Ocular MRI of severe COVID-19 patients shows abnormal findings: Study
France: Ocular MRI findings performed on a series of patients with severe COVID-19 revealed abnormalities in eyes of the patients. According to the study, published in the journal Radiology, all patients had nodules in the macular region, 89% had bilateral nodules and 22% had nodules outside the macular region. 7% patients had one or several FLAIR-WI hyperintense nodules of the posterior pole of the globe.
"Screening of these patients would aid in improving the management of potentially severe ophthalmological manifestations and provide appropriate treatment," wrote the authors.
COVID-19 is a pandemic infection caused by SARS-CoV-2 that negatively affects various organs such as the central nervous system. COVID-19 has been reported to be associated with ophthalmological abnormalities, such as optic neuritis, retinopathy, chemosis or conjunctivitis. MRI orbital abnormalities have been reported but no MRI studies have been published about globe abnormalities.
Augustin Lecler, CHU Strasbourg, Strasbourg, France, and colleagues report a series of patients with severe COVID-19 presenting with abnormal MRI findings of the globe.
They reported 9 patients (1/9 [11%] woman and 8/9 [89%] men) with globe MRI abnormalities obtained from a multicenter cohort of 129 patients presenting with severe COVID-19 from March 4th to May 1st, 2020.
For the purpose, the French Society of Neuroradiology (SFNR) initiated this retrospective observational multicenter study. It included imaging and clinical data of consecutive patients with severe COVID-19 who underwent brain MRI from 16 hospitals including 11 university hospitals and 5 general hospitals from March 4th to May 1st 2020.
Using the patients' electronic medical records, the researchers extracted clinical and ophthalmological data. Virological assessment was made with quantitative real-time RT-PCR tests for SARS-CoV-2 nucleic acid performed on nasopharyngeal or lower respiratory tract swabs and cerebrospinal fluid.
MRI examinations were anonymized and analyzed by two neuroradiologists with 9 years ("blinded") and 30 years ("blinded") of experience in ophthalmological imaging.
Key findings of the study include:
- A total of 129 patients (33% women and 67% men) were included for analysis from March 4th to May 1st 2020.
- 7% of the COVID-19 patients had abnormal MRI findings on the globe, or eyeball, with one or more nodules on the posterior pole.
- All these patients had nodules in the macular region, or the area of the eye responsible for central vision, and eight had nodules in both eyes (89%).
- Eight of the nine patients who had abnormal eye findings on MRI were admitted to the ICU, and seven of these were in the prone position in the ICU for long periods.
"This paper reports a series of patients with severe COVID-19 presenting with abnormal MRI findings of the globe," concluded the authors. "Screening of these patients might be suitable to provide appropriate treatment and improve the management of potentially severe ophthalmological manifestations."
The study tilted, "Ocular MRI Findings in Patients with Severe COVID-19: A Retrospective Multicenter Observational Study," is published in the journal Radiology.
DOI: https://pubs.rsna.org/doi/10.1148/radiol.2021204394
