A cross-sectional comparative analysis of corneal endothelial parameters by specular microscopy in post covid versus normal population in Western India

Abstract

Objective: To observe the changes in corneal endothelium post COVID-19 infection in different age groups using specular microscopy and compare it with the normal population in western India during the pandemic. Materials and Method: 129 patients COVID-19 recovered, and 123 age-matched healthy controls were included in this cross sectional, comparative, monocentric study. Corneal endothelial parameters like Cell Density (CD) (cell/mm2), Coefficient of Variation (CV) (polymegathism, %), Cell hexagonality (polymorphism, %), Average cell area (MCA) (μm2/cell), and mean value of Central Corneal Thickness (CCT) (μm) were evaluated with a non-contact specular microscope (TOMEY EM-4000, CBD.TOMEY USA) Results: The mean (SD) time since COVID diagnosis (months) in the study group was 6.67 (1.94). The mean (SD) time since RT-PCR negative (months) in the study group was 6.34 (1.74). The mean (SD) of CV (%) in the study group was (RE) 37.75 (6.03), (LE) 36.25 (4.66) and in control group was (RE) 35.23 (3.75), (LE) 34.77 (3.64). The mean (SD) of hexagonality (%) in the study group was (RE) 47.33 (6.84), 48.45 (7.33) and in control group was (RE):56.73 (4.13), (LE) 56.21 (5.34). Conclusion: The specular microscopic examination on the COVID-19 recovered patients revealed a decrease in the hexagonality of the endothelial cells (pleomorphism) and an increase in the cell size (polymegathism). Specular microscopic examination can be done to assess such earliest changes in corneal endothelium to evaluate the effects of the infection following recovery on ocular tissue to avoid long term sequalae.