Abstract
PurposeThe purpose of this study is to assess for histopathological changes within the retina and the choroid and determine the long-term sequelae of the SARS-CoV-2 infection.MethodsEyes from seven COVID-19-positive and six similar age-matched control donors with a negative test for SARS-CoV-2 were assessed. Globes were evaluated ex vivo with macroscopic, SLO and OCT imaging. Macula and peripheral regions were processed for Epon embedding and immunocytochemistry.ResultsFundus analysis shows hemorrhagic spots and increased vitreous debris in several of the COVID-19 eyes compared to the controls. OCT-based measurements indicated an increased trend in retinal thickness in the COVID-19 eyes; however, the difference was not statistically significant. Histology of the retina showed presence of hemorrhages and central cystoid degeneration in several of the donors. Whole mount analysis of the retina labeled with markers showed changes in retinal microvasculature, increased inflammation, and gliosis in the COVID-19 eyes compared to the controls. The choroidal vasculature displayed localized changes in density and signs of increased inflammation in the COVID-19 samples.ConclusionsIn situ analysis of the retinal tissue suggests that there are severe subclinical abnormalities that could be detected in the COVID-19 eyes. This study provides a rationale for evaluating the ocular physiology of patients that have recovered from COVID-19 infections to further understand the long-term effects caused by this virus.
Highlights
We are amid the human coronavirus disease 2019 (COVID19) pandemic, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), which is of historic proportions, the likes of which we have not seen in 102 years
Evidence of posterior eye involvement in SARS-COV-2 infection is still scarce, though some recent optical coherence tomography angiography (OCTA)-based findings show that retinal microvasculature is affected in patients that recovered from COVID-19 infection [12, 13]
Optical coherence tomography images (OCT)-based measures were similar for both the OD and OS eyes of the controls and the COVID19 donors suggesting that both eyes were affected (Supplemental Fig. S1S1S1)
Summary
We are amid the human coronavirus disease 2019 (COVID19) pandemic, caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2), which is of historic proportions, the likes of which we have not seen in 102 years. We report a comprehensive analysis of eyes from post-mortem patients infected with the SARS-CoV-2 virus. Fundus imaging provides evidence of increased hemorrhage in the eyes of COVID-19 patients. There is increased gliosis in the COVID-19 eyes compared to the eyes from the age-matched control donors. To our knowledge, this is the first study that provides in vivo molecular information concerning the changes occurring within the retinal tissue of COVID-19 patients. The data reported here provide a rationale for longitudinal ocular assessments in recovered patients to truly gain insights into understanding the long-term effects caused by this virus
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