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  • COVID-19 Can Damage Retinal Microvasculature

    By Lynda Seminara
    Selected by Prem S. Subramanian, MD, PhD
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    Journal Highlights

    British Journal of Ophthalmology
    2022;106(4):559-563

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    Zapata et al. explored the possible ret­inal microvascular anomalies that may result from SARS-CoV-2. They found decreased central retinal vascular density (VD) in moderate and severe cases.

    For this case control study, 96 adult patients with confirmed SARS-CoV-2 infection in the preceding three months were stratified by severity as follows: group 1, those with mild disease (n = 24); group 2, those with moderate disease requiring hospitalization but no acute respiratory distress (n = 24); and group 3, those with severe disease with acute respiratory distress, admission to the ICU, and a serum interleukin-6 level >40 pg/mL (n = 21). Age-matched vol­unteers with negative serologic findings served as controls (n = 27).

    All participants completed a structured questionnaire that covered co- morbidities, concomitant medications, and use of tobacco, alcohol, and rec­reational drugs. In-hospital data were gathered retrospectively from the hos­pital’s COVID-19 database. Participants underwent macula-centered high-defi­nition OCT imaging, angiography with fovea-centered OCT, and color fundus photography of the retinal posterior pole.

    No lesions were detected for any participant by funduscopy or structural OCT. The difference in VD between those in group 1 and controls was nominal. However, VD was lower in those in groups 2 and 3 (p = .009 for group 2 vs. controls and p = .026 for group 3 vs. controls).

    It is possible that the low VD ob­served in moderate and severe disease could signal similar problems in other organs. Retinal vascular occlusion has been reported in association with COVID-19 infection. Moreover, pre­vious research suggests that low VD in the central retina may be a general vascular marker of systemic conditions or specific diseases such as chronic kidney disease, diabetes, and Alzheimer disease.

    Going forward, longitudinal studies are needed to determine the vascular effects of COVID-19, said the authors, who believe their findings will help in designing future investigations. They acknowledged that the reduced VD of the central retina in moderate and severe COVID-19 demonstrates, at the very least, the complex nature of the disease, including its ability to invade multiple organs.

    The original article can be found here.