text: Retinal nerve fibre layer and ganglion cell layer changes in children who recovered from COVID 19 a cohort study To investigate the optic nerve and macular parameters of children who recovered from COVID 19 compared with healthy children using optical coherence tomography OCT Cohort study Hospital Clinico San Carlos Madrid Children between 6 and 18 years old who recovered from COVID 19 with laboratory confirmed SARS CoV 2 infection and historical controls were included All patients underwent an ophthalmological examination including macular and optic nerve OCT Demographic data medical history and COVID 19 symptoms were noted Peripapillary retinal nerve fibre layer thickness macular retinal nerve fibre layer thickness macular ganglion cell layer thickness and retinal thickness 90 patients were included 29 children who recovered from COVID 19 and 61 controls Patients with COVID 19 presented an increase in global peripapillary retinal nerve fibre layer thickness mean difference 7 7 95 CI 3 4 to 12 1 temporal superior mean difference 11 0 95 CI 3 3 to 18 6 temporal inferior mean difference 15 6 95 CI 6 5 to 24 7 and nasal mean difference 9 8 95 CI 2 9 to 16 7 sectors Macular retinal nerve fibre layer analysis showed decreased thickness in the nasal outer p 0 011 and temporal inner p 0 036 sectors in patients with COVID 19 while macular ganglion cell layer thickness increased in these sectors p 0 001 and p 0 015 respectively No differences in retinal thickness were noted Children with recent history of COVID 19 present significant changes in peripapillary and macular OCT analyses 