As the novel coronavirus pandemic evolves, new information is constantly coming to light. Rapidly accumulating global data has shone a spotlight on inequities in social determinants of health, such as healthcare access and utilization. These same inequities contribute to higher rates of medical conditions such as diabetes, an underlying disease for which people are at great risk of severe complications and even death from COVID-19.
Individuals with diabetes are at a heightened risk for eye complications like glaucoma, cataracts, and microvascular complications such as retinopathy, neuropathy, and nephropathy. An article published by National Public Radio (NPR), entitled “Clots, Strokes And Rashes. Is COVID-19 A Disease Of The Blood Vessels?” explains that the virus warps a vital piece of our vascular infrastructure. Dr. William Li, a vascular biologist and founder of the Angiogenesis Foundation, compares the lining of blood vessels to a freshly resurfaced ice-skating rink before a hockey game. "When the virus damages the inside of the blood vessel and shreds the lining, that's like the ice after a hockey game, you wind up with a situation that is really untenable for blood flow,” says Li.
Intensive care units are being filled with patients who have large body mass indexes (BMIs), those with diabetes and with high blood pressure. Over time, these conditions damage the lining of blood vessels, which is then exacerbated by COVID-19.
The fact that the virus is associated with microvascular alterations led a team of researchers at the Eye Clinic, Luigi Sacco Hospital, ASST Fatebenefratelli-Sacco, and the Department of Infectious Diseases in Italy to determine if the COVID-19 disease affects the retina of the eye and its blood vessels. The team’s findings were published in the Lancet journal EClinicalMedicine.
The team screened the fundus (the interior surface of the eye) of patients with COVID-19 to detect alterations to the retina and found ruptured and/or twisted blood vessels. Furthermore, the diameters of arteries and veins were higher in those with COVID-19 when compared to those without. The researchers have stated unequivocally that “COVID-19 can affect the retina. Retinal veins' diameter seems directly correlated with the disease severity. Its assessment could have possible applications in the management of COVID-19.”
The World Report on Vision seeks to contribute to Sustainable Development Goal 3.8 which is to “achieve universal health coverage, including financial risk protection, access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines and vaccines for all.” Ensuring universal health coverage requires a global movement that involves civil society, governments, non-governmental organizations, academia, and industry in order to promote equity and reduce disparities in healthcare access and utilization. The International Federation on Ageing (IFA) works tirelessly with partners and members to achieve the vision of universal health coverage. On 11 November 2021 as part of IFA’s 15th Global Conference on Ageing taking place both virtually and in-person in Niagara Falls, Canada, a Presidential Symposium on Vision Health will bring together a global network of peers in the aim of conveying the importance of integrated care. Register now to learn about the latest global evidence in vision health, emerging policy issues, and the role of civil society in improving health care outcomes for all.
To learn more about COVID-19’s effects on the retina, contact Dr Serge Resnikoff, Professor at the School of Optometry and Vision Science, University of New South Wales from the IFA Expert Centre, which offers a point of contact to specialists in the fields of ageing, vision health, human rights and more. To learn more about how to contribute to the critical conversation on diabetes and vision health, connect with Dr Supriya Venigalla (firstname.lastname@example.org), and join the DR Barometer community.
Serge Resnikoff Professor
Professor Serge Resnikoff is an international expert and consultant in global public health, ophthalmology, and eye health.