Ophthalmic Manifestations Among Patients Surviving COVID-19

Figures & data

Table 1 Clinical Characteristics of Post-COVID-19 Patients

Measure	Total (N=50)
Age, median (IQR), years	46.5 (15.8)
Male, No. (%)	29 (58)
Hypertension^a, No. (%)	15 (30)
Diabetes Mellitus^a, No. (%)	12 (24)
Time between symptom onset and eye examination, median (IQR), days	55 (39–71)
Mild COVID-19, No. (%)	21 (42)
Severe COVID-19, No. (%)	9 (18)
Critical COVID-19, No. (%)	20 (40)
ICU Stay, No. (%)	20 (40)
Invasive Mechanical Ventilation, No. (%)	11 (22)
Ophthalmic symptoms, No (%)	7 (14)
Transitory low visual, No (%)	3 (6)
Retrocular pain, No (%)	4 (8%)

Notes: The data were expressed as medians and interquartile range (IQR) for continuous variables. Categorical variables were expressed as proportions with 95% confidence intervals computed using the Wilson–Brown hybrid method. These analyses were performed using GraphPad Prism^{®. a}Previously referred diagnosis.

Abbreviations: COVID-19, Coronavirus Disease 2019; IQR, Interquartile Range; ICU, Intensive Care Unit.

Table 2 Ocular Findings on Eye Examination of Patients Post-COVID-19

Measure
Biomicroscopy
Subepithelial infiltrates, No. (% - CI)	2 (4%; 95% CI, 0.7–13.5)
Cataract, No. (% - CI)	8 (16%; 95% CI, 8.3–28.5)
Pterygium, No. (% - CI)	2 (4%; 95% CI 0.7–13.5)
Tonometry
Right Eye Median (IQR)	14 (12–16)
Left Eye	14.5 (12–16)
Retinal Findings
Diabetic Retinopathy, No. (% - CI)	2 (4%; 95% CI 0.7–13.5)
Sectoral retinal pallor, No. (% - CI)	1 (2%; 95% CI 0.1–10.5)
Retinal Druses, No. (% - CI)	4 (8%; 95% CI 3.2–18.9)
Vascular thinning/ tortuosity, No. (% - CI)	5 (10%; 95% CI 4.3–21.3)
Macular hole, No. (% - CI)	1 (2%; 95% CI 0.1–10.5)
Retinalchoroidal Scar, No. (% - CI)	2 (4%; 95% CI 0.7–13.5)
Flame-shaped haemorrhages, No. (% - CI)	1 (2%; 95% CI 0.1 −10.5)
OCT Findings
Epiretinal membrane, No. (% - CI)	1 (2%; 95% CI 0.1–10.5)
Macular hole, No. (% - CI)	1 (2%; 95% CI 0.1–10.5)
Intraretinal cysts in the outer nuclear layer, No. (% - CI)	1 (2%; 95% CI 0.1–10.5)
AMD, No. (% - CI)	5 (10%; 95% CI 4.3 −21.3)
Edema of the inner layers and atrophy of the retina, No. (% - CI)	1 (2%; 95% CI 0.1–10.5)
Flame-shaped haemorrhages, No. (% - CI)	1 (2%; 95% CI 0.1–10.5)

Notes: The data were expressed as medians and interquartile range (IQR) for continuous variables. Categorical variables were expressed as proportions with 95% confidence intervals computed using the Wilson–Brown hybrid method. These analyses were performed using GraphPad Prism^®.

Abbreviation: AMD, Age-related macular degeneration.

Figure 1 Main retinal findings and OCT follow-up patient 1 (A–C). (A) Colour fundus photography and red-free 30-days after symptoms imaging of the right eye of a female patient in her 60s revealing well-delimited sectorial pallor at the lower temporal arcade (black arrow). Vasoactive pharmacological support was not necessary during hospitalisation. (B) Colour fundus photography and red-free 70-days with disappearance of the lesion. (C) OCT-A 30-day follow-up shows a triangular area of low blood flow (white arrowhead), corresponding to the region of retinal pallor. (D) OCT B-scan in the 70-day follow-up of the retinal pallor. Note the local retinal thinning, with loss of differentiation of the inner layers of the retina (white arrowhead).

Figure 2 Main retinal findings and OCT follow-up patient 2 (A–C). (A) Colour fundus photography and red-free imaging of the left eye of a male patient revealing a peripapillary and macular flame-shaped haemorrhage (black arrow). Vasoactive pharmacological support was not necessary during hospitalisation. (B) Intraretinal cysts in the outer nuclear layer with 41-day after symptoms. (C) OCT 68-days after symptoms without intraretinal cysts.

Figure 3 Main retinal findings patient 3 (A) Colour fundus photography and red-free imaging of the left eye of a male patient, without comorbidities and revealing a flame-shaped haemorrhage (black arrow). He had a mild condition, without hospitalisation.