Retinal Microvasculature Changes Linked to Executive Function Impairment after COVID-19.

Area of Science:

• Ophthalmology
• Neurology
• Vascular Biology

Background:

• Previous studies indicate reduced retinal vascular density (VD) and larger foveal avascular zones (FAZs) in COVID-19 survivors.
• Severity of COVID-19 correlates with the extent of these retinal microvascular changes.

Purpose of the Study:

• To investigate retinal microvascularization in post-COVID-19 condition (PCC) patients.
• To correlate these microvascular changes with cognitive performance based on COVID-19 severity.

Main Methods:

• Observational cross-sectional study of 104 PCC participants (severe vs. mild COVID-19 history).
• Optical coherence tomography angiography (OCTA) used to measure retinal VD, perfusion density (PD), and FAZ.
• Cognitive assessments performed on all participants.

Main Results:

• Severe PCC cases exhibited significantly lower central and total VD, lower central PD, and larger FAZ areas and perimeters compared to mild cases.
• Severe cases also showed greater cognitive impairment, particularly in processing speed and executive functions.
• Reduced VD, reduced PD, and larger FAZ were associated with poorer executive function in the PCC sample.

Conclusions:

• Retinal microvascular alterations (reduced VD/PD, larger FAZ) are linked to cognitive impairments in PCC.
• Severe COVID-19 appears to cause persistent microvascular damage affecting both retinal and cognitive health.