Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center

Neal S Patel,1,&ast; Jade Y Moon,1,&ast; Raviv Katz,1 Karen M Wai,1 Lucia Sobrin,2 Demetrios G Vavvas,2 John B Miller1,2 1Harvard Retinal Imaging Lab, Mass Eye and Ear, Boston, MA, USA; 2Retina Service, Mass Eye and Ear, Boston, MA, USA&ast;These authors contributed equally to this workC...

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Autores principales:	Patel NS, Moon JY, Katz R, Wai KM, Sobrin L, Vavvas DG, Miller JB
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2021
Materias:	covid-19 sars-cov-2 retina optical coherence tomography fundus photography Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/3d9af82a5c964c01a1d72723ec223869
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spelling	oai:doaj.org-article:3d9af82a5c964c01a1d72723ec2238692021-12-02T17:46:13ZRetrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center1177-5483https://doaj.org/article/3d9af82a5c964c01a1d72723ec2238692021-09-01T00:00:00Zhttps://www.dovepress.com/retrospective-analysis-of-retinal-imaging-in-covid-19-positive-patient-peer-reviewed-fulltext-article-OPTHhttps://doaj.org/toc/1177-5483Neal S Patel,1,&ast; Jade Y Moon,1,&ast; Raviv Katz,1 Karen M Wai,1 Lucia Sobrin,2 Demetrios G Vavvas,2 John B Miller1,2 1Harvard Retinal Imaging Lab, Mass Eye and Ear, Boston, MA, USA; 2Retina Service, Mass Eye and Ear, Boston, MA, USA&ast;These authors contributed equally to this workCorrespondence: John B MillerRetina Service, Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Harvard Retinal Imaging Lab, 243 Charles St, Boston, MA, 02114, USATel +617 573-3750Fax +617 573-3698Email john_miller@meei.harvard.eduPurpose: Since the start of the COVID-19 pandemic, numerous authors have published data demonstrating retinal changes found in patients with COVID-19. However, others have debated the significance of these findings and the effects of COVID-19 on the retina remain uncertain. This study aims to better understand retinal findings in patients with COVID-19.Patients and Methods: A retrospective review of patients with a history of a positive COVID-19 polymerase chain reaction test was performed between March 1st, 2020 and October 31st, 2020. Patients were included if they presented within 90 days of their first positive COVID-19 test and underwent color fundus photography and/or OCT of the macula. All images were reviewed by two independent graders who assessed the presence of retinal heme, cotton wool spots, vascular sheathing, and disc edema, as well as hyper-reflective changes, intra-retinal fluid, and sub-retinal fluid on OCT.Results: A total of 119 eyes from 61 patients were included. Among 83 eyes which underwent OCT of the macula, inner retinal hyper-reflective changes were seen in 16.9% (n=14), outer retinal hyper-reflective changes in 18.1% (n=15), intra-retinal fluid in 28.9% (n=24), and sub-retinal fluid in 14.5% (n=12). Among 48 eyes which underwent color fundus photography, retinal hemorrhage was seen in 27.1% (n=13), optic disc edema in 2.1% (n=1), and cotton wool spots in none of the eyes. Sub-analysis of 70 eyes from 41 patients with no alternative retinal pathology to potentially explain the above findings revealed none of the above exam findings on OCT of the macula (n=35), fundus photography (n=28), or documented exam (n=66).Conclusion: While a number of patients seen after COVID-19 infection demonstrated retinal findings, all could be explained by pre-existing retinal conditions. In a sub-group of eyes without pre-existing retinal disease, we did not identify any retinal findings that could be associated with COVID-19.Keywords: COVID-19, SARS-CoV-2, retina, optical coherence tomography, fundus photographyPatel NSMoon JYKatz RWai KMSobrin LVavvas DGMiller JBDove Medical Pressarticlecovid-19sars-cov-2retinaoptical coherence tomographyfundus photographyOphthalmologyRE1-994ENClinical Ophthalmology, Vol Volume 15, Pp 3727-3731 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	covid-19 sars-cov-2 retina optical coherence tomography fundus photography Ophthalmology RE1-994
spellingShingle	covid-19 sars-cov-2 retina optical coherence tomography fundus photography Ophthalmology RE1-994 Patel NS Moon JY Katz R Wai KM Sobrin L Vavvas DG Miller JB Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center
description	Neal S Patel,1,&ast; Jade Y Moon,1,&ast; Raviv Katz,1 Karen M Wai,1 Lucia Sobrin,2 Demetrios G Vavvas,2 John B Miller1,2 1Harvard Retinal Imaging Lab, Mass Eye and Ear, Boston, MA, USA; 2Retina Service, Mass Eye and Ear, Boston, MA, USA&ast;These authors contributed equally to this workCorrespondence: John B MillerRetina Service, Mass Eye and Ear, Department of Ophthalmology, Harvard Medical School, Harvard Retinal Imaging Lab, 243 Charles St, Boston, MA, 02114, USATel +617 573-3750Fax +617 573-3698Email john_miller@meei.harvard.eduPurpose: Since the start of the COVID-19 pandemic, numerous authors have published data demonstrating retinal changes found in patients with COVID-19. However, others have debated the significance of these findings and the effects of COVID-19 on the retina remain uncertain. This study aims to better understand retinal findings in patients with COVID-19.Patients and Methods: A retrospective review of patients with a history of a positive COVID-19 polymerase chain reaction test was performed between March 1st, 2020 and October 31st, 2020. Patients were included if they presented within 90 days of their first positive COVID-19 test and underwent color fundus photography and/or OCT of the macula. All images were reviewed by two independent graders who assessed the presence of retinal heme, cotton wool spots, vascular sheathing, and disc edema, as well as hyper-reflective changes, intra-retinal fluid, and sub-retinal fluid on OCT.Results: A total of 119 eyes from 61 patients were included. Among 83 eyes which underwent OCT of the macula, inner retinal hyper-reflective changes were seen in 16.9% (n=14), outer retinal hyper-reflective changes in 18.1% (n=15), intra-retinal fluid in 28.9% (n=24), and sub-retinal fluid in 14.5% (n=12). Among 48 eyes which underwent color fundus photography, retinal hemorrhage was seen in 27.1% (n=13), optic disc edema in 2.1% (n=1), and cotton wool spots in none of the eyes. Sub-analysis of 70 eyes from 41 patients with no alternative retinal pathology to potentially explain the above findings revealed none of the above exam findings on OCT of the macula (n=35), fundus photography (n=28), or documented exam (n=66).Conclusion: While a number of patients seen after COVID-19 infection demonstrated retinal findings, all could be explained by pre-existing retinal conditions. In a sub-group of eyes without pre-existing retinal disease, we did not identify any retinal findings that could be associated with COVID-19.Keywords: COVID-19, SARS-CoV-2, retina, optical coherence tomography, fundus photography
format	article
author	Patel NS Moon JY Katz R Wai KM Sobrin L Vavvas DG Miller JB
author_facet	Patel NS Moon JY Katz R Wai KM Sobrin L Vavvas DG Miller JB
author_sort	Patel NS
title	Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center
title_short	Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center
title_full	Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center
title_fullStr	Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center
title_full_unstemmed	Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center
title_sort	retrospective analysis of retinal imaging in covid-19 positive patients at a tertiary eye care center
publisher	Dove Medical Press
publishDate	2021
url	https://doaj.org/article/3d9af82a5c964c01a1d72723ec223869
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Retrospective Analysis of Retinal Imaging in COVID-19 Positive Patients at a Tertiary Eye Care Center

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