Changes in macular ganglion cell and retinal nerve fiber layer thickness during recovery from infection with the B.1.1.7 variant of SARS-CoV-2 in previously hospitalized patients with COVID-19 bilateral pneumonia.

Abstract

Coronavirus disease 2019 (COVID-19) has been associated with various systemic complications, including potential impacts on ocular health. Recent studies have suggested that COVID-19 may lead to changes in retinal structure, particularly in the neuroretinal and retinal nerve fiber layers (RNFL). This study aimed to examine changes in neuroretinal and RNFL of the optic dics based on optical coherence tomography (OCT) in patients hospitalized due to COVID-19 bilateral pneumonia at 2 time points after discharge. A prospective study involved 49 patients with COVID-19 bilateral pneumonia hospitalized between March and May 2021. Baseline ocular evaluations were conducted 2 months post-discharge, with follow-up examinations 6 months later. Retinal parameters, including RNFL and ganglion cell layers (GCL), were assessed. Control group of healthy individuals also underwent similar ophthalmic examinations for comparative analysis. We found that the average thickness of the retinal nerve fiber layer (RNFL) of the optic disc was lower in the COVID-19 group than in controls (p≤0.01). The ganglion cell layer (GCL) was thicker in the inner inferior ring (p=0.008) but thinner in the outer superior, outer nasal, and outer inferior rings (p=0.044, p<0.01, and p<0.01, respectively). OCT parameters were assessed according to sex. At 6 months, the RNFL of the inner inferior and outer temporal rings was thinner in women than in men (p=0.022 and p=0.020, respectively). The GCL of the inner temporal and outer temporal rings was also thinner in women than in men (p=0.004 and p=0.005, respectively). In conclusion: at 6-month follow-up, RNFL and GCL thickness was significantly lower in some areas of the retina compared with baseline. COVID-19 seems to cause changes in the macular retina, highlighting the need for ophthalmologic screening of patients with a history of SARS-CoV-2 infection.