Endothelial Glycocalyx Anomalies and Ocular Manifestations in Patients with Post-Acute COVID-19, 2024, Azar, Salmon+

Endothelial Glycocalyx Anomalies and Ocular Manifestations in Patients with Post-Acute COVID-19
Azar, Georges; Abdelmassih, Youssef; Bonnin, Sophie; Guindolet, Damien; Vasseur, Vivien; Behar Cohen, Francine; Salmon, Dominique; Mauget-Faÿsse, Martine

OBJECTIVES
To report ophthalmological and microvascular findings in patients with post-acute COVID-19.

METHODS
In this prospective, monocentric cohort study, we included patients with post-acute COVID-19 who presented with ophthalmological symptoms. All patients underwent indocyanine green angiography (ICGA), OCT, OCT-angiography, adaptive optics, and GlycoCheck assessments.

RESULTS
We included 44 patients, predominantly female (81.8%), with a mean age of 47.5 ± 11.5 years. Key ICGA findings revealed hyperreflective dots in 32 eyes (36.4%) and hemangioma-like lesions in 7 eyes (8.0%). Capillary non-perfusion in the superficial capillary plexus (SCP) and deep capillary plexus (DCP) was observed in 42 eyes (47.7%) and 21 eyes (23.9%), respectively. Eyes with hyperreflective dots exhibited a lower perfused boundary region (PBR), while those with superficial punctate keratitis showed a higher PBR (p = 0.02 and p = 0.002, respectively). Eyes with capillary non-perfusion in the SCP displayed lower capillary densities (CD4, CD5, and CD4-6; p = 0.001, 0.03, and 0.03, respectively), and eyes with non-perfusion in the DCP had lower CD4 (p = 0.03). A negative correlation was identified between capillary density and the wall-to-lumen ratio.

CONCLUSIONS
Patients with post-acute COVID-19 demonstrate both retinal and choroidal vascular anomalies. Ocular pathology was associated with reduced capillary density. These injuries appear to stem more from microvascular disruptions than from persistent glycocalyx abnormalities.

Link | PDF (Journal of Clinical Medicine) [Open Access]