Abstract
Purpose :
Severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) causes Coronavirus disease 2019 (COVID-19). Patients were not only suffering of acute COVID-19 symptoms, yet patients report of ongoing symptoms (Post-COVID syndrome, PCS). Regarding the neurotropism of SARS-CoV-2 and cognitive impairment, we hypothesize that performance in 3-dimensional (3D) vision is reduced in PCS. The aim of the study was to investigate the reaction time during virtual-3D-environment testing in patients with PCS compared to controls.
Methods :
179 probands were recruited at the Department of Ophthalmology, University of Erlangen-Nuremberg: 130 patients with PCS and 49 controls. Acute COVID-19 was confirmed by a positive real-time reverse-transcription-polymerase-chain reaction test. Mean time between acute COVID-19 and study participation was 435.73±212 days. Major self-reported PCS symptoms were fatigue, including post-exertional malaise (PEM) (92%), reduced concentration (88%) and headaches (75%), arrythmia (73%), muscle pain (68%), and postural orthostatic tachycardia syndrome (POTS) (63%). All patients recieved Virtual-Reality-Ocular-Test-System (VR-OTS) testing virtual-3D-vision, measuring reaction when presenting 3D stimuli with 3 different disparities in 9 different viewing directions. Percentage of correct results (accuracy) and the time to achieve a correct result (i.e. reaction time, RT) were analyzed. Sub-analyses were done considering different levels of difficulty (disparities). A series of Generalized Linear Models (GLM), each accounting for age and gender as covariates, was performed. The study has been approved by the local ethics committee.
Results :
Patients with PCS showed a significantly worse 3D vision accuracy across all difficulties compared to controls (disparity 275″, p-value<0.001; 550″, p-value 0.003; 1100″, p-value 0.019). Accuracy decreased with decreasing disparity in both groups. RT of patients with PCS increased significantly compared to controls (disparity 275″, p-value 0.002; 550″, p-value<0.001; 1100″, p-value<0.001). RT increased with decreasing disparity in both groups.
Conclusions :
Stereoscopic accuracy and reaction time in a virtual 3D environment showed significantly worse results in patients with PCS compared to controls, thus, testing 3D vision seems to be an interesting diagnostic approach for ocular clinical assessments of patients with PCS.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.