新型冠状病毒肺炎患者眼底检查的初步结果分析

Preliminary analysis of fundus examination findings in patients with New Coronavirus pneumonia

目的探讨新型冠状病毒肺炎(COVID-19)患者可能的眼底变化。方法在2020年3月25~27日收集COVID-19住院患者16例,恢复期(出院后2周于发热门诊复查)患者30例。所有患者均接受手持式免散瞳眼底照相检查,以一眼的黄斑和视盘为中心拍摄两张45°眼底照片,观察视网膜情况,并收集患者年龄、发病时间、并发症、用药等情况,分析判断是否存在新冠肺炎相关眼底病变。结果住院患者年龄为(56.8±12.8)岁,采集眼底图像时距离发病时间为6~16 d,平均9.6 d,56.3%(9例)患者有合并症,且以高血压最常见(4例);恢复期患者年龄为(55.3±11.4)岁,采集眼底图像时距离发病时间为28~52 d,平均42.3 d。40.0%(12例)患者有合并症,以糖尿病(5例)和高血压(4例)最常见。所有46例患者住院期间均给予抗病毒治疗,15例患者使用了硫酸羟氯喹,30例患者使用了不同处方的中药,10例患者使用了甲基强地松龙。所有检查患者均未发现明显的眼底改变。结论新冠肺炎可能不会造成早期眼部广泛的微血管改变。

Objective To explore the possible fundus changes in patients with new coronavirus pneumonia(COVID-19).Methods A total of 16 patients with COVID-19 and 30 convalescent patients(reexamined at the fever clinic 2 weeks after discharge)from March 25 to 27,2020 were collected.All patients underwent hand-held non-mydriatic fundus photography.Two 45-degree fundus photographs,one centered on one the macular and one centered on the optic disc was taken to observe the retina.Patients’age,time of COVID-19 onset,complications,medication were collected.Whether COVID-19 related fundus lesions existed was assessed by ophthalmologists.Results The age of hospitalized patients was(56.8±12.8)years old,and the time from the fundus image collection to disease onset ranged from 6 to 16 days,with an average of 9.6 days.56.3%of the patients(9 patients)had comorbidities,and hypertension was the most common type(4 patients).The age of convalescent patients was(55.3±11.4)years old,and the time from the fundus image collection to disease onset ranged from 28 to 52 days,with an average of 42.3 days.40.0%of the patients(12 patients)had comorbidities,with diabetes(5 patients)and hypertension(4 patients)being the most common types.All 46 patients were given antiviral treatment during hospitalization,15 patients used hydroxychloroquine sulfate,30 patients were treated with traditional Chinese medicine of different prescriptions,and 10 patients used hormone(methyl-prednisolone).All patients examined did not reveal obvious fundus changes.Conclusions COVID-19 may not cause extensive microvascular changes in the fundus at an early stage.