Retinal Hemorrhage after SARS-CoV-2 Vaccination

Park, Hyo Song; Byun, Yeojue; Byeon, Suk Ho; Kim, Sung Soo; Kim, Yong Joon; Lee, Christopher Seungkyu

doi:10.3390/jcm10235705

Cited by 27 publications

(31 citation statements)

References 29 publications

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“…Endo et al [ 24 ] reported the case of a 52-year-old man who developed BRVO 15 days after receiving SARS-CoV-2 vaccination, knowing that no recent condition related to developing RVO was present. In a similar case series study, Park et al [ 14 ] also reported 11 cases of subretinal hemorrhage and RVO after receiving SARS-CoV-2 vaccination. This report suggests that RVO onset after SARS-CoV-2 vaccination could occur with or without a related medical history and across any type of vaccine formulation.…”

Section: Discussionmentioning

confidence: 88%

“…[ 4 5 6 7 ] Additional postvaccine adverse events affecting the eyes have also been reported, including keratoplasty rejection,[ 8 9 ] panuveitis,[ 10 ] abducens nerve palsy,[ 11 ] episcleritis,[ 12 ] anterior scleritis,[ 12 ] acute macular neuroretinopathy,[ 12 ] paracentral acute middle maculopathy,[ 12 ] eyelid localized purpuric and ecchymotic reactions,[ 13 ] and subretinal hemorrhage due to age-related macular disease. [ 14 ] Moreover, we reported previously two cases with exacerbation of branch retinal vein occlusion (BRVO), implicating a possible association with SARS-CoV-2 vaccination. [ 15 ] However, the association between SARS-CoV-2 vaccination and the first onset of retinal vascular occlusion disease remains unclear.…”

Section: Introductionmentioning

confidence: 99%

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Branch retinal vein occlusion post severe acute respiratory syndrome coronavirus 2 vaccination

Tanaka¹,

Nagasato²,

Nakakura³

et al. 2022

Taiwan Journal of Ophthalmology

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In this article, we report two patients who experienced the first onset of branch retinal vein occlusion (BRVO) 3 days after the administration of the BNT162b2 (Pfizer–BioNTech) severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccine. Case 1: A 50-year-old woman without any history of retinal disease developed vision loss in her right eye 3 days after receiving the first dose of the SARS-CoV-2 mRNA vaccine. Case 2: A 56-year-old woman without any history of retinal disease developed vision loss in her right eye 3 days after receiving the first dose of the SARS-CoV-2 mRNA vaccine. Case 1: Temporal superior BRVO and secondary macular edema (ME) were observed in the patient's right eye. Her best-corrected visual acuity (BCVA) was 20/25. Case 2: Temporal inferior BRVO and secondary ME were observed in the patient's right eye. Her BCVA was 13/20. Case 1: Three doses of intravitreal ranibizumab (IVR) were administered. Case 2: Three doses of IVR were administered. Case 1: ME resolved and BCVA improved to 20/20. Case 2: ME resolved and BCVA improved to 20/20. Both the cases showed a possible association between the SARS-CoV-2 vaccination and the first onset of BRVO.

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Section: Discussionmentioning

confidence: 88%

Section: Introductionmentioning

confidence: 99%

Branch retinal vein occlusion post severe acute respiratory syndrome coronavirus 2 vaccination

Tanaka¹,

Nagasato²,

Nakakura³

et al. 2022

Taiwan Journal of Ophthalmology

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“…Retinal vascular adverse events after COVID-19 vaccinations appear to be rare [ 11 ]. However, there is now a growing literature reporting single case reports with RVO after both mRNA vaccines including mRNA-1273 (Moderna) [ 12 ] and BNT162b2 (Pfizer) [ 13 – 16 ], and vector-based ChAdOx1 (Vaxzevria) [ 17 – 19 ]. Other single case reports have documented combined CRAO-CRVO shortly after mRNA-1273 (Moderna) [ 20 ], combined CRAO-CRVO with ischemic optic neuropathy after BNT162b2 (Pfizer) [ 21 ], and CRAO after ChAdOx1 (Vaxzevria) [ 22 ].…”

