COVID-19 Associated Choroidopathy

Abstract

The aim of the study is to report on the indocyanine green angiography (ICGA) and OCT findings in patients hospitalized for severe COVID infection. In this observational prospective monocentric cohort study, we included patients hospitalized for severe COVID infection. The main outcomes were ICGA and OCT findings. A total of 14 patients with a mean age of 58.2 ± 11.4 years and a male predominance (9/14 patients; 64%) were included. The main ICGA findings included hypofluorescent spots in 19 eyes (68%), intervortex shunts in 10 eyes (36%), and characteristic “hemangioma-like” lesions in five eyes (18%). “Hemangioma-like” lesions were both unique and unilateral, and showed no washout on the late phase of the angiogram. The main OCT findings included focal choroidal thickening in seven eyes (25%), caverns in six eyes (21%) and paracentral acute middle maculopathy lesions in one eye (4%). All patients hospitalized for severe COVID infection had anomalies on ICGA and OCT. Lesions to both retinal and choroidal vasculature were found. These anomalies could be secondary to vascular involvement related directly or indirectly to the SARS-CoV2 virus.

Evaluation of choroidal thickness with OCT in COVID-19 patients with high D-dimer levels

“…In COVID-19, dark spots showing hypoperfusion in the choriocapillaris have been detected in OCT angiography. This finding was especially detected in patients with high D-dimer levels 33 . Therefore, D-dimer levels of COVID-19 patients are particularly important and there is a risk of pathological changes due to increased coagulation in tissues with high blood supply, such as the choroid.…”

“…In the study of Yaser et al, choroidal leakage and staining were detected in 71% of the patients in COVID-19. It has been reported that this leakage may be due to direct Sars-Cov2 damage in the glycocalyx 33 . In our study, ophthalmological examination findings were not included at the early period of covid disease due to risk of contagion and poor general health condition.…”

The Effect of Corticosteroid Therapy on Choroidal Thickness in Patients With Covid-19 Infection: A Prospective, Comparative, and Observational Study

“…Systemic ocular manifestations of Covid-19 have been reported in numerous studies [4][5][6][7][8][9]. In contrast, the present study evaluated the role of steroid use in the development of these manifestations and also examined the effects of Covid-19 on ocular structures and choroidal thickness.…”

Bilateral anterior ischemic optic neuropathy and choroidal ischemia in a patient with COVID‐19 infection

“…The cause of choroidal hypoperfusion may be secondary to SARS-CoV-2-induced damages, including direct viral-induced cell death, excessive inflammatory reactions accompanied by vascular inflammation and neutrophil infiltration. 13 Nonarteritic anterior ischemic optic neuropathy is caused by hypoperfusion of the optic nerve. Our patient presented with bilateral NAION in the setting of COVID-19 infection.…”

“…Another finding which is in favor of NAION in this case is the presence of sever choroidal ischemia. The cause of choroidal hypoperfusion may be secondary to SARS‐CoV‐2‐induced damages, including direct viral‐induced cell death, excessive inflammatory reactions accompanied by vascular inflammation and neutrophil infiltration 13 …”