COVID-19 changes retinal microvascular findings in children, which can be detected by optical coherence tomography-angiography (OCT-A) in recovered patients, according to a study published in Journal Français d’Ophtalmologie. These changes, however, are not significant in adult patients, the report shows.
Researchers included adult and pediatric patients who tested positive for COVID-19 between 3 and 6 months before baseline assessment (n=157; mean age, 36.23 years and n=40; mean age, 10.4 years, respectively) and age-matched control group participants (n=168; mean age, 36.39 years and n=44; mean age, 11.75 year, respectively) in the prospective study. The team used OCT-A assessments to review how COVID-19 changes retinal microvasculature after recovery, compared with patients from a control group.
The study determined that COVID-19 changes retinal microvasculature by lowering densities in 3 quadrants; the deep nasal, deep inferior, and deep parafoveal densities in pediatric patients (P =.034, P =.029, and P =.022, respectively). Radial peripapillary capillary vessel density intradisc measurements were higher among children who recovered from COVID-19 than pediatric control group participants (53.81% vs 52.09%; P =.025). Measurements related to macular thickness and flow field were not statistically different between pediatric patients who had COVID-19 and the control group.
Despite the pediatric retinal microvascular changes, researchers report adults who have had COVID-19 had no changes to the retinal microvasculature in macular thickness (P =.621), vessel densities (P ≥.278 for all), or optic disc OCT-A findings.
“The retina and choroid are among the tissues with the highest vascularization per unit area in the body. For this reason, the effects of the pathophysiological processes of systemic diseases that will cause inflammation and ischemia can be observed locally in these two tissues,” the researchers explain. “COVID 19 is associated with diffuse microvascular changes; therefore, it has the potential to cause disruption of retinal and choriocapillary blood flow.”
Study limitations include potential confounding due to medications and an inability to examine associations between disease severity or virus titer and COVID-19-related changes to the retinal microvasculature.
Soysal GG, Kimyon S, Mete A, Güngör K. Evaluation of the retina with optical coherence tomography angiography (OCTA) in patients with coronavirus (COVID-19) infection. J Fr Ophtalmol. Published online April 17, 2023. doi:10.1016/j.jfo.2023.02.006