Retinal Microvascular Changes Associated with Covid-19: A Retrospective Case Series
Hongling Wu1, Ning Xu1, Xin Jin1
1Eye Hospital, First Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang Province, China.
Current Eye Research
|August 29, 2025
Summary
COVID-19 can cause retinal microangiopathy, affecting vision and eye comfort in over one percent of patients. Further research is needed to understand the full impact of SARS-COV-2 on retinal health.
Area of Science:
- Ophthalmology
- Infectious Diseases
- Retinal Imaging
Background:
- SARS-COV-2 (COVID-19) infection has been linked to various systemic complications.
- Retinal microangiopathy, a condition affecting small blood vessels in the retina, is increasingly recognized as a potential manifestation of COVID-19.
Purpose of the Study:
- To investigate the correlation between severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) infection and the development of retinal microangiopathy.
- To summarize the clinical characteristics and ocular findings in patients with COVID-19-associated retinal microangiopathy.
Main Methods:
- A retrospective cross-sectional study was conducted at the First Affiliated Hospital of Harbin Medical University.
- Fundus color photography and macular optical correlation tomography were used to diagnose retinal microangiopathy.
- Data from 3666 outpatients were analyzed, with a focus on 41 patients diagnosed with COVID-19-associated retinal microangiopathy.
Main Results:
- Over one percent (1.12%) of outpatients exhibited COVID-19-associated retinal microvascular changes.
- Common symptoms included blurred vision, dark shadow occlusion, visual deformation, dry eyes, and ocular pain.
- High reflection signals were observed in multiple retinal layers, particularly the ganglion cell layer (90.2%) and outer nuclear layer (78.0%).
- Retinal structural changes like fracture of the ellipsoid zone and interdigitation zone were noted in some patients.
Conclusions:
- COVID-19-associated retinal microangiopathy is a recognized complication, though its prevalence may be underestimated due to study limitations.
- The findings highlight the importance of ophthalmological evaluation in patients with a history of COVID-19, especially those experiencing visual symptoms.
