Results of Retinal Microcirculation Analysis in Patients with Diabetes Mellitus after COVID-19; Результаты анализа микроциркуляции сетчатки у пациентов с сахарным диабетом после перенесенного COVID-19

Objective. Monitoring ophthalmological parameters and retinal microcirculation in patients with diabetes mellitus after COVID-19. Patients and methods. Traditional ophthalmological methods, including optical coherence tomography with angiography. Results: 86 patients (86 eyes) were examined and divided into 4 subgroups depending on the presence or absence of diabetes and COVID-19: subgroup Ia: T2DM (–) + Covid-19 (–) — 22 patients (22 eyes) — control; subgroup Ib: T2DM (+) + COVID-19 (–) — 21 patients (21 eyes); subgroup Ic: T2DM (–) + COVID-19 (+) — 20 patients (20 eyes); subgroup Ig: T2DM (+) + COVID-19 (+) — 23 patients (23 eyes). All patients had COVID-19 at home and were not hospitalized. BCVA in all patients was 0.9–1.0. A statistically significant increase in the foveal avascular zone and its highest values were found in the diabetes and COVID-19 subgroup. Thus, the foveal avascular zone area values in the T2DM + COVID-19 group (0.301 ± 0.004 mm2) were statistically significantly higher than in the COVID-19 group (0.260 ± 0.003 mm2) (p < 0.05), than in the T2DM group (0.244 ± 0.004 mm2) (p < 0.05), than in the control group (0.216 ± 0.005 mm2) (p < 0.05), and a statistically significant increase in C-reactive protein (p < 0.05) and D-dimer (p < 0.05) was also found. Treatment of the identified retinal microcirculation disorders in the diabetes and COVID-19 subgroup was carried out according to the new proposed method using drug therapy with Sulodexide at a dosage of 250 LE 2 times a day for forty days, when the values of the area and perimeter of the foveal avascular zone statistically significantly decrease (p < 0.05), which confirms the effectiveness of the proposed treatment method. Conclusion. It was revealed that in patients with diabetes mellitus after suffering COVID-19, there is a violation of retinal microcirculation, which is proven by the size of the foveal avascular zone, which is statistically higher in comparison with patients with diabetes mellitus (p < 0.05). It has been proven that against the background of treatment with Sulodexide at a dosage of 250 LE 2 times a day for forty days, the values of the area and perimeter of the foveal avascular zone of the retina statistically significantly decrease (p < 0.05). © 2025 Elsevier B.V., All rights reserved.