Severe COVID-19 and Retina: Are There Any Retinal Manifestations?

PURPOSE: To investigate whether there are retinal lesions associated with severe COVID-19. METHODS: We studied 232 symptomatic subjects aged 18 - 65 years who had severe COVID-19 and had received treatment. The evaluations included ophthalmological examinations, optical coherence tomography (OCT), imaging modalities with near infrared reflectance (NIR), fundus autofluorescence (FAF), and fundus photography (FP). RESULTS: The mean age of the patients was 49 years, and 67.6% of them were men. There were no findings of microhemorrhage, cotton wool spots (CWS), vitritis, or retinitis in the examination and imaging. CONCLUSIONS: This study indicates that retinal involvement as a complication associated with COVID-19 is questionable, although some reports have demonstrated a relationship that may occur secondary to existing systemic diseases.

Corneal Parameters in Patients with Multiple Sclerosis: A Pilot Study.

OBJECTIVE: To evaluate the corneal topographic parameter values measured with the Pentacam Scheimpflug system in patients with multiple sclerosis (MS). METHODS: A total of 108 eyes of 62 MS patients were studied. In addition to a complete examination of anterior and posterior segments, all patients were scanned using the Pentacam Scheimpflug camera. The diagnosis of MS was made according to the McDonald criteria. All MS patients were clinically assessed using the Multiple Sclerosis Severity Score (MSSS). RESULTS: The mean age was 38.89 ± 10.18 years (36.16 - 41.30) for MS patients and 40.94 ± 9.44 years (38.49 - 43.11) for the controls (p = 0.26). Only central corneal thickness (CCT) and corneal volume (CV) values were significantly lower in MS patients (p < 0.001). The other corneal parameters were not significantly different between the study eyes and control eyes (p > 0.05 for all). Pachymetric measurements at the corneal apex were 525.69 ± 29.35 (518.29 - 533.67) µm for the study eyes versus 563.13 ± 23.70 (562.13 - 576.36) µm for the control eyes. CV were 59.22 ± 4.11(58.18 - 60.20) mm3 for the study eyes versus 62.78 ± 3.09 (62.38 - 64.00) mm3 for the control eyes. CONCLUSION: This is the first study that has reported lower CCT and CV measurements in MS patients than healthy subjects of a similar age. These results should be supported by further studies.

Posterior ocular structural changes and glaucoma susceptibility in patients with hemifacial spasm.

PURPOSE: To evaluate the changes in the posterior ocular structures and glaucoma susceptibility in patients with hemifacial spasm (HFS). STUDY DESIGN: Prospective observational clinical study. METHODS: This study included 46 long-standing HFS patients with a minimum follow-up of 12 months. The participants' eyes were divided into three groups: (1) 46 affected eyes of patients with clinical HFS; (2) 46 unaffected fellow eyes and, (3) 46 eyes of healthy sex and age-matched controls. All participants were assessed by a detailed clinical examination and optical coherence tomography (OCT) with enhanced depth imaging (EDI). EDI-OCT images were binarized using ImageJ software. Peripapillary retinal nerve fiber layer (RNFL), ganglion cell complex (GCC), choroidal thickness (CT), and choroidal vascularity index (CVI) were used to compare the structural characteristics of the affected eyes with fellow and control eyes. The CT measurements were performed from the subfoveal and locations at 750 µm and 3000 µm intervals from the foveal center, and the average of CT measurements at 5 locations was accepted as mean CT. RESULTS: The demographic and clinical characteristics among the groups were similar (for all, P > 0.05). Mean peripapillary RNFL thickness of the inferior quarter was significantly lower in affected eyes, compared to fellow eyes (P = 0.023) and control eyes (P = 0.040). Mean GCC thickness significantly decreased in affected eyes, compared to fellow eyes (P = 0.019) and healthy controls (P = 0.008). Mean CT thickness significantly decreased in affected eyes, compared to fellow eyes (P = 0.002) and healthy controls (P < 0.001). Mean subfoveal CVI (65.94% ± 1.46) was found to be significantly thinner than the unaffected fellow (68.19% ± 1.84, P = 0.011) eyes and control eyes (67.23% ± 0.84, P = 0.044). CONCLUSIONS: This study's outcomes show that long-standing HFS is associated with glaucoma-associated morphological OCT findings and decreased both CT and subfoveal choroidal vascularity. These findings may be related to the fact that the posterior ocular structures are affected by long-lasting paroxysmal orbicularis contractions.

Comparison of the Thickness of the Fiber Layer of the Retinal Nerves in Spectral Domain Optical Coherence Tomography in Normal Eyes Older Than 40 Years.

PURPOSE: To compare measurements of the thickness of the retinal nerve fibre layer (RNFL) and assess the agreement between three different devices for spectral domain optical coherence tomography. MATERIAL AND METHODS: The RNFL thickness of both eyes of 23 normal subjects older than 40 years was measured using Canon HS100, Topcon Maestro, and NIDEK RS-3000 devices. Both eyes of each subject were scanned in random order. All scans were completed on the same day in the morning. The average and four quadrants (superior, inferior, nasal, and temporal) of RNFL thickness were measured. To determine the differences in RNFL thickness, analysis of variance for repeated measurements was performed. A Bland-Altman plot was plotted, and coefficients of determination were calculated. RESULTS: A total of 46 eyes of 23 subjects were enrolled in this study. The average RNFL thickness as determined by the three OCT devices was correlated (p < 0.001), but differed significantly between the three devices, as most were quadrant measurements. The mean average RNFL thickness was 98.5 ± 6.6 µm as measured by Canon HS100, 108.5 ± 8.8 µm as measured by Topcon Maestro, and 104.9 ± 9.0 µm as measured by NIDEK RS-3000. Topcon Maestro showed the highest average RNFL thickness value. Bland-Altman plots revealed considerable agreement among the three devices, except for the inferior quadrants between Topcon Maestro and NIDEK RS-3000 measurements. All three devices reveal considerable coefficients of determination values for mean RNFL thickness (0.917 - 0.127). CONCLUSION: Although the peripapillary RNFL thickness measurements taken with Canon HS100, Topcon Maestro, and NIDEK RS-3000 were in good agreement, they were not interchangeable in clinical practice, as the values differed significantly.