COVID-19: more than a respiratory virus, an optical coherence tomography study

• Published in: International ophthalmology Vol. 41; no. 11; pp. 3815 - 3824
• Main Authors: Dag Seker, Esra, Erbahceci Timur, Inci Elif
• Format: Journal Article
• Language: English
• Published: Dordrecht Springer Netherlands 01-11-2021; Springer Nature B.V
• Subjects: Coronaviruses; COVID-19; Cross-Sectional Studies; Headache; Headaches; Humans; Medicine; Medicine & Public Health; Nerve Fibers; Ophthalmology; Optical Coherence Tomography; Original Paper; Pain; Quadrants; Retina; Retinal Ganglion Cells; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Signs and symptoms; Subgroups; Thickness; Tomography; Tomography, Optical Coherence; Viral diseases; Viruses; COVID-19; Eye; Headache; Retina; SARS-CoV-2; Optic coherence tomography
• ISSN: 0165-5701; 1573-2630
• DOI: 10.1007/s10792-021-01952-5

Purpose
The purpose of this study is to investigate anatomic and morphologic features of inner and outer retinal layers in patients recovered from COVID-19 with Spectral Domain Optical Coherence Tomography (SD-OCT), whether correlate with any symptoms during disease process.
Methods
32 patients recovered from COVID-19 and age- and gender-matched 36 healthy controls were included in this cross-sectional study. Ganglion cell-inner plexiform layer, macular and peripapiller retinal nerve fiber layer (RNFL), inner nuclear layer (INL), outer nuclear layer (ONL), outer plexiform layer (OPL) and the outer retinal hyperreflective bands including external limiting membrane (ELM), ellipsoid zone (EZ) and interdigitation zone (IZ) were examined with SD-OCT. The differences of each retinal layers thickness among subgroup analysis of ocular pain and headache were also compared.
Results
Macular RNFL of inner and outer nasal and outer inferior quadrants were thinner in COVID-19 patients compared to healthy control group (
p
 = 0.046,
p
 = 0.014 and
p
 = 0.016, respectively). Thinning in outer superior quadrant of GCIPL and INL quadrants were detected in patients with headache (
p
 = 0.026 and
p
 = 0.01). Superonasal and inferotemporal sectors of pRNFL were thinner in patients with ocular pain compared to patients without ocular pain (
p
 = 0.024 and
p
 = 0.015). Integrity of EZ, ELM and IZ was evaluated as continuous line and protected on each OCT scans.
Conclusion
The study demonstrated convincing evidence that SARS-CoV-2 can affect the inner and outer retinal layers, with subclinical localized alterations, particularly in patients with headache and ocular pain symptoms during COVID-19 period.