Results
Mean patient age was 68.32 ± 9.97 years, 35 patients were followed up
and treated with non-invasive mechanical ventilation and 58 patients
with invasive mechanical ventilation support (Table 1). Patients were
treated in the hospital for an average of 7 days from the onset of
Covid-19 symptoms. Due to the clinical worsening, the patients were
followed and treated in the intensive care unit, and ophthalmological
examination was also performed in the intensive care unit.
Ophthalmological examinations were performed after an average of 12.43
(2-30) days of admission to intensive care (Table 2). It was observed in
the files of the patients that no ocular symptoms were reported in any
of the patients.
Patients who developed severe chemosis were those who were occasionally
placed in the prone position for treatment. Severe keratitis due to
lagophthalmos was detected in 1 patient, conjunctivitis with the
purulent discharge was detected in 1 patient, and eye closure and drug
treatment (moxifloxacin and artificial tear without preservative) were
initiated. When these patients were examined for control purposes,
improvement was observed in patients with corneal abrasion, but
treatment responses could not be followed up in the patient with
keratitis and purulent conjunctivitis considering that the patients were
dead. In two of the cases with conjunctivitis, PCR test was performed
from conjunctival swabs to detect SARS-CoV-2, but a negative result was
obtained.
Apart from retinal involvement due to systemic diseases, new
intraretinal haemorrhages were observed in 8 patients (8.6%). Bilateral
haemorrhages were observed in 1 patient and splinter haemorrhages in the
temporal side of the optic disc were observed in 2 patients. Cotton wool
spots together with splinter haemorrhage in the temporal side of the
optic disc were observed in 1 patient. In 4 patients, intraretinal
haemorrhages were observed in the macula in the arch. One of the
patients who had haemorrhage in the arch also had cerebral haemorrhage
and bilateral papilloedema. There was no statistically significant
difference in both comorbid systemic diseases and findings of laboratory
parameters of these patients. The distribution and comparison of
systemic disease and laboratory parameters of patients with retinal
haemorrhage compared to other patients are shown in Table 3.
Of the 93 patients followed, 19 (20%) patients survived, whereas other
patients were lost due to complications due to Covid-19. 14 (15.05%) of
the 19 patients were followed up and treated with non-invasive
ventilation, 5 (5.3%) were treated with mechanical ventilation, and
their treatment continued in the ward when the intensive care
requirements decreased.