculature assessed with multimodal imaging. Graefes Arch Clin Exp Ophthalmol 2023;261:1115–25.
15
A YÇ, O K, D U. Evaluation of retinal microvascular impairment after COVID-19 and its clinical correlates using optical coherence tomography angiography. Turk J Ophthalmol 2022;52:324–30.
16
Wang S, Wang J, Hu J, Wang N. Retinal microvascular impairment in COVID-19 patients: a metaanalysis. Immun Inflamm Dis 2022;10:e619.
17
Sodhi PK, Arora R, Kumar S, Jaisingh K, Archana TR, Rao KC, et al. Optical coherence tomography angiography parameters of the retina in SARS-CoV-2 recovered subjects. Cureus 2023;15:e33548.
18
Guemes-Villahoz N, Burgos-Blasco B, Vidal-Villegas B, Donate-López J, Muela MH, López-Guajardo L, et al. Reduced macular vessel density in COVID-19 patients with and without associated thrombotic events using optical coherence tomography angiography. Graefes Arch Clin Exp Ophthalmol 2021;259:2243–9.
19
A NB, A D, F K, H G, Z H, SE M, et al. Retinal findings of COVID-19 patients using ocular coherence tomography angiography two to three months after infection: Ocular appearance recovered COVID-19 patient. Photodiagnosis Photodyn Ther 2022;38;(102726).
20
Hohberger B, Ganslmayer M, Lucio M, Kruse F, Hoffmanns J, Moritz M, et al. Retinal microcirculation as a correlate of a systemic capillary impairment after severe acute respiratory syndrome coronavirus 2 infection n.d.
21
T. K, Y. O, S. I, H. O, T. TKK, Y. O, et al. Renin-Angiotensin system hyperactivation can induce inflammation and retinal neural dysfunction. Int J Inflam 2012;2012;(581695).
22
Zhang YH, Zhang YH, Dong XF, Hao QQ, Zhou XM, Yu QT, et al. ACE2 and Ang-(1-7) protect endothelial cell function and prevent early atherosclerosis by inhibiting inflammatory response. Inflamm Res 2015;64:253–60.
23
Xu B, Zhang J, Zhang Y, Cheng Y, Huang Q. Transient increase in patient numbers with “acute macular neuroretinopathy” post SARS-CoV-2 infection—case series during the first surge of infection in December 2022. J Inflamm Res 2023;16:2763–71.

Citation

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

Article metrics

Google scholar: See link

The statements, opinions and data contained in the journal are solely those of the individual authors and contributors and not of the publisher and the editor(s). We stay neutral with regard to jurisdictional claims in published maps and institutional affiliations.