Assessment of Retinal Neurodegeneration and Choroidal Thickness in COVID-19 Patients Using Swept-Source OCT Technology

Abstract

Purpose To analyze the central macular thickness (CMT), retinal nerve fiber layer thickness (RNFLT), ganglion cell layer thickness (GCLT), and choroidal thickness (ChT) measurements in patients with coronavirus disease 2019 (COVID-19).

Methods The study was conducted cross-sectionally 4 weeks after the completed treatment of COVID-19. The diagnosis of COVID-19 was based on the polymerase chain reaction test and/or clinical and radiological findings. The patients with treated COVID-19 were enrolled in the COVID-19 group; age- and sex-matched healthy participants served as the control group. All patients in the COVID-19 group were hospitalized and treated with favipiravir, moxifloxacin, and heparin without the requirement for intubation. The measurements of CMT, RNFLT (in four quadrants), GCLT (in six sectors of two different boundaries), and ChT (in five locations) were performed by swept-source optical coherence tomography (SS-OCT).

Results Similar visual acuity (p = 0.582) and intraocular pressure (p = 0.766) values were observed between the COVID-19 and control groups. Regarding SS-OCT measurements, all mean CMT, RNFLT (in four quadrants), GCLT (in six sectors of two different boundaries), and ChT (in five locations) values were similar in the COVID-19 and control groups (p > 0.05 for all). In the COVID-19 group, a statistically significant negative correlation was noted between the mean ferritin level and temporal RNFLT (r = − 0.378, p = 0.014) and a positive correlation was observed between the mean ferritin level and nasal RNFLT (r = + 0.371, p = 0.016).

Conclusion SS-OCT measurements showed no retinal neurodegenerative and choroidal thickness alterations in COVID-19 patients. Nonsignificant results might be due to the examination of the patients in the early period of the COVID-19 after the treatment. Therefore, late period OCT measurements should be reviewed with new studies in the future.

Zusammenfassung

Zweck Analyse der Dicke der zentralen Makuladicke (CMT), der Netzhautnervenfaserschichtdicke (RNFLT), der Ganglienzellschichtdicke (GCLT) und der Aderhautdicke (ChT) bei Patienten mit Coronavirus-Krankheit 2019 (COVID-19).

Methoden Die Studie wurde 4 Wochen nach Abschluss der Behandlung mit COVID-19 im Querschnitt durchgeführt. Die Diagnose von COVID-19 basierte auf dem Polymerasekettenreaktionstest und/oder klinischen und radiologischen Befunden. Die Patienten mit behandeltem COVID-19 wurden in die COVID-19-Gruppe aufgenommen, wobei alters- und geschlechtsangepasste gesunde Teilnehmer als Kontrollgruppe dienten. Alle Patienten in der COVID-19-Gruppe wurden ins Krankenhaus eingeliefert und mit Favipiravir, Moxifloxacin und Heparin behandelt, ohne dass eine Intubation erforderlich war. Die Messungen CMT, RNFLT (in 4 Quadranten), GCLT (in 6 Sektoren mit 2 verschiedenen Grenzen) und ChT (an 5 Orten) wurden mittels optischer Kohärenztomografie (SS-OCT) mit Swept-Source durchgeführt.

Ergebnisse Zwischen der COVID-19- und der Kontrollgruppe wurden ähnliche Werte für Sehschärfe (p = 0,582) und Augeninnendruck (p = 0,766) beobachtet. In Bezug auf SS-OCT-Messungen waren alle mittleren CMT-, RNFLT- (in 4 Quadranten), GCLT-Werte (in 6 Sektoren mit 2 verschiedenen Grenzen) und ChT-Werte (an 5 Stellen) in der COVID-19- und Kontrollgruppe ähnlich (p > 0,05 für alles). In der COVID-19-Gruppe wurde eine statistisch signifikante negative Korrelation zwischen dem mittleren Ferritinspiegel und der temporalen RNFLT (r = − 0,378, p = 0,014) und eine positive Korrelation zwischen dem mittleren Ferritinspiegel und der nasalen RNFLT festgestellt (r = + 0,371, p = 0,016).

Schlussfolgerung SS-OCT-Messungen zeigten bei COVID-19-Patienten keine Veränderungen der neurodegenerativen und choroidalen Dicke der Netzhaut. Statistisch nicht signifikante Ergebnisse können auf die Untersuchung der Patienten in der frühen Phase des COVID-19 nach der Behandlung zurückzuführen sein. Daher sollten spätere OCT-Messungen in Zukunft mit neuen Studien überprüft werden.

Key words

COVID-19 - optical coherence tomography - retinal nerve fiber layer - ganglion cell layer - choroidal thickness

Schlüsselwörter

COVID-19 - optische Kohärenztomografie - Netzhautnervenfaserschicht - Ganglienzellschicht - Dicke der Aderhaut

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