Long-term ocular damage after recovery from COVID-19: lack of evidence at three months

Abstract

Importance A small number of COVID-19 patients has been reported to suffer from acute keratoconjunctivitis. In very rare cases, acute inflammatory retinal vein occlusion, papillophlebitis or retinopathy have been observed. Objective To determine possible long-term effects on the eye, especially on the retina, in patients who had suffered from COVID-19 at least 3 months after recovery. Design Prospective cross-sectional study. Setting Hospital of the Ludwig Maximilians University, Munich. Participants Patients who had been tested positive for SARS-CoV-2 or for anti-SARS-CoV-2 IgG serum antibodies in the Hospital of the Ludwig Maximilians University, Munich between May and September. Methods Patients who had tested positive were either hospitalized or discharged into home quarantine via the emergency room. Three months after recovery, they were invited to participate voluntarily for this study during their follow-up in our clinic. A complete ophthalmological exam including functional and imaging end points (including optical coherence tomography (OCT), OCT angiography) was performed. Main outcomes and measures Visual acuity, slit lamp, bio microscopy and fundoscopy, multimodal imaging findings. Results In total, 21 patients were examined. The mean age (SD) of the patients was 48.7 (18.3) years. Of these, 14 (66.6%) were hospitalized and 7 (33.3) were discharged home. Two hospitalized patients (9.5%) received invasive ventilation. During the infection, 14 of the 21 patients (66.6%) were in regular care whereas 2 patients (9.5%) received intensive care ventilation for 8.5 (SD) (0.7) days on average in the COVID ICU. Ophthalmological examination of the previously hospitalized group took place 111.4 (23.2) days after recovery and discharge from the hospital, while non-hospitalized patients were examined after mean 123.4 (44.7) days. All patients showed normal findings for anterior and posterior segment of both eyes. OCT and OCT-A showed no evidence of retinal damage, or vascular or microvascular events. Conclusion and relevance This study with a small prospective cohort of 21 patients indicates that there might be no evidence of ocular complications at 3 months after recovery from COVID-19, without previous eye involvement. Further studies with more participants with and without acute ocular symptoms are necessary for final evidence.

Virtual reality for assessing stereopsis performance and eye characteristics in Post-COVID

“…For example, ocular impairments in COVID patients (often due to retinal manifestations in vein occlusions) were reported, potentially leading to visual impairment 50 – 57 . Brantl et al 58 found no significant changes in the visual functions after three months. However, they also state that the database is insufficient to be certain.…”

Use of Imaging Technology to Assess the Effect of COVID-19 on Retinal Tissues: A Systematic Review

“…It is vital to highlight Brantl’s [ 43 ] study, which did not find any retinal signs in patients 3 months post COVID-19 recovery. Twenty-one patients were examined 3 months after their initial presentation to the emergency department (14 had been hospitalised and 7 discharged home).…”

Long‐term effects of coronavirus disease 2019 on diabetes complications and mortality in people with diabetes: Two cohorts in the UK and Hong Kong

“…In addition to cardiovascular disease, an increased likelihood of ESRD (~2‐fold [UKB] and 1.2‐fold [HK]) was observed following COVID‐19 in people with diabetes, indicating that the long‐term management postdiagnosis with COVID‐19 in such patients should not only focus on cardiovascular, but also on microvascular, disease. Previously, some studies also reported risks associated with long COVID for decline in kidney function (nephropathy) leading to ESRD 40 and long‐term ocular damage in COVID‐19 survivors, leading to diabetic retinopathy 41 . Although statistically significant risks were associated with a few microvascular complications in this study, like retinopathy (HR [UKB]: 1 [95% CI: 1.2, 2.2]) and nephropathy (HR [HK]: 1.2 [95% CI: 1.1, 1.3]), others did not always reach statistical significance, possibly because of the small sample size of patients developing these complications.…”