Retinal microvascular and perfusional disruption in paediatric COVID-19: A case-control optical coherence tomography angiography study

Abstract

Purpose : To investigate the short-term effect of coronavirus 2019 (COVID-19) on the retinal capillary network and choroid in children. Materials and Methods : This prospective, cross-sectional, case-control study included 19 recovered COVID-19 paediatric patients and 20 healthy children. Macular thickness, choroidal thickness, vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) values were obtained. Central vessel and perfusion densities were measured at the central 6-mm area, and the values were compared among three subgroups according to location. Results : The mean ages of patients and controls were 12.42 ± 3.3 years and 13.35 ± 1.2 years, respectively. Significant differences were observed between the two groups in terms of inner, outer, and full VD, as well as inner and full PD. No significant differences in centre VD and PD were observed between groups. Although it was not evident in analysis of choroidal values, inflammatory sites were thickened. FAZ area significantly differed between groups (p < 0.05). Conclusions : Retinal microvascularity was impaired in the acute phase of disease in recovered COVID-19 patients aged 10–15 years. However, the microvascularity impairment was subclinical. The choroid was thickened because of inflammation during the acute phase of disease. Paediatric COVID-19 patients should undergo follow up via optical coherence tomography angiography to detect subclinical retinal changes. (Clinically asymptomatic retinal changes) Long-term follow-up studies are needed to validate these findings.

OCT and OCTA evaluation of vascular and morphological structures in the retina in recovered pediatric patients with COVID-19

“…More recently, few manuscripts have been reported evaluating retinal and choroidal thickness changes in pediatric patients with COVID-19 by OCT imaging and comparing them with healthy children[ 6 , 8 , 9 ]. Zengin et al [6] .…”

“…Recent studies of eye involvement in pediatric patients with COVID-19 have included limited numbers of patients and have focused primarily on pathologies occurring in the anterior segment of the eye. To the best of our knowledge, there are few studies investigating posterior segment involvement in this age group [5] , [6] , [7] , [8] , [9] , [10] .…”

The optical coherence tomography angiography study on paediatric COVID-19 cases

“…We read with interest the research article entitled “Retinal microvascular and perfusional disruption in paediatric COVID-19: A case-control optical coherence tomography angiography study”, [1] it was a cross-sectional study on choroidal structural and vascular changes on paediatric COVID-19 subjects. We are particularly interested in the possible confounding on the optical coherence tomography angiography (OCT-A) measurements.…”

“…Firstly, we appreciated Zengin and Güven for recording the autorefraction measurement values of all patients, [1] however these data were not presented. High myopia subjects were not excluded according to the primary study's methodology.…”

“…High myopia subjects were not excluded according to the primary study's methodology. [1] Refraction, with and without cycloplegic, or more precisely the axial length is proven by different large paediatric ophthalmology cohorts to have statistically significant effects on the macular and choroidal parameters on OCT-A. [ 2 , 3 , 4 , 5 ]…”