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Klin Monbl Augenheilkd 2023; 240(02): 169-179
DOI: 10.1055/a-1964-7596
Klinische Studie

Retinal Findings in Hospitalized COVID-19 Patients, Is Routine Ophthalmological Examination Required after Discharge? Prospective Case-Control Study

Netzhautbefunde bei hospitalisierten COVID-19-Patienten; ist nach der Entlassung eine routinemäßige augenärztliche Untersuchung erforderlich? Prospektive Fall-Kontroll-Studie
Irfan Akalin
Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
,
Ahmet Kalkisim
Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
,
Betul Onal Gunay 
Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
,
Cenap Mahmut Esenulku
Department of Ophthalmology, University of Health Sciences, Trabzon Kanuni Training and Research Hospital, Trabzon, Turkey
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Abstract

Objectives To investigate retinal findings by comparing patients hospitalized for COVID-19 with the control group.

Methods In this prospective study, 188 eyes of 94 recovered COVID-19 patients and 108 eyes of 54 healthy participants as a control group were evaluated. Patients were divided into three groups, those with mild, moderate, and severe COVID-19. Refractometry, tonometry, optical biometry, optical coherence tomography (OCT) measurements, and complete ophthalmological examinations were performed on healthy volunteers and COVID-19 patients on average 2 weeks after discharge. Pulse O2 and vital parameters were also assessed. Primary outcomes were evaluated, such as retinal findings, and secondary outcomes as retinal thickness, choroidal thickness (CT), retinal nerve fiber layer thickness, and ganglion cell layer thickness.

Results There was no difference between the groups in terms of demographic data, ocular biometry, and intraocular pressure (p > 0.05). Pulse O2 was lower in the study group (p < 0.001). Retinal findings were detected in 68 (36.1%) of 188 eyes in the study group and 28 (25.9%) of 108 eyes in the control group (p = 0.07). The two most common retinal findings were hypertensive retinopathy and retinal pigment epithelium alterations and/or drusen in both groups. In OCT measurements, significant thinning was observed in nasal macular thickness and superior 2 mm CT in the study group compared to the control group (p < 0.05). In patients divided into subgroups according to disease severity, no significant difference was found between the groups in any OCT parameter (p > 0.05).

Conclusion It has been observed that COVID-19 infection does not cause a specific and sensitive finding in the ocular tissues, especially the retina, and does not produce a reproducible measurement result. Recommending routine eye exam after COVID-19 does not seem cost-effective.

Zusammenfassung

Ziel Untersuchung der Netzhautbefunde durch Vergleich von Patienten, die wegen COVID-19 ins Krankenhaus eingeliefert wurden, mit der Kontrollgruppe.

Methode In dieser prospektiven Studie wurden 188 Augen von 94 genesenen COVID-19-Patienten und 108 Augen von 54 gesunden Teilnehmern als Kontrollgruppe ausgewertet. Die Patienten wurden in 3 Gruppen von leichtem, mittelschwerem und schwerem COVID-19 eingeteilt. Refraktometrie, Tonometrie, optische Biometrie, optische Kohärenztomografie-Messungen und vollständige ophthalmologische Untersuchungen wurden an gesunden Freiwilligen und Patienten im Durchschnitt 2 Wochen nach der Entlassung durchgeführt. Puls-O2 und Vitalparameter wurden ebenfalls bewertet. Primäre Endpunkte wurden als Netzhautbefunde ausgewertet, sekundäre Endpunkte als Netzhautdicke, Aderhautdicke, Dicke der retinalen Nervenfaserschicht und Dicke der Ganglienzellschicht.

Ergebnisse Es gab keinen Unterschied zwischen den Gruppen in Bezug auf demografische Daten, Augenbiometrie und Augeninnendruck (p > 0,05). Der Puls-O2 war in der Studiengruppe niedriger (p < 0,001). Netzhautbefunde wurden bei 68 (36,1%) von 188 Augen in der Studiengruppe und bei 28 (25,9%) von 108 Augen in der Kontrollgruppe festgestellt (p = 0,07). Bei der OCT-Messung wurde in der Studiengruppe im Vergleich zur Kontrollgruppe eine signifikante Ausdünnung der nasalen Makuladicke und der oberen Aderhautdicke von 2 mm beobachtet (p < 0.05). Es gab keinen signifikanten Unterschied zwischen Patienten mit und ohne Netzhautbefund (p > 0.05). Bei den Patienten, die nach Schweregrad der Erkrankung in Untergruppen eingeteilt wurden, wurde in keinem Parameter ein signifikanter Unterschied zwischen den Gruppen gefunden (p > 0,05).

Schlussfolgerung Es wurde beobachtet, dass eine COVID-19-Infektion keinen spezifischen und sensitiven Befund im Augengewebe, insbesondere der Netzhaut, hervorruft und kein reproduzierbares Messergebnis liefert. Eine routinemäßige Augenuntersuchung nach COVID-19 scheint nicht kosteneffektiv zu sein.

Key words

choroid - cotton wool spots - COVID-19 - OCT - retina

Schlüsselwörter

Aderhaut - Watteflecken - COVID-19 - OCT - Retina


Publikationsverlauf

Eingereicht: 13. August 2022

Angenommen: 09. Oktober 2022

Artikel online veröffentlicht:
12. Januar 2023

© 2022. Thieme. All rights reserved.

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Rüdigerstraße 14, 70469 Stuttgart, Germany

 

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