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Link to original content: https://pubmed.ncbi.nlm.nih.gov/36359227/
Pathogenesis of Vascular Retinal Manifestations in COVID-19 Patients: A Review - PubMed Skip to main page content
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Review
. 2022 Oct 26;10(11):2710.
doi: 10.3390/biomedicines10112710.

Pathogenesis of Vascular Retinal Manifestations in COVID-19 Patients: A Review

Elisa D'Alessandro  1 , Aki Kawasaki  1 , Chiara M Eandi  1   2
Affiliations
Review

Pathogenesis of Vascular Retinal Manifestations in COVID-19 Patients: A Review

Elisa D'Alessandro et al. Biomedicines. .

Abstract

Pandemic infection secondary to coronavirus disease 2019 (COVID-19) had an important impact on the general population affecting not only respiratory tract but also many other organs. Ocular manifestations are quite common at the level of the anterior segment (conjunctivitis, dry eye), while posterior segment and, in particular, retinal findings are less frequent. In the retina, COVID-19 is associated with vascular events. Since retinal arteries and veins represent an accessible window to the microvasculature of the rest of the body, a better understanding of the profile of retinal vascular occlusive events may help elucidate mechanisms of thrombo-occlusive complications in other organs in patients affected by COVID-19. In this review, we conducted a systematic literature search focused on retinal arterial and/or retinal venous manifestations. Twenty-one studies were included, describing a wide range of manifestations from mild signs like cotton wool spots, focal and flame-shaped hemorrhages, and vein dilation to more severe retinal artery and vein occlusions. Two principal pathogenetic mechanisms are considered responsible for these complications: a hypercoagulative state and a massive inflammatory response leading to a disseminated intravascular coagulation-like syndrome.

Keywords: COVID-19; mechanism; pathophysiology; retina; vasculature.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
PRISMA 2020 flow diagram showing the search strategy in this systematic review.
Figure 2
Figure 2
SARS-CoV-2 access and subsequent immune response. Ang I: angiotensin I; Ang II: angiotensin II; ACE1: angiotensin converting enzyme 1; ACE2: angiotensin converting enzyme 2; ACER2: angiotensin converting enzyme receptor 2; RBD: receptor-binding domain.
See this image and copyright information in PMC

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