Section: Discussionmentioning

confidence: 99%

Retinal vascular occlusion and SARS-CoV-2 vaccination

Vujosevic

Limoli

Romano

et al. 2022

Graefes Arch Clin Exp Ophthalmol

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Purpose To assess the clinical and retinal imaging features of patients in whom retinal vascular occlusion (VO) had developed in temporal associations with COVID-19 vaccination. Methods In this retrospective case series, all consecutive adult patients with new onset VO within 6 weeks of vaccination against COVID-19 were included in the study between May 1 and October 31, 2021. All patients had a systemic medical health assessment, full ophthalmic evaluation, and complete fundus imaging. Results Fifteen eyes of VO (14 patients) after COVID-19 vaccinations were identified. The median time between vaccination and symptoms onset was 14 days (range 7–42 days). The mean best-corrected visual acuity (BCVA) was 20/55 with a range of 20/20 to 20/200. Eleven of 15 eyes (73.3%) had visual acuity improvement after intravitreal treatment at 60–90 days (range, 45–105 days) from the presentation. Four of 5 cases without systemic risk factors for VO had a mean BCVA > 20/32 at presentation and > 20/25 at the latest evaluation. Between May 1 and October 31, 2021, a temporal association was found between the 15 reported cases and COVID-19 vaccination out of a total of 29 VO (p = 0.05). The incidence of VO was higher in the considered period compared to the equivalent 6-month period in 2019 (1.17% vs 0.52%, respectively; p = 0.0134). Conclusions Retinal vascular occlusion with different grades of severity are reported in temporal association with COVID-19 vaccination. The exact pathogenic mechanism needs to be further studied. No certain causal relationship can be established from this case series.

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“…The cases with vitreous hemorrhage (cases #6~8) had a history of vitrectomy due to vitreous hemorrhage which accompanied the RVO, meaning that there was previous neovascularization. Park et al reported on submacular hemorrhage and vitreous hemorrhage in a patient with age-related macular degeneration and RVO [ 7 ]. The vessel vulnerable to microvascular dysfunction including neovascularization due to AMD and RVO may develop hemorrhagic complications after COVID-19 vaccination.…”

Section: Discussionmentioning

confidence: 99%

“…Serious vaccine-related effects, including thrombotic thrombocytopenia, cerebral venous sinus thrombosis, splanchnic vein thrombosis, and pulmonary embolism, were reported after vaccination for COVID-19 [ 2 , 3 , 4 , 5 , 6 ]. In terms of ophthalmic reaction to COVID-19 vaccination, various manifestations including eyelid swelling, ptosis, superior ophthalmic vein thrombosis, acute graft rejection after keratoplasty, cranial nerve palsy, retinal vein occlusion, submacular hemorrhage, scleritis, uveitis, acute macular neuroretinopathy, optic neuritis, and paracentral acute middle maculopathy were found in several cases [ 7 , 8 , 9 , 10 , 11 , 12 , 13 ]. The COVID-19 vaccines with reported ophthalmic reactions included the mRNA vaccine (BNT162b2, Pfizer, Brooklyn, NY, USA; mRNA-1273, Moderna, Cambridge, MA, USA), vector vaccine (Ad26COVS1, Janssen Johnson & Johnson, New Brunswick, NJ, USA; AZD1222, Oxford–AstraZeneca, Cambridge, UK), and whole virus (PiCoVacc, Sinovac Biotech, Beijing, China; BBIBP-CorV, Sinopharm, Beijing, China) [ 14 , 15 ].…”

Section: Introductionmentioning

confidence: 99%

Vision-Threatening Ocular Adverse Events after Vaccination against Coronavirus Disease 2019

Choi

Seo

Choi

et al. 2022

JCM

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A single-center retrospective observational case series was conducted. This case series enrolled patients who showed ophthalmic manifestations within one week after COVID-19 vaccination at Korea University Guro Hospital in Seoul, Korea, from May 2021 to January 2022. The medical records of patients who complained of ocular symptoms and showed ophthalmic adverse events within one week after COVID-19 vaccination were reviewed. Seventeen eyes from 16 patients with a mean age of 63.8 (range 33–83) years were included in the case series, and all symptoms developed within 1–7 days following inoculation. Retinal vein occlusion in nine eyes (52.9%), retinal artery occlusion in one eye (5.9%), newly developed anterior uveitis in one eye (5.9%), exacerbation of previously diagnosed panuveitis in two eyes (11.8%), and angle-closure attack with high intraocular pressure in four eyes (23.5%) were included. Twelve patients (75%) had been vaccinated with the AstraZeneca (AZD1222) and four (25%) with the Pfizer (BNT162b2) vaccines. Of these, 10 patients (62.5%) experienced ocular disease exacerbation after the first dose, 4 (25%) after the second dose, and 2 (12.5%) after the third dose (booster shot). Eleven patients (64.7%) underwent tests for hematological abnormalities, and three of them tested positive for anti-PF4 antibodies, but no abnormal findings were noted. A causal relationship between vaccination and the ocular manifestations could not be determined, which is a limitation of this study. However, clinicians should consider the effect of COVID-19 vaccination on ophthalmic disease. Further studies are required to elucidate the possible effects of COVID-19 vaccination on the eye.

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Retinal Hemorrhage after SARS-CoV-2 Vaccination

Cited by 27 publications

References 29 publications

Branch retinal vein occlusion post severe acute respiratory syndrome coronavirus 2 vaccination

Branch retinal vein occlusion post severe acute respiratory syndrome coronavirus 2 vaccination

Retinal vascular occlusion and SARS-CoV-2 vaccination

Vision-Threatening Ocular Adverse Events after Vaccination against Coronavirus Disease 2019

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