Longitudinal Alterations of Retinal and Choroidal Structure in Patients with COVID-19
Kiana Hassanpour1 *, Mojtaba Abrishami2 , Ghodsiyeh Zamani2 , Seyedeh Maryam Hosseini 2 , Nasser Shoeibi 2 , Zahra Emamverdian 2 , Amir Zamani3 , Majid Abrishami 2
- Ophthalmic Research Center, Research Institute for Ophthalmology and Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of General Surgery, Loghman Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
Abstract: To evaluate the midterm longitudinal changes in choroidal and retinal structures in patients with coronavirus disease 2019 (COVID-19)
Methods: In this prospective observational study, the health workers of a tertiary eye center with a definite diagnosis of COVID-19 were included between June 2020 and September 2021. The patients underwent retinal and choroidal imaging with enhanced-depth imaging (EDI) optical coherence tomography (OCT) upon the recovery from the disease (baseline), after 1 and 3 months, respectively. Automated retinal thickness measurements in fovea, parafovea, and perifovea were recorded. In EDI images, the luminal and total choroidal area was measured using Sonada’s method with ImageJ and the choroidal vascularity index(CVI) was calculated. Choroidal thickness(CT) was measured at the subfoveal area, 500 microns temporal, and nasal to the fovea.
Results: A total of 34 eyes of 17 COVID-19 patients were enrolled in the present study. Mean CVI was 0.64 ± 0.04, at baseline (Median= 0.64, Range= 0.27) that significantly increased to 0.67 ± 0.05 (Median 0.66, range=0.17, P= 0.012) after 1 month and again significantly decreased to 0.63 ± 0.05 (Median 0.063, range= 0.17) after 3 months. (P< 0.001). While the stromal component showed a significant decrease between the baseline and first-month values (1.16 ± 0.29 to 1.01 ± 0.27, P= 0.03), the luminal area decrease mostly occurred between month 1 and 3 (2.03 ± 0.28 to 1.91 ± 0.23, P= 0.045) Average of the total choroidal area and subfoveal choroidal thickness remained unchanged between the study periods. In the same way, retinal thickness and volume at different macular zones were comparable in all study visits. The intra-rater and inter-rater correlation revealed acceptable agreement, respectively. (Chronbach’s Alpha= 0.90 and 0.81, respectively)
Conclusion: Choroidal vascularity index is increased in patients with COVID-19 1 month after recovery from COVID-19, but the increased level return to the baseline values after 3 months. Regarding the reversible nature of the choroidal changes, there might be a more prominent role for inflammation rather than ischemic changes.
