Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center.
Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center.
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DOI：
10.2147/opth.s309346
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Miller JB
中科院分区：
文献类型：
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作者：
Patel NS;Moon JY;Katz R;Wai KM;Sobrin L;Vavvas DG;Miller JB
自COVID-19大流行开始以来，许多作者发表了数据，证明在COVID-19患者中发现的视网膜变化。然而，其他人对这些发现的重要性存在争议，COVID-19对视网膜的影响仍然不确定。本研究旨在更好地了解COVID-19患者的视网膜表现。对2020年3月1日至2020年10月31日期间有COVID-19聚合酶链反应检测阳性病史的患者进行了回顾性审查。如果患者在首次COVID-19检测呈阳性后90天内就诊，并接受了彩色眼底摄影和/或黄斑OCT检查，则将其纳入研究。所有图像均由两名独立的分级员进行审查，他们评估了OCT上视网膜血红素、棉絮斑、血管鞘和椎间盘水肿的存在，以及高反射变化、视网膜内液体和视网膜下液体。共纳入61例患者的119只眼。在接受黄斑OCT检查的83只眼中，16.9%（n=14）的患者出现视网膜内高反射改变，18.1%（n=15）的患者出现视网膜外高反射改变，28.9%（n=24）的患者出现视网膜内积液，14.5%（n=12）的患者出现视网膜下积液。眼底彩色摄影48只眼，视网膜出血13只眼（27.1%），视盘水肿1只眼（2.1%），无棉絮斑。对41例患者的70只眼睛进行子分析，没有其他视网膜病理学可能解释上述结果，在黄斑OCT（n=35）、眼底摄影（n=28）或记录检查（n=66）中没有发现上述检查结果。虽然在COVID-19感染后观察到的一些患者表现出视网膜病变，但所有这些都可以用预先存在的视网膜疾病来解释。在一个没有预先存在视网膜疾病的眼睛亚组中，我们没有发现任何可能与COVID-19相关的视网膜发现。
Since the start of the COVID-19 pandemic, numerous authors have published data demonstrating retinal changes found in patients with COVID-19. However, others have debated the significance of these findings and the effects of COVID-19 on the retina remain uncertain. This study aims to better understand retinal findings in patients with COVID-19. A retrospective review of patients with a history of a positive COVID-19 polymerase chain reaction test was performed between March 1st, 2020 and October 31st, 2020. Patients were included if they presented within 90 days of their first positive COVID-19 test and underwent color fundus photography and/or OCT of the macula. All images were reviewed by two independent graders who assessed the presence of retinal heme, cotton wool spots, vascular sheathing, and disc edema, as well as hyper-reflective changes, intra-retinal fluid, and sub-retinal fluid on OCT. A total of 119 eyes from 61 patients were included. Among 83 eyes which underwent OCT of the macula, inner retinal hyper-reflective changes were seen in 16.9% (n=14), outer retinal hyper-reflective changes in 18.1% (n=15), intra-retinal fluid in 28.9% (n=24), and sub-retinal fluid in 14.5% (n=12). Among 48 eyes which underwent color fundus photography, retinal hemorrhage was seen in 27.1% (n=13), optic disc edema in 2.1% (n=1), and cotton wool spots in none of the eyes. Sub-analysis of 70 eyes from 41 patients with no alternative retinal pathology to potentially explain the above findings revealed none of the above exam findings on OCT of the macula (n=35), fundus photography (n=28), or documented exam (n=66). While a number of patients seen after COVID-19 infection demonstrated retinal findings, all could be explained by pre-existing retinal conditions. In a sub-group of eyes without pre-existing retinal disease, we did not identify any retinal findings that could be associated with COVID-19.