Background Different ocular alterations have been described in patients with coronavirus disease 2019(COVID-19).Our aim was to determine whether COVID-19 affected retinal cells and establish correlations with clinical...Background Different ocular alterations have been described in patients with coronavirus disease 2019(COVID-19).Our aim was to determine whether COVID-19 affected retinal cells and establish correlations with clinical parameters.Methods Retinal sections and flat-mount retinas from human donors with COVID-19(n=16)and controls(n=15)were immunostained.The location of angiotensin-converting enzyme 2(ACE2)and the morphology of microglial cells,Muller cells,astrocytes,and photoreceptors were analyzed by confocal microscopy.Microglial quantification and the area occupied by them were measured.Correlations among retinal and clinical parameters were calculated.Results ACE2 was mainly located in the Muller cells,outer segment of cones and retinal pigment epithelium.Cell bodies of Muller cells in COVID-19 group showed greater staining of ACE2 and cellular retinaldehyde-binding protein(CRALBP).The 81.3%of COVID-19 patients presented disorganization of honeycomb-like pattern formed by Muller cells.Gliosis was detected in 56.3%of COVID-19 patients compared to controls(40%)as well as epiretinal membranes(ERMs)or astrocytes protruding(50%).Activated or ameboid-shape microglia was the main sign in the COVID-19 group(93.8%).Microglial migration towards the vessels was greater in the COVID-19 retinas(P<0.05)and the area occupied by microglia was also reduced(P<0.01)compared to control group.Cone degeneration was more severe in the COVID-19 group.Duration of the disease,age and respiratory failure were the most relevant clinical data in relation with retinal degeneration.Conclusions The retinas of patients with COVID-19 exhibit glial activation and neuronal alterations,mostly related to the inflammation,hypoxic conditions,and age.展开更多
基金supported from grants funded by the Spanish Ministry of Science and Innovation(FEDER-PID2019-106230RB-I00)Spanish Ministry of Universities(FPU16/04114 and FPU18/02964)+2 种基金National Institute of Health Carlos III(RETICS-FEDER RD16/0008/0016)Generalitat Valenciana(IDIFEDER/2017/064,PROMETEO/2021/024)Valencia University General Hospital Foundation.
文摘Background Different ocular alterations have been described in patients with coronavirus disease 2019(COVID-19).Our aim was to determine whether COVID-19 affected retinal cells and establish correlations with clinical parameters.Methods Retinal sections and flat-mount retinas from human donors with COVID-19(n=16)and controls(n=15)were immunostained.The location of angiotensin-converting enzyme 2(ACE2)and the morphology of microglial cells,Muller cells,astrocytes,and photoreceptors were analyzed by confocal microscopy.Microglial quantification and the area occupied by them were measured.Correlations among retinal and clinical parameters were calculated.Results ACE2 was mainly located in the Muller cells,outer segment of cones and retinal pigment epithelium.Cell bodies of Muller cells in COVID-19 group showed greater staining of ACE2 and cellular retinaldehyde-binding protein(CRALBP).The 81.3%of COVID-19 patients presented disorganization of honeycomb-like pattern formed by Muller cells.Gliosis was detected in 56.3%of COVID-19 patients compared to controls(40%)as well as epiretinal membranes(ERMs)or astrocytes protruding(50%).Activated or ameboid-shape microglia was the main sign in the COVID-19 group(93.8%).Microglial migration towards the vessels was greater in the COVID-19 retinas(P<0.05)and the area occupied by microglia was also reduced(P<0.01)compared to control group.Cone degeneration was more severe in the COVID-19 group.Duration of the disease,age and respiratory failure were the most relevant clinical data in relation with retinal degeneration.Conclusions The retinas of patients with COVID-19 exhibit glial activation and neuronal alterations,mostly related to the inflammation,hypoxic conditions,and age.
