Состояние сетчатки у пациентов, перенесших COVID-19 с поражением легких

Abstract

Microvascular lesions are one of the main factors of lung and other organ damage in COVID-19. We hypothesized that patients with post-COVID lung dysfunction may also retain signs of systemic micro-vascular damage, in particular of the retina. Aim. To evaluate vascular and macular retinal area status in COVID-19 patients with pulmonary damage. Methods. 61 patient, average age 60.5 years, after in-patient COVID-19 treatment was examined. The volume of lung lesions according to high resolution computed tomography (HRCT) data ranged from 12 to 90 %. Decrease of diffusion capacity for carbon monoxide (DLCO) was observed in all patients after recovery: in 3 months in 18 patients (29.5 %) with severe COVID-19 DLCO was 58.4 % and in moderate COVID-19 – 73.2 % of the proper one. Optical coherence tomography (iVue-100, Optovue, USA) using Linear Scan and Nerve Fiber 3D Disc map was performed after 1 and 3 months. The control group included 20 patients comparable by sex, age, and comorbidity. Results. All patients showed typical signs of micro-circulatory disturbances in the posterior pole of the eye, increased caliber of arteries and first-order veins. In patients with severe COVID-19 an increase of arterial caliber by 22.5 μm and veins caliber by 35.04 μm, a decrease of retinal thickness in the macular region (by 8.78 μm in the fovea and by 6.6 μm in parafovea) compared to control group were revealed. After 6 months no significant dynamics of these parameters was revealed. Retinal changes in patients with moderate COVID-19 were similar but less pronounced. Conclusion.The revealed changes of retinal vessels and macular zone may indicate microcirculation disturbances and blood flow retardation in the posterior pole of the eye. The severity of the disturbances is comparable with the severity of the disease and the degree of DLCO reduction. Key words: COVID-19 with lung damage; retina; caliber of retinal vessels.