During the early days of the ongoing COVID-19 pandemic, critical care physicians at Emory University Hospital in Atlanta started seeing that some of the hardest hit and most critically ill COVID-19 patients also had blood spots and "cotton wool" spots in their eyes. Perhaps evidence that the retina was not getting the oxygen it needs?
So, critical care physicians partnered with a team of ophthalmologists, including Steven Yeh, MD, to take a closer look.
Their findings were fascinating. There were cotton wool spots, retinal hemorrhage, even one patient with retinal vascular occlusion, or blockage of a retinal artery.
"Close to 40%," in the study sample of critically ill COVID-19 patients, Dr. Yeh said, "had some evidence of retinopathy," or damage to the retina.
The clinician-scientists immediately took note. The eyes are not just the window to the soul - but, often to the rest of the body, as well.
"The retina is one of the very few structures where you can actually see blood vessel damage," Dr. Yeh explained.
And in these patients, that type of eye damage was associated with greater systemic disease morbidity involving multiple organs.
Dr. Yeh brought this research project with him to UNMC, when he became Stanley Truhlsen Jr. Endowed Chair and Professor in Ophthalmology at the Truhlsen Eye Institute, earlier this year.
The project already was multidisciplinary, employing ophthalmology, critical care medicine, infectious disease specialists and hospital medicine. Now, as Emory University and UNMC join forces as they have in other endeavors, "it’s a truly multi-institutional collaboration," Dr. Yeh said.
Dr. Yeh and team recently published their study in the journal Ocular Immunology and Inflammation. Dr. Yeh also presented to the Retina Society Annual Meeting.
What does it mean for patients with COVID-19? Retinopathy may offer unique insight into disease pathogenesis in severe COVID-19.
Or, understanding how COVID-19 affects the eye may tell us more about the way this new disease works, particularly its effect on blood vessels. While we don’t understand this process for certain, there are good clues to follow-up on.
"Is this something we need to continue to think about and understand?" Dr. Yeh said. "I’m biased as an ophthalmologist but there are a number of disease states such as HIV and diabetes where the findings in the eye inform us about the systemic condition, and vice versa."
The study was funded in part by Emory’s Woodruff Health Sciences Center Synergy Award, which supports inter-disciplinary research projects.
Outstanding achievements in science!
Thank you so much for your research and dedication Dr. Yeh! It's great to have you as part of TEI family!
Wow. Wow. Wow. Great work, Dr. Yeh.
Very impressive Dr. Yeh. The more we know the better we can fight this virus. Thank you for your work.