Purpose

To evaluate the occurrence of retinal microvasculopathy in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and who developed coronavirus disease (COVID-19).

Design

Systematic review and meta-analysis.

Methods

The Pubmed and Embase databases were comprehensively searched to identify studies that reported retina vascular changes in eyes with COVID-19. Two independent reviewers selected papers and extracted data for analysis. Data of interest were extracted and analyzed in RevMan Web versions 3.3. Quality of evidence was assessed using the National Institute of Health quality assessment tool for a case-control study.

Results

Thirty-one studies reporting on 1373 subjects (972 COVID-19 and 401 controls) were included. Only case-control studies were included in the pooled analysis. There was a significantly higher likelihood of retinal microvasculopathy in subjects with COVID-19 compared to controls (odds ratio [95% confidence interval], 8.86 [2.54-27.53], P < .01). Optical coherence tomography angiography (OCTA) revealed reduced vessel density and enlarged foveal avascular zone in subjects with COVID-19 compared to controls.

Conclusions

The results suggested that COVID-19-related retinal microvasculopathy is a significant ocular manifestation of COVID-19 and may herald future retinal complications. These microvascular impairments might have occurred antecedent to clinically visible changes and could be detected earlier by OCTA. These findings are significant, due to the large numbers with COVID-19, and need to be recognized by ophthalmologists as a potential long-term sequalae of the disease.

中文翻译：

---

与 COVID-19 相关的视网膜微血管病变——当前证据回顾

目的

评估感染严重急性呼吸系统综合症冠状病毒 2 (SARS-CoV-2) 并发展为冠状病毒病 (COVID-19) 的患者视网膜微血管病变的发生率。

设计

系统评价和荟萃分析。

方法

对 Pubmed 和 Embase 数据库进行了全面搜索，以确定报告 COVID-19 眼视网膜血管变化的研究。两名独立评审员选择论文并提取数据进行分析。在 RevMan Web 版本 3.3 中提取和分析感兴趣的数据。使用美国国立卫生研究院质量评估工具评估证据质量以进行病例对照研究。

结果

纳入了 31 项关于 1373 名受试者（972 名 COVID-19 和 401 名对照组）的研究报告。只有病例对照研究被纳入汇总分析。与对照组相比，COVID-19 受试者发生视网膜微血管病变的可能性明显更高（比值比 [95% 置信区间]，8.86 [2.54-27.53]，P < .01 ）。光学相干断层扫描血管造影 (OCTA) 显示，与对照组相比，COVID-19 患者的血管密度降低，中心凹无血管区扩大。

结论

结果表明，与 COVID-19 相关的视网膜微血管病变是 COVID-19 的重要眼部表现，可能预示着未来的视网膜并发症。这些微血管损伤可能发生在临床可见变化之前，并且可以通过 OCTA 更早地检测到。由于 COVID-19 患者人数众多，这些发现意义重大，眼科医生需要将其视为该疾病的潜在长期后遗症。