Vascular retinal findings after COVID-19 vaccination in 11 cases: a coincidence or consequence?

Achados vasculares retinianos pós vacinação contra COVID-19 em uma série de 11 casos: coincidência ou consequência?

Letícia S. C. da Silva Luciana P. S. Finamor Gabriel C. Andrade Luiz H. Lima Claudio Zett Cristina Muccioli Eduardo P. Sarraf Paula M. Marinho Julia Peruchi Raiza D. de L. Oliveira Lena Giralt Ivonne Charcan Alex Fonollosa Jose D. Diaz Janet L. Davis Heloisa Nascimento Rubens Belfort JrAbout the authors

ABSTRACT

Purpose:

The primary purpose of this study was to assess vascular retinal findings temporally related to COVID-19 vaccination. With greater information regarding all possible future adverse events, we hope to understand the real dimension and relevance of what was presented.

Methods:

Eleven patients with visual complaints after COVID-19 vaccination were enrolled. Data on the following were included: age, sex, vaccine, time of symptom onset, systemic findings, medical history, best-corrected visual acuity, and ocular findings by slit-lamp biomicroscopy as well as multimodal retinal imaging (color fundus, red-free photography, spectral-domain optical coherence tomography, optical coherence tomography angiography, and fluorescein-angiography). Inclusion criteria were the presence of ophthalmologic signs within 30 days after the first or second dose of any COVID-19 vaccine.

Results:

Of 11 patients, five had arterial occlusion (45.4%), four had venous occlusion (36.4%), and two (18.2%) had nonspecific vascular alterations suggestive of retinal ischemia such as cotton-wool spots. The mean age was 57 (SD = 16; range: 27-84) years. The mean time of symptoms onset was 10 (SD = 5.4; range: 3-16) days. Nine patients were female (81.8%). Systemic risk factors were observed in 36.4% of patients. Two patients had both neurological and visual symptoms, with arterial occlusion. Overall, 36.4% patients had COVID-19 in the previous year. Seven patients (63.6%) received ChAdOx1 nCoV-19 (AZD1222) vaccine.

Conclusions:

Our data suggest that retinal events temporally related to COVID-19 vaccination are possible but are very rare. The relationship of these events with post-COVID-19 vaccination warrants further attention to derive a meaningful conclusion.

Keywords:
COVID-19; Coronavirus infection; Vaccine; Arterial occlusion; Venous occlusion; Susac syndrome

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