Abstract
The ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2′s) to cause multi-organ ischemia and coronavirus-induced posterior segment eye diseases in mammals gave concern about potential sight-threatening ischemia in post coronavirus disease 2019 patients. The radial peripapillary capillary plexus (RPCP) is a sensitive target due to the important role in the vascular supply of the peripapillary retinal nerve fiber layer (RNFL). Eighty patients one month after SARS-CoV-2 infection and 30 healthy patients were selected to undergo structural OCT (optical coherence tomography) and OCTA (optical coherence tomography angiography) exams. Primary outcome was a difference in RPCP perfusion density (RPCP-PD) and RPCP flow index (RPCP-FI). No significant difference was observed in age, sex, intraocular pressure (IOP) and prevalence of myopia. RPCP-PD was lower in post SARS-CoV-2 patients compared to controls. Within the post-COVID-19 group, patients with systemic arterial hypertension had lower RPCP-FI and age was inversely correlated to both RPCP-FI and RPCP-PD. Patients treated with lopinavir + ritonavir or antiplatelet therapy during admission had lower RPCP-FI and RPCP-PD. RNFL average thickness was linearly correlated to RPCP-FI and RPCP-PD within post-COVID-19 group. Future studies will be needed to address the hypothesis of a microvascular retinal impairment in individuals who recovered from SARS-CoV-2 infection.
Highlights
Coronaviruses are a subfamily of single-stranded positive-sense RNA viruses widely diffused among animal species
radial peripapillary capillary plexus (RPCP) microvascular impairment is more evident in older patients (RPCP PD and RPCP FI are both inversely correlated with age in post-COVID-19 group) and patients affected by systemic arterial hypertension
RPCP perfusion density (RPCP-PD) was lower in post severe acute respiratory syndrome (SARS)-CoV-2 patients compared to controls
Summary
Coronaviruses are a subfamily of single-stranded positive-sense RNA viruses widely diffused among animal species Their genome length (26–30 kb) is one of the largest known sequences among RNA viruses. HCoV-NL63 and -HKU1 were discovered only in 2004 and 2005, respectively In addition to these four endemic HCoVs, two epidemic CoVs have emerged in humans in the last two decades, severe acute respiratory syndrome (SARS)-CoV and the Middle East respiratory syndrome (MERS)-CoV discovered in 2003 and followed by 2012 in Saudi Arabia [2]. The first coronavirus epidemic, caused by Severe Acute Respiratory Syndrome coronavirus 1 (SARS-CoV-1), affected 8000 people causing 774 death around the world [3,4]. SARS-CoV-2 has led to the death of 500,000 people globally and this number is constantly growing [5,6,7]
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