Abstract: Recent evidence suggests that SARS-CoV-2 may induce subtle anatomical changes
in the retina, detectable through advanced imaging techniques. This retrospective case–
control study utilized optical coherence tomography (OCT) to assess medium-term retinal
alterations in 55 healthcare workers, including 25 individuals with PCR-confirmed COVID19 and 30 non-COVID-19 controls, all of whom had worked in COVID-19 clinical settings.
Comprehensive ophthalmological examinations, including OCT imaging, were conducted
six months after infection. The analysis considered demographic variables, comorbidities,
COVID-19 severity, risk factors, and treatments received. Central macular thickness (CMT)
was significantly increased in the post-COVID-19 group (p < 0.05), with a weak but statistically significant positive correlation between CMT and disease severity (r = 0.245, p < 0.05),
suggesting potential post-inflammatory retinal responses. No significant differences were
observed in retinal nerve fiber layer (RNFL) or ganglion cell complex (GCL + IPL) thickness.
However, mild negative trends in inferior RNFL and average GCL+IPL thickness may
indicate early neurodegenerative changes. Notably, patients with comorbidities exhibited a significant reduction in superior and inferior RNFL thickness, pointing to possible
long-term neurovascular impairment. These findings underscore the value of OCT imaging in identifying subclinical retinal alterations following COVID-19 and highlight the
need for continued surveillance in recovered patients, particularly those with pre-existing
systemic conditions.
