- Compared with people of the same age who did not contract COVID-19, the eyes of adults who recovered from COVID-19 infection demonstrated a significant reduction in choroidal thickness within 15 to 40 days after onset of the infection, which returned to normal thickness at 9 years. months after the onset of infection.
- More studies are needed to determine the importance of this finding.
The authors evaluated data from 32 eyes of 16 patients with COVID-19 and 34 eyes of 17 age-matched healthy control subjects to determine "subclinical choroidal involvement in patients with systemic COVID-19 infection and evaluate its long-term evolution." ".
The authors found that "choroidal thickness was reduced in all areas measured and this decrease affected all choroidal layers," but was reversible and recovered by the ninth month after infection. They also concluded that the changes had occurred in both the choroidal stroma and the blood vessels. The authors discuss the thromboembolic complications of COVID-19.
Specifically, they state, "The current study suggested that these ocular vascular changes in COVID-19 were not limited to the retina and the choroid was also affected by the inflammation and prothrombotic state induced by the disease." However, there were no supporting changes on clinical ophthalmic examination in the patients they report on.
Overall, this is a significant report regarding COVID-19 that presents data with a normal control group and asks important questions about the pathobiology of its vascular effects.
Summary Aim To investigate subclinical choroidal involvement in patients with systemic coronavirus 2019 (COVID-19) infection and evaluate its long-term evolution. This prospective longitudinal study included 32 eyes of 16 COVID-19 patients and 34 eyes of 17 age-matched healthy control subjects. All participants had a detailed ophthalmologic evaluation, including visual acuity assessment, slit lamp examination, and indirect ophthalmoscopy. Depth-enhanced optical coherence tomography of the posterior pole and peripapillary region was performed in the early (days 15-40) and late (9th month) postinfectious periods. Choroidal vascularization index (CVI) was calculated using ImageJ software (National Institutes of Health, Bethesda, Maryland). Results None of the patients had any examination findings associated with COVID-19 ocular involvement. Subfoveal choroidal thickness (SFCT) was significantly decreased in the early postinfectious period compared with healthy control individuals (p = 0.045). SFCT increased significantly in the late postinfectious period compared with the early period (p = 0.002), and the difference between patients and control individuals became statistically insignificant (p = 0.362). There was a similar trend for peripapillary choroidal thickness measurements. CVI remained unchanged (p = 0.721) despite the significant decrease in SFCT and total choroidal area (p = 0.042), indicating that this decrease occurred in both choroidal stroma and blood vessels. CVI remained unchanged in the late postinfectious period (p = 0.575) compared with the early period, indicating that recovery occurred throughout the choroidal tissue. Conclusion This study demonstrates that choroidal thickness was reduced in all areas measured and that this decrease affected all choroidal layers. This choroidopathy was reversible and recovered in the ninth month post-infection. |
