Purpose The purpose is to evaluate macular vascular densities (VDs) using optical coherence tomography angiography (OCTA) in patients affected by coronavirus disease-2019 (COVID-19). Methods The superficial (SF) and deep macular VD of 50 patients with SARS CoV2 pneumonia who had positive polymerase chain reaction (PCR) tests and who recovered after receiving treatment and 55 healthy age- and gender-matched controls were compared using OCTA. Blood inflammation parameters were also recorded. Results There was no statistically significant difference between the two groups in terms of age and gender (p = 0.147 and p = 0.504, respectively). Nor was there a difference with respect to smokers between the two groups (p = 0.231). In COVID-19 patients, the VDs in superior hemi quadrant, superior quadrant and inferior quadrant, were significantly lower (p = 0.033, p = 0.029 and p = 0.042, respectively) in superficial plexus. It was also significantly lower in parafovea, superior hemi and superior quadrants (p = 0.026, p < 0.001 and p = 0.004, respectively) in deep plexus. In addition, white blood cell and neutrophil counts were significantly negatively correlated with the VD of the deep parafovea, deep superior quadrant and deep superior hemi quadrant (p < 0.05). There was no difference between the patient and control groups in both superficial and deep foveal avascular zone (FAZ) (p = 0.101 and p = 0.691 respectively) Conclusion In COVID-19 disease, VD is low in some sectors in both SF and deep layers, but no change in FAZ. The effect of COVID 19 disease on the retina and whether it makes the retina sensitive to damage can only be understood with long-term follow-up.
Purpose To recognize dysfunctions in the autonomic nervous system (ANS) with changes in dynamic and static pupillary responses in patients who recovered from coronavirus disease-2019 (COVID-19) Methods One month after recovery from COVID-19, patients were subjected to eye examinations. Pupillary responses were measured using a pupillometry system. Dynamic pupil parameters (i.e., pupil contraction amplitude, pupil dilatation latency, pupil contraction latency, pupil dilatation duration, pupil dilatation velocity, pupil contraction duration, pupil contraction velocity, resting pupil diameter [PD]) and static pupil parameters (i.e., mesopic PD, scotopic PD, high photopic PD, and low photopic PD) were registered. Results Although high photopic and scotopic PDs were significantly higher in patients recovering from COVID-19 than in healthy controls ( P = 0.04 and P = 0.002), no statistically significant difference was found in mesopic and low photopic PD ( P = 0.19 and P = 0.41). Regarding dynamic pupillometry parameters, resting PD and pupil contraction velocity ( P = 0.04 and P = 0.02, respectively) were significantly higher in patients recovering from COVID-19 than in healthy controls ( P < 0.001 and P < 0.001, respectively), whereas pupil dilatation latency and pupil contraction duration were lower in these patients than in healthy controls ( P = 0.01 and P = 0.008, respectively). No significant differences in pupil contraction amplitude, pupil dilatation duration, pupil contraction latency, and pupil dilatation velocity were found between the study groups ( P = 0.93, P = 0.91, P = 0.42, and P = 0.48, respectively). Conclusion Pupil responses, which are controlled by the ANS, were impaired in patients recovering from COVID-19. Pupillometry shows promise as a non-invasive, easy-to-apply diagnostic technology for detecting autonomic dysfunction in patients recovering from COVID-19. Clinical trial registration Not applicable.
Purpose To demonstrate the effects of the disease on the corneal endothelium in individuals recovering from COVID-19 through specular microscopy. Methods Eighty individuals recovering from COVID-19 (group 1) and 72 healthy controls (group 2) were included in this prospective study. After examining visual acuity, refractive defect detection, anterior and posterior segment examinations, and specular microscopy measurements were calculated from images with at least 100 cells. The mean cell density (CD), mean coefficient of variation (CV), mean hexagonal cell percentage, mean cell area (AVG), and central corneal thickness (CCT) were evaluated. Results The mean time from diagnosis of the disease in group 1 was 54.25 ± 6.36 days. The mean time elapsed since the PCR test became negative was 38.45 ± 6.87 days. Only four were treated in the hospital. Specular microscopy data showed that the CD was 2713.56 ± 246.25 and 2845.80 ± 299.27 in groups 1 and 2, respectively ( p = 0.003). The CV values were 42.92 ± 6.79 and 40.16 ± 5.97, respectively ( p = 0.009). The hexagonality were 46.51 ± 7.35 and 49.12 ± 6.87, respectively ( p = 0.024). The AVG was 371.60 ± 34.64 and 353.16 ± 35.29, respectively ( p = 0.007). The CCT values were 553.00 ± 73.2, and 526.84 ± 33.57, respectively ( p = 0.005). Conclusion A decrease in the number of endothelial cells and hexagonal cells (polymorphism) as well as an increase in the cell area change coefficient (polymegatism) and the average cell area were observed from corneal specular microscopic examination of individuals recovering from COVID-19 in the early period of the disease. These results may be important in understanding the systemic effects of the disease.
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