Evaluation of corneal structural changes in post-COVID-19 patients using anterior segment optical coherence tomography and specular microscopy

Abstract

Purpose To detect corneal structural changes in people who have recovered from COVID-19 infection by specular microscopy and anterior segment optical coherence tomography (AS-OCT). Moreover, the study compares corneal endothelial and structural parameters between those who have recovered from COVID-19 and individuals who have neither been infected nor vaccinated. Methods This is a prospective observational case–control comparative study involving 108 eyes from 54 individuals. The participants are divided into two groups: the case group (individuals recovered from COVID-19 infection) with 54 eyes (27 individuals) and the control group (individuals with no history of COVID-19 infection or vaccination) with 54 eyes (27 individuals). Both groups are matched for age and sex. The study involves architectural analysis of the cornea using anterior segment OCT and evaluation of the corneal endothelium using specular microscopy. Results The case group’s mean cell density (CD) was 2445.5±310.6 cells/mm, while the control group was 2689.6±398.7 cells/mm (P value 0.001). This indicates a statistically significant decrease in CD among individuals in the case group compared with the control group. The case group’s mean cell area (SD) standard deviation was 169.6±115.2. In contrast, in the control group, it was 135.87±39.29 (P value 0.004), signifying a statistically significant increase in the case group. There was also a statistically significant increase in the average cell area (AVE) in the case group compared with the control group (P value 0.024). However, there were no statistically significant differences in other specular parameters, such as coefficient of variation (CV) or 6A or in the pachymetry. Similarly, no statistically significant differences in AS-OCT parameters were observed between both groups. Conclusion The study reveals a decrease in corneal endothelial cell count and an increase in the average cell area among individuals who have recovered from COVID-19 during their recovery period. However, it is noteworthy that the specular microscopy parameters remained within the clinically normal range for both groups, and visual acuity was unaffected.