Retinal nerve fibre layer and ganglion cell layer changes in children who recovered from COVID-19: a cohort study

Arch Dis Child. 2022 Feb;107(2):175-179. doi: 10.1136/archdischild-2021-321803. Epub 2021 Aug 2.

Abstract

Objective: To investigate the optic nerve and macular parameters of children who recovered from COVID-19 compared with healthy children using optical coherence tomography (OCT).

Design: Cohort study.

Setting: Hospital Clinico San Carlos, Madrid.

Patients: Children between 6 and 18 years old who recovered from COVID-19 with laboratory-confirmed SARS-CoV-2 infection and historical controls were included.

Interventions: All patients underwent an ophthalmological examination, including macular and optic nerve OCT. Demographic data, medical history and COVID-19 symptoms were noted.

Main outcome measures: Peripapillary retinal nerve fibre layer thickness, macular retinal nerve fibre layer thickness, macular ganglion cell layer thickness and retinal thickness.

Results: 90 patients were included: 29 children who recovered from COVID-19 and 61 controls. Patients with COVID-19 presented an increase in global peripapillary retinal nerve fibre layer thickness (mean difference 7.7; 95% CI 3.4 to 12.1), temporal superior (mean difference 11.0; 95% CI 3.3 to 18.6), temporal inferior (mean difference 15.6; 95% CI 6.5 to 24.7) and nasal (mean difference 9.8; 95% CI 2.9 to 16.7) sectors. Macular retinal nerve fibre layer analysis showed decreased thickness in the nasal outer (p=0.011) and temporal inner (p=0.036) sectors in patients with COVID-19, while macular ganglion cell layer thickness increased in these sectors (p=0.001 and p=0.015, respectively). No differences in retinal thickness were noted.

Conclusions: Children with recent history of COVID-19 present significant changes in peripapillary and macular OCT analyses.

Keywords: COVID-19; neurology; ophthalmology.

MeSH terms

  • Adolescent
  • COVID-19 / complications*
  • COVID-19 / immunology
  • COVID-19 / virology
  • Case-Control Studies
  • Child
  • Cohort Studies
  • Healthy Volunteers
  • Humans
  • Macula Lutea / cytology
  • Macula Lutea / diagnostic imaging
  • Macula Lutea / immunology
  • Macula Lutea / pathology
  • Male
  • Nerve Fibers / immunology
  • Nerve Fibers / pathology*
  • Nervous System Diseases / diagnosis
  • Nervous System Diseases / immunology
  • Nervous System Diseases / pathology
  • Optic Nerve / diagnostic imaging*
  • Optic Nerve / immunology
  • Optic Nerve / pathology
  • Organ Size
  • Retinal Ganglion Cells / immunology
  • Retinal Ganglion Cells / pathology*
  • SARS-CoV-2 / immunology
  • Tomography, Optical Coherence / statistics & numerical data