Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography Angiography

The purpose of this study was to evaluate the presence of retinal and microvascular alterations in COVID-19 patients with bilateral pneumonia due to SARS-COV-2 that required hospital admission and compare this with a cohort of age- and sex-matched controls. COVID-19 bilateral pneumonia patients unde...

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Main Authors: Jorge González-Zamora, Valentina Bilbao-Malavé, Elsa Gándara, Anna Casablanca-Piñera, Claudia Boquera-Ventosa, Manuel F. Landecho, Javier Zarranz-Ventura, Alfredo García-Layana
Format: Article
Language:English
Published: MDPI AG 2021-03-01
Series:Biomedicines
Subjects:
Online Access:https://www.mdpi.com/2227-9059/9/3/247
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author Jorge González-Zamora
Valentina Bilbao-Malavé
Elsa Gándara
Anna Casablanca-Piñera
Claudia Boquera-Ventosa
Manuel F. Landecho
Javier Zarranz-Ventura
Alfredo García-Layana
author_facet Jorge González-Zamora
Valentina Bilbao-Malavé
Elsa Gándara
Anna Casablanca-Piñera
Claudia Boquera-Ventosa
Manuel F. Landecho
Javier Zarranz-Ventura
Alfredo García-Layana
author_sort Jorge González-Zamora
collection DOAJ
description The purpose of this study was to evaluate the presence of retinal and microvascular alterations in COVID-19 patients with bilateral pneumonia due to SARS-COV-2 that required hospital admission and compare this with a cohort of age- and sex-matched controls. COVID-19 bilateral pneumonia patients underwent retinal imaging 14 days after hospital discharge with structural optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) measurements. Vessel density (VD) and foveal avascular zone (FAZ) area were evaluated in the superficial, deep capillary plexus (SCP, DCP), and choriocapillaris (CC). After exclusion criteria, only one eye per patient was selected, and 50 eyes (25 patients and 25 controls) were included in the analysis. COVID-19 patients presented significantly thinner ganglion cell layer (GCL) (<i>p</i> = 0.003) and thicker retinal nerve fiber layer (RNFL) compared to controls (<i>p</i> = 0.048), and this RNFL thickening was greater in COVID-19 cases with cotton wool spots (CWS), when compared with patients without CWS (<i>p</i> = 0.032). In both SCP and DCP, COVID-19 patients presented lower VD in the foveal region (<i>p</i> < 0.001) and a greater FAZ area than controls (<i>p</i> = 0.007). These findings suggest that thrombotic and inflammatory phenomena could be happening in the retina of COVID-19 patients. Further research is warranted to analyze the longitudinal evolution of these changes over time as well as their correlation with disease severity.
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spelling doaj.art-bc624f7ad90e48b988190a47d356ba6a2023-12-03T12:10:07ZengMDPI AGBiomedicines2227-90592021-03-019324710.3390/biomedicines9030247Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography AngiographyJorge González-Zamora0Valentina Bilbao-Malavé1Elsa Gándara2Anna Casablanca-Piñera3Claudia Boquera-Ventosa4Manuel F. Landecho5Javier Zarranz-Ventura6Alfredo García-Layana7Department of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, SpainDepartment of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, SpainDepartment of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, SpainInstitut Clínic de Oftalmología (ICOF), Hospital Clínic de Barcelona, 08028 Barcelona, SpainInstitut Clínic de Oftalmología (ICOF), Hospital Clínic de Barcelona, 08028 Barcelona, SpainCOVID-19 Unit, Clínica Universidad de Navarra, 31008 Pamplona, SpainInstitut Clínic de Oftalmología (ICOF), Hospital Clínic de Barcelona, 08028 Barcelona, SpainDepartment of Opthalmology, Clínica Universidad de Navarra, 31008 Pamplona, SpainThe purpose of this study was to evaluate the presence of retinal and microvascular alterations in COVID-19 patients with bilateral pneumonia due to SARS-COV-2 that required hospital admission and compare this with a cohort of age- and sex-matched controls. COVID-19 bilateral pneumonia patients underwent retinal imaging 14 days after hospital discharge with structural optical coherence tomography (OCT) and optical coherence tomography angiography (OCTA) measurements. Vessel density (VD) and foveal avascular zone (FAZ) area were evaluated in the superficial, deep capillary plexus (SCP, DCP), and choriocapillaris (CC). After exclusion criteria, only one eye per patient was selected, and 50 eyes (25 patients and 25 controls) were included in the analysis. COVID-19 patients presented significantly thinner ganglion cell layer (GCL) (<i>p</i> = 0.003) and thicker retinal nerve fiber layer (RNFL) compared to controls (<i>p</i> = 0.048), and this RNFL thickening was greater in COVID-19 cases with cotton wool spots (CWS), when compared with patients without CWS (<i>p</i> = 0.032). In both SCP and DCP, COVID-19 patients presented lower VD in the foveal region (<i>p</i> < 0.001) and a greater FAZ area than controls (<i>p</i> = 0.007). These findings suggest that thrombotic and inflammatory phenomena could be happening in the retina of COVID-19 patients. Further research is warranted to analyze the longitudinal evolution of these changes over time as well as their correlation with disease severity.https://www.mdpi.com/2227-9059/9/3/247SARS-COV-2COVID-19coronavirusretinamicrovascularcotton wool spot
spellingShingle Jorge González-Zamora
Valentina Bilbao-Malavé
Elsa Gándara
Anna Casablanca-Piñera
Claudia Boquera-Ventosa
Manuel F. Landecho
Javier Zarranz-Ventura
Alfredo García-Layana
Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography Angiography
Biomedicines
SARS-COV-2
COVID-19
coronavirus
retina
microvascular
cotton wool spot
title Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography Angiography
title_full Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography Angiography
title_fullStr Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography Angiography
title_full_unstemmed Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography Angiography
title_short Retinal Microvascular Impairment in COVID-19 Bilateral Pneumonia Assessed by Optical Coherence Tomography Angiography
title_sort retinal microvascular impairment in covid 19 bilateral pneumonia assessed by optical coherence tomography angiography
topic SARS-COV-2
COVID-19
coronavirus
retina
microvascular
cotton wool spot
url https://www.mdpi.com/2227-9059/9/3/247
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