PCR POZİTİF VE NEGATİF COVID-19 HASTALARINDA OPTİK KOHERENS TOMOGRAFİSİ İLE OPTİK SİNİR VE RETINAL KATMAN ÖLÇÜMLERİ

Giriş ve Amaç Covid-19 sadece akciğerleri değil tüm doku ve organ sistemlerini hedef almaktadır. Kapsamlı mikrovasküler beslenmeye sahip optik sinir ve retina viral tutuluma yatkındır. Optik koherens tomografi, hem optik sinir hem de retina yapısı hakkında detaylı bilgi veren bir teknolojidir. Çalışma, Covid-19 enfeksiyonu olan PCR pozitif ve negatif hastaların optik sinir ve retina yapısındaki olası değişiklikleri araştırmak amacıyla gerçekleştirilmiştir. Metod Çalışmaya farklı yaş ve farklı başvuru şikayetlerine sahip PCR pozitif 30 Covid-19 hastası dahil edildi. Benzer yaş ve cinsiyet grubundaki yirmi beş PCR negatif Covid-19 hastası karşılaştırma yapabilmek adına ikincil bir grup olarak tanımlandı. Tüm hastalara yarık lamba biyomikroskopisi, fundoskopi ve OCT dahil oftalmolojik muayene yapıldı. Bu muayeneler, zorunlu izolasyona tam uyum için Covid-19 tanısından dört hafta sonra yapıldı. Ayrıca RNFL, retina kalınlığı ve retina hacmi ölçümleri yapıldı. Sonuç RNFL ölçümlerinde her iki göz için karşılaştırmalı analiz yapıldığında PCR pozitif Covid-19 hastaları ile PCR negatif grup arasında herhangi bir parametrede istatistiksel anlamlılık gözlenmedi. Retina kalınlığı ölçümlerinde sol göz santral retina kalınlığı açısından PCR pozitif ve negatif gruplar arasında anlamlı fark vardı (p=0.047). Bununla birlikte, retina hacim ölçümlerinde istatistiksel bir fark yoktu. Tartışma Optik koherens tomografi ile retina görüntüleme, COVID-19 sırasında subklinik veya aşikar retina patolojilerinin tespit edilebildiği, invazif olmayan, tekrarlanabilir ve hızlı bir tekniktir. Bu nedenle COVID-19 hastalarının yönetimi, özellikle baş ağrısı ve oküler ağrısı olan hastalarda yakın takip ile retina değerlendirmesini içermelidir.

Anahtar Kelimeler:

OCT, RNFL, Covid-19, Optik Sinir

OPTIC NERVE AND RETINAL LAYER MEASUREMENTS WITH OPTICAL COHERENCE TOMOGRAPHY IN PCR POSITIVE AND NEGATIVE COVID-19 PATIENTS

Objective and Aim Covid-19 targets all tissue and organ systems, not just the lungs. The optic nerve and retina with extensive microvascular nutrition are prone to viral involvement. Optical coherence tomography is a technology that provides detailed information about both optic nerve and retinal structure. The study was carried out to investigate possible changes in the optic nerve and retinal structure of patients with Covid-19 infection, dividing PCR positivity or negativity. Methods Thirty PCR positive Covid-19 patients with different ages and varying admission complaints were included in the study. Twenty-five Covid-19 patients who were PCR negative with similar age and gender were selected as a secondary group for comparison. All patients underwent ophthalmologic examination, including slit-lamp biomicroscopy, funduscopy, and OCT. These examinations were performed four weeks after the diagnosis of Covid-19 for full compliance with the mandatory isolation. In addition, RNFL, retinal thickness, and retinal volume measurements were performed. Results No statistical significance was observed in any parameter between the PCR positive or negative patients when the comparative analysis for both eyes in RFNL measurements. There was a significant difference in retinal thickness measurements between the PCR positive and negative groups regarding left eye central retinal thickness (p=0.047). However, there was no statistical difference in retinal volume measurements. Conclusion Retinal imaging with optical coherence tomography is a non-invasive, reproducible, and rapid technique in which subclinical or overt retinal pathologies can be detected during COVID-19. Therefore, management of COVID-19 patients should include retinal assessment with close follow-up, especially in patients with headaches and optic pain.

Keywords:

OCT, RNFL, Covid-19, Optic Nerve,

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