Long-Term Effect of SARS-CoV-2 Infection on the Retinal and Choroidal Microvasculature

Area of Science:

• Ophthalmology
• Vascular Biology
• Infectious Diseases

Background:

• COVID-19 pneumonia can lead to systemic complications, including potential microvascular damage.
• Ocular microvascular changes may persist long after acute infection.

Purpose of the Study:

• To assess persistent microvascular alterations in the retina and choroid of COVID-19 patients using optical coherence tomography angiography (OCTA).
• To evaluate changes 2 and 8 months after hospital discharge.

Main Methods:

• Prospective case-control study involving 49 COVID-19 patients and 45 healthy controls.
• Optical coherence tomography angiography (OCTA) was used to measure vessel density (VD) and foveal avascular zone (FAZ) parameters.
• Follow-up assessments were conducted 2 and 8 months post-discharge.

Main Results:

• COVID-19 patients exhibited significantly decreased VD in the superficial capillary plexus (SCP), deep capillary plexus (DCP), and choriocapillaris (CC).
• An enlarged foveal avascular zone in the deep capillary plexus (FAZd) was observed in COVID-19 patients.
• Gender-specific differences were noted, with women showing decreased foveal VD and enlarged FAZ in SCP compared to men.

Conclusions:

• Persistent ocular microvascular changes are evident in COVID-19 survivors.
• OCTA reveals lasting alterations in retinal and choroidal vasculature, including widened FAZ and reduced VD, up to 8 months post-infection.