Neuro-Ophthalmological Complications of the COVID-19 Vaccines: A Systematic Review

Lotan, Itay; Lydston, Melissa; Lévy, Michaël

doi:10.1097/wno.0000000000001537

Cited by 16 publications

(13 citation statements)

References 61 publications

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“…Lotan and associates identified 61 cases from the literature of post-COVID-19 vaccination associated optic neuritis, which included optic perineuritis and MOG IgG positivity. 18 Martinez-Alvarez and colleagues collected and analyzed data from 55 patients in 10 countries who received 3 COVID-19 vaccines (AstraZeneca, Pfizer-BioNTech and Sinovac) and then developed optic neuritis.D The AstraZeneca vaccine had the highest number of cases (n=38) followed by Pfizer-BioNTech (n=13) and then Sinovac (n=4). Forty-four patients were White, with a median age of 44 years.…”

Section: Discussionmentioning

confidence: 99%

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Bhatti

Gilbert

Watson

et al. 2023

Survey of Ophthalmology

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Section: Discussionmentioning

confidence: 99%

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Bhatti

Gilbert

Watson

et al. 2023

Survey of Ophthalmology

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“…Optic neuropathy is suspected as one of adverse events of the COVID-19 vaccine, which includes ON associated with or without demyelinating CNS diseases [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], NA-AION [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], and NMOSD [ 8 , 9 ]. Lotan et al reviewed 14 case reports and 2 case series by electronic searches of the published literature regarding neuro-ophthalmological complications of COVID-19 vaccines and reported that optic neuritis was the most common, occurring in 61 of 76 cases (80.3%) [ 25 ]. We reviewed the previous reports of newly onset optic neuropathy after receiving COVID-19 vaccines and compared clinical manifestations, management, and outcomes in Table 1 .…”

Section: Discussionmentioning

confidence: 99%

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

2022

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Background: We report a case of atypical unilateral optic neuritis after receiving the BNT162b2 mRNA-based COVID-19 vaccine. Case Presentation: An 86-year-old man complained of blurred vision and decreased visual acuity in his right eye 8 days after receiving the second BNT162b2 mRNA-based COVID-19 vaccine and was referred to our hospital. He also had pain with eye movement. Best corrected visual acuity (BCVA) in the right eye was 20/200 and critical flicker frequency dropped to 16 Hz. Relative afferent pupillary defect was positive and central scotomas were observed on visual field analysis. Fundus examination and SD-OCT revealed optic disc swelling and apparent thickening of the retinal nerve fiber layer around the optic disc in the right eye. Although either an increase in CRP or ESR on laboratory tests, demyelinating lesion on MRI, or positive of anti-MOG antibodies or anti-AQP4 antibodies were not observed, fluorescein angiography presented only hyperfluorescence of the optic disc in the right eye, but there were no findings such as papillary deficiency and choroidal delay that would suggest ischemic optic neuropathy. We diagnosed atypical optic neuritis developed after the SARS-CoV-2 mRNA-based vaccination and initiated oral corticosteroid therapy. One month later, the optic disc swelling disappeared and BCVA improved to 20/100; however, the central scotoma remained and no further improvement in visual function OD was obtained. Conclusions: An atypical acute idiopathic optic neuritis can occur after receiving the second vaccination with BNT162b2, which may present a limited response to corticosteroid therapy.

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“…3,4 ON after the COVID-19 vaccination has been described in a multitude of case reports and studies. 5 ON has also been reported in Vaccine Adverse Event Reporting System (VAERS) data. VAERS is a passive surveillance system managed by Centers for Disease Control and Prevention (CDC) and the US Food and Drug Administration (FDA),which accepts reports by providers and patients of adverse events after vaccination.…”

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confidence: 95%

Optic Neuritis After COVID-19 Vaccination: An Analysis of the Vaccine Adverse Event Reporting System

Jaffry¹,

Aftab²,

Mostafa³

et al. 2023

Journal of Neuro-Ophthalmology

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Background: To investigate the association of optic neuritis (ON) after the COVID-19 vaccines. Methods: Cases of ON from Vaccine Adverse Event Reporting System (VAERS) were collected and divided into the prepandemic, COVID-19 pandemic, and COVID-19 vaccine periods. Reporting rates were calculated based on estimates of vaccines administered. Proportion tests and Pearson χ2 test were used to determine significant differences in reporting rates of ON after vaccines within the 3 periods. Kruskal–Wallis testing with Bonferroni-corrected post hoc analysis and multivariable binary logistic regression was used to determine significant case factors such as age, sex, concurrent multiple sclerosis (MS) and vaccine manufacturer in predicting a worse outcome defined as permanent disability, emergency room (ER) or doctor visits, and hospitalizations. Results: A significant increase in the reporting rate of ON after COVID-19 vaccination compared with influenza vaccination and all other vaccinations (18.6 vs 0.2 vs 0.4 per 10 million, P < 0.0001) was observed. However, the reporting rate was within the incidence range of ON in the general population. Using self-controlled and case-centered analyses, there was a significant difference in the reporting rate of ON after COVID-19 vaccination between the risk period and control period (P < 0.0001). Multivariable binary regression with adjustment for confounding variables demonstrated that only male sex was significantly associated with permanent disability. Conclusions: Some cases of ON may be temporally associated with the COVID-19 vaccines; however, there is no significant increase in the reporting rate compared with the incidence. Limitations of this study include those inherent to any passive surveillance system. Controlled studies are needed to establish a clear causal relationship.

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Neuro-Ophthalmological Complications of the COVID-19 Vaccines: A Systematic Review

Abstract: Supplemental Digital Content is Available in the Text.

Cited by 16 publications

References 61 publications

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A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

Optic Neuritis After COVID-19 Vaccination: An Analysis of the Vaccine Adverse Event Reporting System

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