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The aim of the study was to assess retinal microcirculation in patients with coronavirus disease 2019 (COVID-19) through the use of optical coherence tomography angiography (OCT-A) and compare the results with those obtained in healthy controls.The study enrolled 39 patients who had fully recovered from COVID-19 and 40 healthy controls. OCT-A image acquisitions were obtained using AngioVue software (version 2017.1.0.151) and the RTVue XR Avanti imaging system (Optovue Inc., Fremont, CA, USA). Nonflow area in the superficial capillary plexus (SCP), foveal avascular zone (FAZ) area in the whole retinal vasculature, FAZ perimeter, acircularity index of FAZ, and foveal density were automatically obtained with the FAZ assessment tool. Vessel density (VD) at the SCP and deep capillary plexus were also measured.Compared to the control group, the nonflow area and the FAZ area in the whole retina was greater in the COVID-19 group; however no statistically significant difference was observed (p 0.05 respectively). As for vessel densities, all superficial parafoveal VD parameters were considerably higher in the COVID-19 group compared to the control group (p 0.05 respectively). Despite the fact that the vessel densities in the remaining zones were lower in the COVID-19 group, those differences were not statistically significant (p 0.05 respectively).VD at the parafoveal area of the SCP was significantly higher among patients in the late post-recovery period of COVID-19 disease compared to healthy controls. These findings show the impact of COVID-19 on the retinal microvasculature and its possible role as a risk factor for the development of ocular diseases.Ziel dieser Studie war es, die retinale Mikrozirkulation in von der Coronavirus-Krankheit 2019 (COVID-19) betroffenen Patienten mithilfe der optischen Kohärenztomografieangiografie (OCT-A) zu untersuchen und mit den Ergebnissen von gesunden Kontrollpersonen zu vergleichen.In der Studie wurden 39 Patienten, die sich vollständig von der Coronavirus-Krankheit erholt hatten, und 40 gesunde Kontrollpersonen untersucht. Zur OCT-A-Bildakquisition wurde die AngioVue-Software (Version 2017.1.0.151) und das RTVue-XR-Avanti-Bildgebungssystem (Optovue Inc., Fremont, CA, USA) verwendet. Das FAZ-Bewertungstool ermittelt automatisch den Non-Flow-Bereich im oberflächlichen Kapillarplexus (SCP), im Bereich der fovealen avaskulären Zone (FAZ) und im gesamten retinalen Gefäßsystem sowie den FAZ-Perimeter, den FAZ-Azirkularitätsindex und die foveale Dichte. Die Gefäßdichte (VD) im SCP und im tiefen Kapillarplexus wurde auch gemessen.Auch wenn kein statistisch signifikanter Unterschied beobachtet wurde, war der Non-Flow-Bereich und der FAZ-Bereich in der gesamten Netzhaut in der COVID-19-Gruppe größer im Vergleich zur Kontrollgruppe (jeweils p 0,05). Bezüglich der Gefäßdichten waren alle oberflächlichen parafovealen VD-Parameter in der COVID-19-Gruppe erheblich höher im Vergleich zur Kontrollgruppe (jeweils p 0,05). Obwohl die Gefäßdichten in den verbleibenden Zonen in der COVID-19-Gruppe niedriger waren, waren diese Unterschiede statistisch nicht signifikant (jeweils p 0,05).Die VD im parafovealen Bereich des SCP war bei Patienten im späten Rekonvaleszenzstadium der Coronavirus-Erkrankung signifikant höher verglichen mit gesunden Kontrollen. Diese Ergebnisse zeigen die Auswirkungen von COVID-19 auf die retinale Mikrovaskulatur und ihre mögliche Rolle als Risikofaktor für die Entwicklung von Augenerkrankungen auf.

CLINICAL RELEVANCE: The SARS-COV 2 virus, which is responsible for the COVID-19 pandemic, acts on the angiotensin converting enzyme 2 (ACE-2) receptor in the host cell. Ocular effects may occur because of the ACE-2 receptor in the retina. BACKGROUND: To investigate the impact of COVID-19 on the retinal layers and optic disc parameters in previously confirmed COVID-19 patients using spectral domain optical coherence tomography (SD-OCT). METHODS: This study included 60 eyes of 60 subjects; 35 of them were in the COVID-19 group and the remaining 25 were in the control group. Patients with the diagnosis of COVID-19 that had a negative result after treatment were included in the study. Macular and peripapillary retinal nerve fiber layer (RNFL) thickness measurements, each retinal layer thickness of all participants were done 14-30 days after COVID-19 symptom onset, following the negative result of real time reverse transcriptase-polymerase chain reaction test using SD-OCT. RESULTS: The mean value of central macular thickness was significantly higher in the COVID-19 group than the control group (p = 0.02). The mean values of the ganglion cell layer and inner nuclear layer thickness in the COVID-19 group were signii¬cantly thinner than control group (p = 0.04 and p = 0.04, respectively). Even though mean RNFL thickness measurements in all sections in the COVID-19 group was thinner than controls, there were no significant differences between groups (p > 0.05 for all). CONCLUSION: In the early recovery phase, changes in the macula, ganglion cell layer and inner nuclear layer could be seen. These patients should be followed up closely for the recognition of new pathologies that could be seen in the late recovery phase.

The severe acute respiratory syndrome coronavirus 2 virus, which causes the coronavirus disease 2019 (COVID-19) pandemic, can bind to epithelial cells in the human cornea and conjunctiva, which may result in changes of corneal and lenticular densitometry.We aimed to report the corneal and lenticular clarity of patients who had been diagnosed previously with confirmed infection of COVID-19.This was a prospective, cross-sectional study. Fifty-three patients who had recovered from COVID-19 and 51 healthy individuals who had not had COVID-19 (control) were included in this study. Measurement of the corneal (at a corneal diameter of 12 mm) and lens densitometry of participants was performed using a Pentacam HR Scheimpflug imaging system. Three different optimal depths as anterior, central, and posterior layers and four concentric zones, consisting of diameters of 0 to 2, 2 to 6, 6 to 10, and 10 to 12 mm, were chosen to perform the corneal densitometric measurements. The mean lenticular densitometric values were calculated in zone 1 at 2.0 mm, zone 2 at 4.0 mm, and zone 3 at 6.0 mm by taking the central part of the pupil as reference point.When compared with the individuals in the control group, the corneal densitometry measurements in the patients in the COVID-19 group were considerably higher in anterior 0 to 2 mm, 2 to 6 mm, 6 to 10 mm zones and total diameter; center 0 to 2 and 2 to 6 mm zones and total diameter; posterior 0 to 2 mm zone; and total corneal 0 to 2 and 2 to 6 mm zones and total diameter (P.05, for each). When compared with the individuals in the control group, all of the lens densitometry measurements, except for those located in zone 1, were determined to be significantly higher among the patients in the COVID-19 group (P.05, for each).Significant alterations were found in corneal and lenticular densitometric values in patients who had had COVID-19. The virus could adversely affect cornea and lens transparency.