Retinal changes in patients with different COVID-19 course

Aim of the study
To study the peculiarities of retinal changes’ structure and frequency according to fundoscopy data in patients with different clinical course of COVID-19.

Material and methods
This was prospective, uncontrolled cross-sectional study. A total of 117 patients (234 eyes) with varying severity of COVID-19 clinical course were divided into groups: 1) an extremely severe course; 2) a severe course; 3) moderate se¬verity with decompensated accompanying pathology; 4) moderate severity with compensated concomitant pathology. Registration of patients’ eye fundus with the portable fundus camera Pictor Plus Fundus Camera and VistaView (Volk Optical).

Results
Cotton wool spots, narrowed retinal vessels, central retinal vein occlusion (CRVO) (8.8%), petechial and intraretinal hemor¬rhages (23.5%), tortuosity and dilatation of retinal venules (11.8%), prethrombosis of the central retinal vein (CRV) (a state determi¬ned by venous blood stasis, characterized by dilated appearance of the eye fundus veins, their dark color, curved structure, optic nerve edema) (2.9%) and vitreous hemorrhage (5.9%) were found in 1st group patients; in 29.4% of cases there were no retinal changes. Retinal changes were absent in 59.3% in 4th group patients and in 86.7% in 3rd group patients; no clinically significant retinal changes were detected in these patients.

Conclusions
Retinal changes’ structure and frequency in patients with COVID-19 correlate with the severity of its clinical course. Within 1st group patients cotton wool spots, narrowed retinal ves¬sels, petechial and intraretinal hemorrhages, thrombosis/prethrom¬bosis of CRV, tortuosity and dilatation of retinal venules, and vitreo¬us hemorrhage are diagnosed, which is significantly more common than in patients of 3rd and 4th groups (p < 0.05). A trend of decre¬asing risk of clinically significant retinal changes (thrombosis/ prethrombosis of CRV) and vitreous hemorrhage with decreasing severity of the disease was observed.