Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent Lancet publication

Demetrios G Vavvas^{1

2

3

4}, David Sarraf^{5

6

7

8}, SriniVas R Sadda^{9

10

11}, Dean Eliott^{12

13}, Justis P Ehlers¹⁴, Nadia K Waheed¹⁵, Yuki Morizane¹⁶, Taiji Sakamoto¹⁷, Miltiadis Tsilimbaris¹⁸, John B Miller^{12

19

20}

Affiliations

¹ Department of Ophthalmology Retina Service, Harvard Medical School, Boston, MA, USA. vavvas@mee.harvard.edu.
² Ocular Regenerative Medical Institute, Boston, MA, USA. vavvas@mee.harvard.edu.
³ Massachusetts Eye and Ear Infirmary, Boston, MA, USA. vavvas@mee.harvard.edu.
⁴ Massachusetts General Hospital, Boston, MA, USA. vavvas@mee.harvard.edu.
⁵ Department of Ophthalmology, Stein Eye Institute at UCLA, Los Angeles, CA, USA.
⁶ Retinal Disorders and Ophthalmic Genetics Division, Los Angeles, CA, USA.
⁷ Pacific Retina Club and International Retinal Imaging Symposium, Los Angeles, CA, USA.
⁸ International Retinal Imaging Society, Los Angeles, CA, USA.
⁹ Doheny Eye Institute, Los Angeles, CA, USA.
¹⁰ Doheny Image Reading Center (DIRC), Los Angeles, CA, USA.
¹¹ Department of Ophthalmology, University of California - Los Angeles (UCLA) Geffen School of Medicine, Los Angeles, CA, USA.
¹² Department of Ophthalmology Retina Service, Harvard Medical School, Boston, MA, USA.
¹³ Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
¹⁴ The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
¹⁵ Boston Image Reading Center and Tufts Medical Center, Boston, MA, USA.
¹⁶ Department of Ophthalmology, Okayama University, Okayama, Japan.
¹⁷ Department of Ophthalmology, Kagoshima University, Kagoshima, Japan.
¹⁸ Department of Ophthalmology, University of Crete, Heraklion, Greece.
¹⁹ Department of Retinal Imaging, Retina Service, Massachusetts Eye and Ear, Boston, MA, USA.
²⁰ Harvard Retinal Imaging Lab, Boston, MA, USA.

PMID: 32647303
PMCID: PMC7347265
DOI: 10.1038/s41433-020-1084-9

Editorial

Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent Lancet publication

Demetrios G Vavvas et al. Eye (Lond). 2020 Dec.

. 2020 Dec;34(12):2153-2154.

doi: 10.1038/s41433-020-1084-9. Epub 2020 Jul 9.

Authors

Affiliations

¹ Department of Ophthalmology Retina Service, Harvard Medical School, Boston, MA, USA. vavvas@mee.harvard.edu.
² Ocular Regenerative Medical Institute, Boston, MA, USA. vavvas@mee.harvard.edu.
³ Massachusetts Eye and Ear Infirmary, Boston, MA, USA. vavvas@mee.harvard.edu.
⁴ Massachusetts General Hospital, Boston, MA, USA. vavvas@mee.harvard.edu.
⁵ Department of Ophthalmology, Stein Eye Institute at UCLA, Los Angeles, CA, USA.
⁶ Retinal Disorders and Ophthalmic Genetics Division, Los Angeles, CA, USA.
⁷ Pacific Retina Club and International Retinal Imaging Symposium, Los Angeles, CA, USA.
⁸ International Retinal Imaging Society, Los Angeles, CA, USA.
⁹ Doheny Eye Institute, Los Angeles, CA, USA.
¹⁰ Doheny Image Reading Center (DIRC), Los Angeles, CA, USA.
¹¹ Department of Ophthalmology, University of California - Los Angeles (UCLA) Geffen School of Medicine, Los Angeles, CA, USA.
¹² Department of Ophthalmology Retina Service, Harvard Medical School, Boston, MA, USA.
¹³ Massachusetts Eye and Ear Infirmary, Boston, MA, USA.
¹⁴ The Tony and Leona Campane Center for Excellence in Image-Guided Surgery and Advanced Imaging Research, Cole Eye Institute, Cleveland Clinic, Cleveland, OH, USA.
¹⁵ Boston Image Reading Center and Tufts Medical Center, Boston, MA, USA.
¹⁶ Department of Ophthalmology, Okayama University, Okayama, Japan.
¹⁷ Department of Ophthalmology, Kagoshima University, Kagoshima, Japan.
¹⁸ Department of Ophthalmology, University of Crete, Heraklion, Greece.
¹⁹ Department of Retinal Imaging, Retina Service, Massachusetts Eye and Ear, Boston, MA, USA.
²⁰ Harvard Retinal Imaging Lab, Boston, MA, USA.

PMID: 32647303
PMCID: PMC7347265
DOI: 10.1038/s41433-020-1084-9

No abstract available

PubMed Disclaimer

Conflict of interest statement

The authors declare no conflict of interest.

Figures

Fig. 1. Spectral domain OCT images of a healthy adult from the pre-COVID era showing the appearance of normal vessels in the inner retina similar to the findings reported in the letter by Marinho et al.
As noted on the near infrared, these findings correspond to normal retinal vessels. Top panel shows a vessel in oblique cross-section, and bottom panel shows a vessel along its long axis. Green line highlights where the B-scan of the OCT was acquired superimposed automatically by the acquisition instrument on an en face infrared fundus image. White arrows and bracket point to the vessels imaged on the OCT.

See this image and copyright information in PMC

Comment on

Retinal findings in patients with COVID-19.
Marinho PM, Marcos AAA, Romano AC, Nascimento H, Belfort R Jr. Marinho PM, et al. Lancet. 2020 May 23;395(10237):1610. doi: 10.1016/S0140-6736(20)31014-X. Epub 2020 May 12. Lancet. 2020. PMID: 32405105 Free PMC article. No abstract available.

References

1. Marinho PM, Marcos AAA, Romano AC, Nascimento H, Belfort R. Retinal findings in patients with COVID-19. Lancet. 2020. 10.1016/S0140-6736(20)31014-X. - PMC - PubMed
1. Brown GC, Brown MM, Hiller T, Fischer D, Benson WE, Magargal LE. Cotton-wool spots. Retina. 1985;5:206–14. doi: 10.1097/00006982-198500540-00003. - DOI - PubMed
1. Ioannides A, Georgakarakos ND, Elaroud I, Andreou P. Isolated cotton-wool spots of unknown etiology: management and sequential spectral domain optical coherence tomography documentation. Clin Ophthalmol. 2011;5:1431–3. doi: 10.2147/OPTH.S16272. - DOI - PMC - PubMed
1. Lee CS, Tyring AJ, Wu Y, Xiao S, Roken A, DeRuyter NP, et al. Generating retinal flow maps from structural optical coherence tomography with artificial intelligence. Sci Rep. 2019;9:5694. doi: 10.1038/s41598-019-42042-y. - DOI - PMC - PubMed

Publication types

Actions
Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

P30 EY025585/EY/NEI NIH HHS/United States

LinkOut - more resources

Full Text Sources

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent Lancet publication

Affiliations

Concerns about the interpretation of OCT and fundus findings in COVID-19 patients in recent Lancet publication

Authors

Affiliations

Conflict of interest statement

Figures

Comment on

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources