新冠感染康复者视网膜改变的发生频率：观察性研究

简介：
SARS-CoV-2利用Ace2受体进入细胞，该受体在视网膜细胞上也有表达
 
目的：
确定视网膜改变的发生频率及其性质，评价新冠感染康复者视功能。
 
研究对象和方法：
年龄在28至79岁间的31名新冠感染康复者（基于CT的病情分级：1-3；已治愈15至40日不等)参与了该观察性研究。研究过程中采用了标准眼科检查，光学相干断层扫描（OCT)；为评价视功能，进行了视力检查及静态视野检查。
 
结果：
未发现眼表的病理改变。行检眼镜检查时，仅一名康复者存在视网膜改变。OCT显示，27名（87%)康复者视网膜内丛状层及神经节细胞层的神经上皮有新发改变，具体表现为边界清楚的高反射性灶；18（67%)名康复者有单眼损伤。观察对象的最大矫正视力较之前均未有变化，视网膜感光亦未发现异常。未发现肺部CT影像学改变的程度与视网膜变化之间的关联。研究中所观察到的视网膜变化同嗅、味觉缺失的症状没有相关性。在12-15日后的OCT复查中，未观察到高反射灶的动态改变:在形状，大小及回声水平方面保持不变。
 
结论：
87%的新冠感染康复者视网膜内丛状层及神经节细胞层的神经上皮有新发改变，视网膜的解剖学改变不表现为其功能异常。视网膜改变同第Ⅰ，Ⅸ对颅脑神经损伤无关。

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