Fundus Lesions in Patients Hospitalized With COVID-19 Infection in Mumbai, India: A Retrospective Review

Background and objective Coronavirus disease 2019 (COVID-19) is a viral infection that has grown to be a global pandemic, and it is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The ocular involvement in COVID-19, both in the anterior and posterior segments, is increasingly being recognized by ophthalmologists. We report the fundus photographic and systemic findings in 25 patients without recent-onset visual symptoms who were hospitalized with COVID-19. Methods Patients with COVID-19 infection who were admitted to an isolation ward/ICU in Mumbai, India during June-August 2020 underwent a comprehensive clinical and systemic evaluation. We performed a fundus evaluation using a handheld fundus camera during their admission period. We conducted a retrospective case record review and extracted demographic characteristics, laboratory findings, and fundus photographs from each case record. Results We screened 25 non-consecutive patients, and they included 20 (80%) men and five (20%) women, with ages ranging from 31 to 79 years (mean: 56.3 years). Systemically, the spectrum of severity on admission varied from mild to moderate to severely ill. The majority of the patients had no complaints of recent visual loss. An analysis of fundus photographs of 50 eyes of 25 patients revealed no evidence of fundus lesions in as many as 48 photographs. Two photographs of two eyes of patients showed incidental lesions. Conclusions We found no evidence of vascular, inflammatory, or thromboembolic disease that could be linked to COVID-19 infection in any of the images we studied; however, fundus examination may be utilized in patients with co-infection.