Pupillographic Analysis of COVID-19 Patients: Early and Late Results After Recovery

Abstract

Purpose: We aimed to investigate the short and long-term static and dynamic pupillary responses of patients recovered from coronavirus disease – 19 (COVID-19) by using quantitative infrared pupillography. Methods: This study included patients who recovered from COVID-19 (Group 1) and age- and gender-matched controls (Group 2). A detailed ophthalmic examination was performed at one month and six months after the diagnosis of COVID-19. Photopic, mesopic, and scotopic pupil diameters (PDs) were measured by using a quantitative infrared pupillography which was integrated into Scheimpflug/Placido photography-based topography system. Pupil diameters at 0, 2nd, 4th and 6th seconds, and average pupil dilation speeds at 2nd, 4th, 6th and 8th seconds were recorded. Results: Eighty-six eyes of 86 patients (Group 1: n=42; Group 2: n=44) were included. While the mean photopic, mesopic and scotopic PDs were significantly larger in the COVID-19 group than the control group in the first month (p = 0.035, p = 0.017, p = 0.018, respectively), no statistically significant difference was found in the sixth month. Besides, average pupil dilation speeds and PDs at the 0, 2nd, 4th and 6th seconds were not statistically significantly different between the two groups in the first month and sixth month. Conclusions: Pupil diameters were significantly larger in COVID-19 patients in all light intensities in the first month after COVID-19. However, pupillary dilation was transient, and no significant difference was found in the sixth month. We suggest that the transient pupillary dilation may be secondary to the autonomic nervous system dysfunction following COVID-19.