Evaluation of retinal, choroidal, and optic disc vascular structures in individuals with a history of COVID-19: 5-year outcomes

ABSTRACT

PURPOSE: This study aimed to compare retinal, choroidal, and optic disc vascular density parameters before infection and at 6 months and 5 years after infection in individuals with a history of coronavirus disease 2019 (COVID-19) using optical coherence tomography angiography.
METHODS: A total of 17 eyes from 17 healthcare workers were included in this study. Retinal, choroidal, and optic disc vascular parameters were evaluated using optical coherence tomography angiography before infection and at 6 months and 5 years after infection. The Friedman test and Wilcoxon signed-rank test with Bonferroni correction were used for statistical analysis.
RESULTS: The foveal avascular zone area was significantly larger at 5 years after infection than at 6 months after infection (p=0.002). Inner retinal parafoveal (p=0.022) and perifoveal (p=0.012) thicknesses were significantly lower at 5 years after infection than before infection. Total optic disc vascular density was significantly lower at 5 years after infection than at 6 months after infection (p=0.005). Furthermore, intraoptic disc vascular density was significantly lower at 5 years after infection than before infection (p=0.009).
CONCLUSION: Microvascular impairment following COVID-19 may persist over the long term. COVID-19 may also have lasting effects on retinal and optic nerve head microcirculation beyond the acute phase of infection. Larger prospective studies with longer follow-up periods are warranted to clarify the clinical significance of these alterations and their potential impact on visual function.

Keywords: COVID-19; Coronavirus disease; Microcirculation; Microvascular density; Optic disk; Tomography, optical coherence;  Angiography; Health personnel

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