Are the optic nerve head parameters and retinal nerve fiber layer thickness affected in patients who had a mild Covid- 19 infection?

Abstract

Aim: The aim of this study was to evaluate the peripapillary retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) parameters by using a spectral domain optical coherence tomography (SD-OCT) device in patients who had a history of a mild-COVID-19 infection. Material and Methods: This prospective cross-sectional study included 70 patients who had a history of a mild COVID-19 infection and 65 healthy individuals. After detailed ophthalmological examination, the peripapillary RNFL thickness and ONH parameters were measured with the SD-OCT device in all patients. Results: No significant difference was present between the groups in terms of age and gender (p=0.907, p=0.979, respectively). The mean, superior, inferior, nasal, and temporal peripapillary RNFL thicknesses were not statistically significantly different between the groups (p=0.797, p=0.488, p=0.079, p=0.820, p=0.820, respectively). Regarding the ONH parameters, no significant difference was found between the groups in terms of disc area, cup area, rim area, cup/disc ratio, horizontal and vertical cup/disc ratio and cup and rim volume (p=0.239, p=0.995, p=0.522, p=0.959, p=0.716, p= 0.873, p=0.476, p=0.701, respectively). Conclusion: No significant difference was found between the patients who had a mild COVID-19 infection and the control group in terms of the peripapillary RNFL thickness and ONH parameters. However, the results may vary according to the severity of the infection and the acute and long-term data.

Keywords

• COVID-19
• peripapillary retinal nerve fiber layer thickness
• optic nerve head parameters
• optic coherence tomography

Supporting Institution

Yazının herhangi bir finansal desteği yoktur.

Hafif Covid-19 enfeksiyonu geçiren hastalarda optik sinir başı parametreleri ve retina sinir lifi tabakası kalınlığı etkilenir mi?

Abstract

Amaç: Bu çalışmanın amacı hafif COVID-19 enfeksiyonu geçiren hastalarda peripapiller retina sinir lifi tabakası (RSLT) kalınlığı ve optik sinir başı (OSB) parametrelerini, spektral domain optik koherens tomografi (SD-OKT) cihazı kullanarak değerlendirmektir. Gereç ve Yöntemler: Bu prospektif cross-sectional çalışmaya hafif COVID -19 enfeksiyonu geçirmiş 70 hasta ile 65 sağlıklı birey dahil edildi. Ayrıntılı oftalmolojik muayene sonrası tüm hastalara SD-OKT cihazı ile peripapiller RSLT kalınlığı ve OSB parametrelerinin ölçümleri yapıldı. Bulgular: Gruplar arasında yaş ve cinsiyet açısından anlamlı farklılık yoktu (p=0.907, p=0.979, sırasıyla). Ortalama, superior, inferior, nazal ve temporal peripapiller RSLT kalınlığı, gruplar arasında istatistiksel açıdan anlamlı değildi (p=0.797, p=0.488, p=0.079, p=0.820, p=0.820, sırasıyla). OSB parametrelerine bakıldığında disc alanı, cup alanı, rim alanı, cup/disc oranı, horizontal ve vertical cup/disc oranı, cup ve rim volume açısından gruplar arasında anlamlı farklılık tespit edilmedi (p=0.239, p= 0.995, p=0.522, p=0.959, p=0.716, p= 0.873, p=0.476, p=0.701, sırasıyla). Sonuçlar: Hafif COVID-19 enfeksiyonu geçiren hastalarla kontrol grubu arasında peripapiller RSLT kalınlığı ve OSB parametreleri açısından anlamlı farklılık tespit edilmedi. Ancak bulduğumuz bu sonuçlar enfeksiyonun şiddeti ile enfeksiyonun akut ve uzun dönem verilerine göre değişkenlik gösterebilir.

Keywords

• COVID-19
• peripapiller retina sinir lifi tabakası kalınlığı
• optik sinir başı parametreleri
• optik koherens tomografi

References

1. Yüce M, Filiztekin E, Özkaya KG. Covid-19 diagnosis-A review of current methods. Biosens Bioelectron. 2021;172:112752.
2. Cucinotta D, Vanelli M. WHO Declares COVID-19 a Pandemic. Acta Biomed. 2020;91(1):157-160.
3. Harapan BN, Yoo HJ. Neurological symptoms, manifestations, and complications associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 19 (COVID-19). J Neurol. 2021;268(9):3059-3071.
4. Sen M, Honavar SG, Sharma N, Sachdev MS. COVID-19 and eye: A review of ophthalmic manifestations of COVID-19. Indian J Ophthalmol. 2021;69(3):488–509.
5. Zhou Z, Kang H, Li S, Zhao X. Understanding the neurotropic characteristics of SARS-CoV-2: from neurological manifestations of COVID-19 to potential neurotropic mechanisms. Journal of Neurology. 2020;267(8):2179–2184.
6. Casagrande M, Fitzek A, Püschel K, et al. Detection of SARS-CoV-2 in Human Retinal Biopsies of Deceased COVID-19 Patients. Ocul Immunol Inflamm. 2020;28(5):721-725.
7. Alomari SO, Abou-Mrad Z, Bydon A. COVID-19 and the central nervous system. Clin Neurol Neurosurg. 2020;198:106116.
8. Siddiqi HK, Libby P, Ridker PM. COVID-19 – A vascular disease. Trends Cardiovasc Med. 2021;31(1):1–5.

