Does COVID-19 Involve the Retina?
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COMMENTARY
Does COVID-19 Involve the Retina? Michael Karampelas
. Maria Dalamaga . Irene Karampela
Received: August 18, 2020 / Accepted: September 3, 2020 Ó The Author(s) 2020
ABSTRACT Endothelial cell involvement with COVID-19 has been shown in the lung, heart, kidney, intestine and brain with histopathological evidence of endotheliitis and vasculitis. Viral RNA of COVID-19 has been detected in the retina of affected patients and recent publications highlight the possibility of retinal microangiopathy in patients with confirmed COVID-19 infection. Given the magnitude of the current pandemic, emphasis should be given to better reporting of clinically significant ocular symptoms, e.g. new scotoma, which could indicate the need for a retinal examination as well as follow-up testing after recovery from COVID19. Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12907244. M. Karampelas (&) Medical Retina Department, Hippokration General Hospital, Athens, Greece e-mail: [email protected] M. Dalamaga Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, Athens, Greece I. Karampela Second Department of Critical Care, Attikon General University Hospital, Medical School, National and Kapodistrian University of Athens, Chaidari, Greece
Keywords: COVID-19; Microangiopathy; Retina; SARS-CoV-2
Key Summary Points Endothelial cell involvement with COVID-19 has been shown in the lung, heart, kidney, intestine and brain. Viral RNA of COVID-19 has been detected in the retina of affected patients. Recent publications provide evidence of retinal microangiopathy in patients with confirmed COVID-19 infection. Emphasis should be given to better reporting of clinically significant ocular symptoms, e.g. new scotoma, which could indicate the need for a retinal examination as well as follow-up testing after recovery from COVID-19.
DIGITAL FEATURES This article is published with digital features to facilitate understanding of the article. To view digital features for this article go to https://doi. org/10.6084/m9.figshare.12907244.
Ophthalmol Ther
Recently, Marinho et al. reported optical coherence tomography (OCT) findings from 12 patients with confirmed COVID-19 infection [1]. All cases demonstrated focal hyper-reflective areas located in the inner retina and four cases also exhibited subtle cotton wool spots and retinal microhaemorrhages. Subsequently, Vavvas et al. highlighted the fact that the observed hyper-reflective areas on OCT could possibly represent normal retinal vessels while the presence of subtle cotton wool spots might be related to some other pathologic process or alternatively represent a discrete area of myelinated nerve fibres [2]. It was also pointed out that the absence of near-infrared reflectance imaging, OCT angiography abnormalities as well as follow-up scans should be taken into account while interpreting these findings. Furthermore, Virgo and Mohamed presented two patients with paracentral acute middl
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