OCT, OCT-A show retinal changes in children recovered from COVID-19
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An OCT and OCT-A study of pediatric patients recovered from COVID-19 showed that morphological and vascular structural changes in the macula and optic disc may occur, including in eyes that appear normal on biomicroscopy and fundus exam.
“The morphological differences may be due to the neuroinvasion and neuroinflammation potential of SARS-CoV-2, while the vascular differences may be due to hypercoagulation and enhanced thrombosis,” Semra Tiryaki Demir, MD, FEBO, said at the virtual Euretina congress.
The prospective, cross-sectional, observational study evaluated 32 eyes of 16 pediatric patients aged between 6 and 18 years who contracted COVID-19 and compared them with an equal number of healthy controls. All patients underwent detailed ophthalmology examination as well as OCT and OCT angiography quantitative assessment of the morphology and vascular structures in the retina. Examination was performed 34 days on average after the onset of COVID-19 symptoms.
Quantitative OCT analysis showed no significant difference in mean retinal thickness between the groups. However, mean choroidal, peripapillary retinal nerve fiber layer and ganglion cell layer thickness values were significantly greater in the COVID-19 group. Quantitative OCT-A showed no significant difference in foveal avascular zone diameter between the groups, although mean superficial and deep capillary plexus vessel density and choriocapillary flow area were lower in the COVID-19 group, and mean radial peripapillary capillary plexus vessel density values were higher.
Best corrected visual acuity was 20/20, and mean IOP was 16 mm Hg. Biomicroscopy and fundus examination showed no sign of pathology in the patients with COVID-19.
“Our findings demonstrated that OCT and OCT-A are useful for noninvasive evaluation of morphological and vascular characteristics of the macula and optic disc in pediatric patients with COVID-19,” Tiryaki Demir said. “However, the long-term pathological effects of these morphological and vascular changes remain to be determined. Further studies including larger sample sizes are required to elucidate the clinical significance of structural and vascular changes in pediatric patients with COVID-19.”
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Tiryaki Demir S. Optical coherence tomography (OCT) and OCT angiography evaluation of morphology and vascular structures in the retina in recovered pediatric patients with novel coronavirus disease 2019 (COVID-19). Presented at: Euretina congress; Sept. 9-12, 2021 (virtual meeting).
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