9. Gencer S, Lacy M, Atzler D, van der Vorst EPC, Döring Y, Weber C. Immunoinflammatory, Thrombohaemostatic, and Cardiovascular Mechanisms in COVID-19. Thromb Haemost. 2020;120(12):1629–1641.
10. Marinho PM, Marcos AAA, Romano AC, Nascimento H, Belfort Jr.R. Retinal findings in patients with COVID-19. Lancet 2020;395 (10237):1610.
11. Yow AP, Tan B, Chua J, Husain R, Schmetterer L, Wong D. Segregation of neuronal-vascular components in a retinal nerve fiber layer for thickness measurement using OCT and OCT angiography. Biomed Opt Expres. 2021;12(6):3228-3240.
12. Jossy A, Jacob N, Sarkar S, Gokhale T, Kaliaperumal S, Deb AK. COVID-19-associated optic neuritis – A case series and review of literature. Indian J Ophthalmol. 2022;70(1):310–316.
13. Seah I, Agrawal R. Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals Ocul Immunol Inflamm. 2020;28(3):391-395.
14. Haidar MA, Shakkour Z, Reslan MA, et al.SARS-CoV-2 involvement in central nervous system tissue damage. Neural Regen Res. 2022;17(6):1228-1239.
15. Moriguchi T, Harii N, Goto J, et al. A first case of meningitis/encephalitis associated with SARS-Coronavirus-2. Int J Infect Dis. 2020; 94:55–58.
16. Sawalha K, Adeodokun S,Kamoga GR. COVID-19-Induced Acute Bilateral Optic Neuritis. J Investig Med High Impact Case Rep. 2020 ;8:2324709620976018.
17. Beyerstedt S, Casaro EB, Rangel ÉB. COVID-19: angiotensin-converting enzyme 2 (ACE2) expression and tissue susceptibility to SARS-CoV-2 infection. Eur J Clin Microbiol Infect Dis. 2021;40(5):905-919.
18. Pereira LA, Soares LCM, Nascimento PA, et al. Retinal findings in hospitalised patients with severe COVID-19. Br J Ophthalmol. 2022;106(1):102-105.
19. Campbell JP, Zhang M, Hwang TS , et al. Detailed Vascular Anatomy of the Human Retina by Projection-Resolved Optical Coherence Tomography Angiography. Sci Rep. 2017;7:42201.
20. Yu PK, Balaratnasingam C, Xu J, et al. Label-Free Density Measurements of Radial Peripapillary Capillaries in the Human Retina. PLoS One. 2015;10(8):e0135151.
21. Ugurlu A, Agcayazi SB, Icel E, et al. Assessment of the optic nerve, macular, and retinal vascular effects of COVID-19. Can J Ophthalmol. 2022;S0008-4182(22)00189-2.
22. Cennamo G, Reibaldi M, Montorio D, D'Andrea L, Fallico M, Triassi M. Optical Coherence Tomography Angiography Features in Post-COVID-19 Pneumonia Patients: A Pilot Study. Am J Ophthalmol. 2021;227:182-190.
23. Nouri-Vaskeh M, Sharifi A, Khalili N, Zand R, Sharifi A. Dyspneic and non-dyspneic (silent) hypoxemia in COVID-19: Possible neurological mechanism. Clin Neurol Neurosurg. 2020;198:106217.
24. Kaur C, Sivakumar V, Foulds WS. Early response of neurons and glial cells to hypoxia in the retina. Invest Ophthalmol Vis Sci. 2006;47(3): 1126-1141.
25. Zinkernagel MS, Chinnery HR, Ong ML, et al. Interferon γ-dependent migration of microglial cells in the retina after systemic cytomegalovirus infection. Am J Pathol. 2013;182(3):875-885.
26. Yildiz AM, Gunduz GU, Yalcinbayir O, Ozturk NAA, Avci R, Coskun F. SD-OCT assessment of macular and optic nerve alterations in patients recovered from COVID-19. 2022;57(2):75-81.
27. Zor KR, Biçer GY, Günaydın NT, Küçük E, Yılmaz U.B. Can the coronavirus disease 2019 (COVID-19) cause choroiditis and optic neuropathy? European Journal of Inflammation. 2021;19:1-7.
28. Ozmen S, Cakir B, Okan HD, Aksoy NO, Guclu E. The effect of COVID-19 infection on retinal nerve fiber layer and ganglion cell complex layer thicknesses. Exp Biomed Res. 2021;4(3):175-180.
29. Burgos-Blasco B, Güemes-Villahoz N, Vidal-Villegas B, et al. Optic nerve and macular optical coherence tomography in recovered COVID-19 patients. Eur J Ophthalmol. 2022;32(1):628-636.
30. Abrishami M, Daneshvar R, Emamverdian Z,Tohidinezhad F,Eslami S. Optic Nerve Head Parameters and Peripapillary Retinal Nerve Fiber Layer Thickness in Patients with Coronavirus Disease 2019. Ocul Immunol Inflamm. 2021;30(5):1035-1038.