This review explores the potential of optical coherence tomography angiography (OCTA) to assess the radial peripapillary capillary (RPC) network in individuals infected with SARS-CoV-2, with the aim of understanding COVID-19-related microvascular changes in the retina. A comprehensive search of the PubMed database was conducted to identify original research and review articles that utilized OCTA to visualize the RPC network and quantify its parameters in COVID-19 patients. Current evidence suggests that COVID-19-associated systemic hypoxia, inflammatory processes, and hypercoagulability can compromise the RPC network. Alterations in RPC metrics were detectable both during the acute phase of infection and several months post-infection. Notably, reductions in RPC parameters were associated with subsequent thinning of the retinal nerve fiber layer, indicating potential long-term retinal and optic nerve involvement. OCTA provides a non-invasive means to evaluate retinal microvascular integrity in patients with a history of COVID-19. Monitoring RPC network parameters over time may help identify ischemic or inflammatory sequelae affecting the retina, optic nerve, and choroid, highlighting the importance of ocular follow-up in this population.
