Camada de células ganglionares da retina em sobreviventes de COVID-19 grave

Abstract

INTRODUCTION: The purpose of this study was to evaluate the impact of severe COVID-19 on the thickness of the retinal ganglion cell layer. METHODS: The study was observational, prospective and analytical, performed in the Ophthalmology Department of the FACISA University Center – Campina Grande. Three groups were recruited: group I (control) – 29 healthy individuals who did not develop severe COVID-19; group II (infirmary) - 24 individuals who had COVID-19 and were hospitalized in the infirmary; and group III (ICU) – 25 individuals who had severe COVID-19 and require Intense Care Unit (ICU). All individuals had a complete ophthalmologic examination and underwent assessment of the retinal ganglion cell layer thickness using Optical Coherence Tomography (OCT). Quantitative variables were expressed by their means and standard deviations and qualitative variables by their absolute and relative frequencies. Statistical tests were used as required. p ≤ 0.05 was accepted to reject the null hypothesis. The project was approved by the Research Ethics Committee of the Institution. All recruited individuals signed the free and informed consent form. RESULTS: It was observed that the mean thickness measurements of the ganglion cell layer of the internal plexiform layer was significantly decreased in individuals from GIII (ICU) = 77.9 ± 8.9 µm, as compared with GII (Infirmary) = 83.9 ± 10.9 µm and GI (Control) = 82.8 ± 6.5 µm (p = 0.0027). The mean measurements from the thickness of the nerve fiber layer of the optic nerve head were similar. However, when evaluated sectorally, the mean fiber layer thickness of the temporal sector of the optic disc was significantly lower in group GIII (p < 0.001). CONCLUSION: The thickness of the retinal ganglion cell layer from patients with severe COVID-19, who required ICU, was significantly reduced. The thickness of the temporal nerve fiber layer of the optic disc was also reduced. The findings support the hypothesis that the SARS-CoV-2 has systemic action and affinity for nerve cells, related to the severity of the infection.