Retinal Changes in Patients With Covid-19 and Different Expressiveness of Metabolic Changes

České info

Cíl studie: Zkoumání vztahu mezi závažností metabolických změn vyvolaných COVID-19 a strukturou a četností změn na sítnici podle dat z vyšetření očních pozadí pacientů s různým klinickým průběhem onemocnění COVID-19.

Materiál a metody: Vyšetřeno bylo 117 pacientů s onemocněním COVID-19. Při vyšetření pacientů byla zjišťována závažnost průběhu onemocnění COVID-19 a expresivita metabolických změn; záznam obrazu očních pozadí byl pořizován pomocí přenosných fundus kamer Pictor Plus Fundus Camera a VistaView (Volk Optical).

Výsledky: Výsledkem výzkumu je zjištění změn na sítnici u 49 (41,9 %) pacientů s onemocněním COVID-19. V 8 (16,3 %) případech byly pozorovány klinicky významné změny sítnice a oka indukované infekcí COVID-19 (krvácení do sklivce, pretrombóza centrální sítnicové žíly nebo větví centrální sítnicové žíly, trombóza centrální sítnicové žíly nebo větví centrální sítnicové žíly), které vedly ke snížení zrakové ostrosti. Ve 41 (83,7 %) případech byly pozorovány klinicky nevýznamné změny sítnice indukované infekcí COVID-19 (vatovitá ložiska, zúžené sítnicové cévy, intraretinální a petechiální krvácení, tortuozita a dilatace sítnicových venul). Klinicky významné změny na sítnici se vyskytly u pacientů se statisticky významně vyšší hladinou D-dimerů a vyšším procentuálním výskytem lézí plicního parenchymu oproti skupině pacientů s klinicky nevýznamnými sítnicovými změnami (p < 0,05).

Závěry: Struktura retinálních změn u pacientů s COVID-19 koreluje se závažností klinického průběhu onemocnění a metabolických změn pacientů. Metabolické změny korelují se změnami sítnice a mohou mít prediktivní význam v prevenci celkových cévních komplikací spojených s onemocněním COVID-19.

Klíčová slova:

metabolismus – sítnice – Retina – COVID-19 – oftalmoskopie – sítnicové cévy

Authors: Kateryna Hutsaliuk ^1,2; Nataliia Skalska ³; Nadiia Ulianova ^2,4
Authors place of work: The Regional Ophthalmology Center, ME "Volyn Regional Clinical Hospital" of the Volyn Regional Council, Lutsk, Ukraine ¹; The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine, Odesa, Ukraine ²; Infectious Department, ME "Volyn Regional Clinical Hospital" of the Volyn Regional Council, Lutsk, Ukraine ³; Department of Post-traumatic eye pathology, SI "The Filatov Institute of Eye Diseases and Tissue Therapy of the National Academy of Medical Sciences of Ukraine", Odesa, Ukraine ⁴
Published in the journal: Čes. a slov. Oftal., 80, 2024, No. 3, p. 156-166
Category: Original Article
doi: https://doi.org/10.31348/2024/12

Summary

Aims: To study the relationship between the severity of COVID-induced metabolic changes and the structure and frequency of retinal chan-
ges, according to funduscopy data in patients with different clinical courses of COVID-19.

Materials and methods: 117 patients with COVID-19 were examined. While examining patients, severity of the course of COVID-19, the expressiveness of changes in the metabolic status were determined; fundus image registration was performed with portable fundus cameras Pictor Plus Fundus Camera and VistaView (Volk Optical).

Results: As a result of the research, retinal changes were found in 49 (41.9 %) patients with COVID-19. In 8 (16.3 %) cases, clinically significant (vitreous hemorrhage, prethrombosis of the central retinal vein or branches of the central retinal vein, thrombosis of the central retinal vein or branches of the central retinal vein) COVID-induced retinal and ophthalmological changes were observed, which caused a decrease in visual acuity. In 41 (83.7 %) cases, clinically insignificant changes (cotton wool spots, narrowed retinal vessels, intraretinal and petechial hemorrhages, tortuosity and dilatation of retinal venules) COVID-induced retinal changes were observed. Clinically significant retinal changes occur in patients with a statistically significantly higher level of D-dimer and a greater percentage of lung parenchyma lesion than in the group of patients with clinically insignificant retinal changes (p < 0.05).

Conclusions: The structure of retinal changes in patients with COVID-19 correlates with the severity of the clinical course of the disease and changes in the metabolic status of patients. Metabolic changes are correlated with retinal changes and can be predictive for preventing general vascular complications in COVID-19.

Keywords:

Metabolism – Retinal vessels – Retina – COVID-19 – ophthalmoscopy

Zdroje

Poděkování: Doc. Vitaly Guryanov, Oddělení péče o zdraví, O. O. Bogomolcova národní lékařská univerzita

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