Retinal Manifestations in Patients with COVID-19: A Prospective Cohort Study

Area of Science:

• Ophthalmology
• Infectious Diseases
• Cardiovascular Medicine

Background:

• The Coronavirus SARS-CoV-2 pandemic has highlighted multi-organ involvement, including ocular manifestations.
• While conjunctivitis and retinopathy have been noted, the prevalence and significance of retinal lesions in COVID-19 patients remain unclear.

Purpose of the Study:

• To investigate the prevalence and characteristics of retinal abnormalities in hospitalized COVID-19 patients.
• To explore the association between retinal findings and systemic disease severity or patient comorbidities.

Main Methods:

• A prospective, observational study was conducted on 172 hospitalized patients with confirmed COVID-19.
• Widefield fundus photography was used for screening at hospital admission.
• Patient data, including medical history and inflammatory markers, were collected.

Main Results:

• Retinal lesions, specifically cotton wool spots (CWS) and/or hemorrhages, were detected in 11% (19/172) of patients, irrespective of ocular symptoms.
• Patients with retinal abnormalities more frequently had a history of diabetes, were overweight, and had elevated C-reactive protein.
• A history of systemic hypertension was more common in patients without retinal findings.
• All observed CWS resolved by the 3-month follow-up.

Conclusions:

• Ocular screening via fundus photography can reveal retinal abnormalities in a significant portion of hospitalized COVID-19 patients.
• Retinal findings in COVID-19 may be associated with specific comorbidities and inflammatory markers.
• The transient nature of CWS suggests potential for recovery, but further research is needed on long-term implications.