Retinal microvascular and perfusional disruption in paediatric COVID-19: A case-control optical coherence tomography angiography study

PURPOSE: To investigate the short-term effect of coronavirus 2019 (COVID-19) on the retinal capillary network and choroid in children. MATERIALS AND METHODS: This prospective, cross-sectional, case-control study included 19 recovered COVID-19 pediatric patients and 20 healthy children. Macular thickness, choroidal thickness, vessel density (VD), perfusion density (PD), and foveal avascular zone (FAZ) values were obtained. Central vessel and perfusion densities were measured at the central 6-mm area, and the values were compared among three subgroups according to location. RESULTS: The mean ages of patients and controls were 12. 42 ± 3.3 years and 13.35 ± 1.2 years, respectively. Significant differences were observed between the two groups in terms of inner, outer, and full VD, as well as inner and full PD. No significant differences in center VD and PD were observed between groups. Although it was not evident in analysis of choroidal values, inflammatory sites were thickened. FAZ area significantly differed between groups (p < 0.05). CONCLUSIONS: Retinal microvascularity was impaired in the acute phase of disease in recovered COVID-19 patients aged 10–15 years. However, the microvascularity impairment was subclinical. The choroid was thickened because of inflammation during the acute phase of disease. pediatric COVID-19 patients should undergo follow up via optical coherence tomography angiography to detect subclinical and asymptomatic retinal changes. Long-term follow-up studies are needed to validate these findings.