Ocular Vascular Events following COVID-19 Vaccines: A Systematic Review

Abstract

The main aim of this study is to investigate the current evidence regarding the association between COVID-19 vaccination and ocular vascular events. The protocol is registered on PROSPERO (CRD42022358133). On 18 August 2022, an electronic search was conducted through five databases. All original articles reporting individuals who were vaccinated with COVID-19 vaccines and developed ophthalmic vascular events were included. The methodological quality of the included studies was assessed using the NIH tool. A total of 49 studies with 130 ocular vascular cases were included. Venous occlusive events were the most common events (54.3%), which mostly occurred following the first dose (46.2%) and within the first five days following vaccination (46.2%). Vascular events occurred more with the Pfizer and AstraZeneca vaccines (81.6%), and mostly presented unilaterally (73.8%). The most frequently reported treatment was intravitreal anti-VEGF (n = 39, 30.4%). The majority of patients (90.1%) demonstrated either improvement (p = 0.321) or persistence (p = 0.414) in the final BCVA. Ophthalmic vascular events are serious vision-threatening side effects that have been associated with COVID-19 vaccination. Clinicians should be aware of the possible association between COVID-19 vaccines and ocular vascular events to provide early diagnosis and treatment.

Case Report: Branch Retinal Vein Occlusion Post mRNA SARS-CoV-2 (COVID-19) Vaccination

“…Retinal vascular occlusion was the most reported ocular vascular event after different types of COVID-19 vaccination 20 . Discussion continues about reported retinal vascular issues after COVID-19 vaccination.…”

“…Retinal vascular occlusion was the most reported ocular vascular event after different types of COVID-19 vaccination. 20 Discussion continues about reported retinal vascular issues after COVID-19 vaccination. Further studies and data are required to justify its direct association in light of the increase in the incidence of these events.…”

Bilateral central retinal vein occlusion following COVID-19 vaccination: Cause or coincidence?

“…Indeed, bilateral CRVO occurred 18 days following third shot of Pfizer-BioNTech Covid-19 vaccine. Several cases of retinal vascular diseases development after SARS-CoV-2 vaccination have been reported, [5][6][7][8] most of them being unilateral CRVO. [9][10][11][12] To our best knowledge, this is the first and only reported case with bilateral CRVO after Covid-19 vaccination.…”

“…Indeed, bilateral CRVO occurred 18 days following third shot of Pfizer-BioNTech Covid-19 vaccine. Several cases of retinal vascular diseases development after SARS-CoV-2 vaccination have been reported, 5–8 most of them being unilateral CRVO. 9–12…”

Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus Vaccination

“…The published literature assessing the association between retinal vessel occlusion and SARS-CoV-2 vaccination is limited to case reports, series, and review articles. 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , Although the evidence in the literature speculated a causal association between the adenoviral vector and mRNA-based SARS-CoV-2 vaccines, the precise mechanism is not completely understood. An immunologic basis has been hypothesized, ultimately leading to the activation of platelets causing dysregulated coagulation.…”