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Open AccessArticle

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

1
Ophthalmology Unit, Fondazione Policlinico Universitario A. Gemelli IRCCS, 00196 Rome, Italy
2
Department of Ophthalmology, Catholic University of “Sacro Cuore”, 00168 Rome, Italy
3
Department of Ophthalmology, Western Eye Hospital, Imperial College Healthcare NHS Trust, London NW1 5QH, UK
4
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; https://doi.org/10.3390/jcm9092895
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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