Analysis of retinal changes in COVID-19 patients: A cross-sectional study at the Navy General Hospital, Colombo, Sri Lanka

Introduction: The systemic implications of COVID-19 extend beyond the respiratory system, with emerging evidence suggesting potential retinal involvement. COVID-19 infection may be associated with changes in immune and coagulation systems and possible viral spread through the blood-brain barrier, with clinical and anatomopathological findings of disseminated intravascular coagulopathy (DIC), the effects of these alterations on the eye, specifically regarding posterior segment involvement, have not been fully explored.
This study compares retinal changes observed in Sri Lankan COVID-19 patients with findings reported in other international studies.
Methods: A descriptive cross-sectional study was conducted involving 79 COVID-19 positive navy personnel. Retinal evaluations, including Optical Coherence Tomography (OCT), were performed, and the results were compared with normative data from the Cirrus HD OCT machine and published findings from similar studies conducted globally.
Results: Among the 158 eyes examined, 46 (29.11%) showed deviations in macular thickness, with the central foveal region being most affected. These findings are consistent with other studies reporting retinal changes post- COVID-19, albeit with variations in the prevalence and type of retinal involvement. The absence of significant findings in visual acuity and slit-lamp examinations contrasts with the OCT results, emphasizing the importance of advanced imaging techniques in detecting subtle retinal changes.
Conclusions: The study’s findings align with international reports, highlighting the presence of retinal changes in a subset of COVID-19 patients. These results support the assumption of SARS-CoV-2 may have direct or indirect effects on the retina, necessitating further investigation and routine OCT screening in COVID-19 patients.