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Open AccessArticle

Peripapillary Retinal Vascular Involvement in Early Post-COVID-19 Patients

Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy
Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
Department of Ophthalmology, Western Eye Hospital, Imperial College Healthcare NHS Trust, London NW1 5QH, UK
Neuroscience Institute, Consiglio Nazionale delle Ricerche, Istituto di Neuroscienze, 56124 Pisa, Italy
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
J. Clin. Med. 2020, 9(9), 2895;
Received: 5 August 2020 / Revised: 30 August 2020 / Accepted: 3 September 2020 / Published: 8 September 2020
(This article belongs to the Special Issue New Advances in Retinal Research)
The ability of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2′s) to cause multi-organ ischemia and coronavirus-induced posterior segment eye diseases in mammals gave concern about potential sight-threatening ischemia in post coronavirus disease 2019 patients. The radial peripapillary capillary plexus (RPCP) is a sensitive target due to the important role in the vascular supply of the peripapillary retinal nerve fiber layer (RNFL). Eighty patients one month after SARS-CoV-2 infection and 30 healthy patients were selected to undergo structural OCT (optical coherence tomography) and OCTA (optical coherence tomography angiography) exams. Primary outcome was a difference in RPCP perfusion density (RPCP-PD) and RPCP flow index (RPCP-FI). No significant difference was observed in age, sex, intraocular pressure (IOP) and prevalence of myopia. RPCP-PD was lower in post SARS-CoV-2 patients compared to controls. Within the post-COVID-19 group, patients with systemic arterial hypertension had lower RPCP-FI and age was inversely correlated to both RPCP-FI and RPCP-PD. Patients treated with lopinavir + ritonavir or antiplatelet therapy during admission had lower RPCP-FI and RPCP-PD. RNFL average thickness was linearly correlated to RPCP-FI and RPCP-PD within post-COVID-19 group. Future studies will be needed to address the hypothesis of a microvascular retinal impairment in individuals who recovered from SARS-CoV-2 infection. View Full-Text
Keywords: OCT angiography; peripapillary capillary perfusion; personalized medicine; SARS-CoV-2 OCT angiography; peripapillary capillary perfusion; personalized medicine; SARS-CoV-2
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Savastano, A.; Crincoli, E.; Savastano, M.C.; Younis, S.; Gambini, G.; De Vico, U.; Cozzupoli, G.M.; Culiersi, C.; Rizzo, S.; Gemelli Against COVID-19 Post-Acute Care Study Group. Peripapillary Retinal Vascular Involvement in Early Post-COVID-19 Patients. J. Clin. Med. 2020, 9, 2895.

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