The influence of post-COVID-19 syndrome on microcirculation of the optic nerve head among patients with primary open-angle glaucoma

Abstract

BACKGROUND: Glaucoma is one of the leading causes of blindness in the world. This is a multifactorial ophthalmopathology, which also results from impaired microcirculation in the optic nerve. One of the diseases affecting ocular blood flow is acute coronavirus infection (COVID-19). AIM: The aim of this study is the assessment of blood flow parameters of the optic nerve head in patients with primary open-angle glaucoma (POAG) against the background of post-COVID-19 syndrome using laser speckle flowgraphy. MATERIALS AND METHODS: The study included 40 patients with advanced stage primary open-angle glaucoma who had COVID-19 within the previous 3 months. Patients were divided into 2 subgroups depending on the severity of the disease. The comparison group consisted of 20 individuals with an advanced stage of primary open-angle glaucoma who did not have COVID-19. All subjects were over 60 years old and had normal blood pressure parameters. Optic nerve head blood flow was measured using the LSFG-NAVI device (Japan) and assessed by LSFG Analyzer software. MBR parameters (MA, MV and MT), as well as pulse wave indicators (Skew, BOS, BOT, RR, FR, FAI, ATI and RI) were analyzed. RESULTS: The most significant decrease was found for the MV and MT parameters, reflecting the blood flow in large vessels and the microvasculature of the optic disc. MV decrease by 20%, MT — by 23%, MA — by 16% were noted, as well as pulse wave parameter changes, in patients with an advanced stage of primary open-angle glaucoma, post-COVID syndrome after moderate COVID-19 compared with patients with an advanced stage of primary open-angle glaucoma who did not have COVID-19 (p ≤ 0.05). CONCLUSIONS: Laser speckle flowgraphy allows rapid and effective assessment of ocular blood flow. Parameters estimated at the examination may be considered as new biomarkers for the detection and evaluation of vascular diseases.