Retinal vein occlusion in the general population after COVID-19 vaccination and infection

Napal, Beatriz; García-Palacios, José David; González-Mesones, Belén; Napal, José Javier; Hernández, José Luis

doi:10.1016/j.medcli.2023.04.027

Cited by 7 publications

(3 citation statements)

References 31 publications

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“…The exact mechanism of vascular occlusion following mRNA vaccination remains unclear; however, it is worth noting that all vaccines may increase the risk of thrombotic events, with viral vector vaccines having a higher reported risk [ 13 ]. The association between COVID-19 vaccination and retinal vascular occlusions lacks a definitive conclusion and has mainly been reported in case studies [ 2 , 3 , 14 ].…”

Section: Discussionmentioning

confidence: 99%

“…Ocular complications related to COVID-19 vaccination, such as retinal vascular occlusion and vaccine-induced uveitis, have been documented. Although retinal vascular occlusions have been extensively reported [ 1 ], definitive consensus in cohort studies is lacking [ 2 , 3 ], and a clear causal relationship has not been established. Herein, we report a case of central retinal artery occlusion (CRAO) accompanied by paracentral acute middle maculopathy (PAMM) that developed the day after receiving the Pfizer COVID-19 vaccine, with a favorable visual outcome.…”

Section: Introductionmentioning

confidence: 99%

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Recovery From Central Retinal Artery Occlusion Accompanying Paracentral Acute Middle Maculopathy After COVID-19 Vaccination

Yamagishi,

Kitamura,

Baba

2024

Cureus

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Although ocular complications following COVID-19 vaccination have been reported, particularly retinal vascular occlusion and uveitis, their definitive causal relationships remain uncertain. This report presents a case of central retinal artery occlusion (CRAO) with paracentral acute middle maculopathy (PAMM) developed one day after receiving Pfizer COVID-19 vaccine, with a favorable outcome. The patient experienced sudden vision loss in her left eye, and her vision dropped to hand motion the day after vaccination. The initial examination suggested CRAO, but optical coherence tomography (OCT) revealed PAMM. We administered intravenous d-mannitol and acetazolamide and performed ocular massage. Two days later, her corrected visual acuity improved to 0.4, and further improvement to 1.2 occurred after 16 days. To the best of our knowledge, no reports have documented CRAO with PAMM following mRNA COVID-19 vaccination. The relationship between COVID-19 vaccination and retinal vascular occlusion remains unknown, highlighting the need for further research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Recovery From Central Retinal Artery Occlusion Accompanying Paracentral Acute Middle Maculopathy After COVID-19 Vaccination

Yamagishi,

Kitamura,

Baba

2024

Cureus

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“…SARS-CoV-2, the virus responsible for COVID-19, has been associated with multi-organ damages, including the eye ( 3 , 4 ). Retinal microvascular abnormalities, such as hemorrhages, cotton wool spots(CWS), tortuous vessels, and retinal vascular diseases, including retinal vein occlusion ( 5 – 7 ) and paracentral acute middle maculopathy ( 8 ) have been reported in COVID-19 patients, with potential implications for severe visual impairment ( 9 , 10 ). This is postulated to occur due to hypercoagulability and inflammation associated with COVID-19 and that the retina's high demand for oxygen makes it particularly susceptible to microvascular thrombosis ( 11 ).…”

Section: Introductionmentioning

confidence: 99%

New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study

Zhang,

Cheng,

Chen

et al. 2024

Front. Immunol.

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PurposeTo investigate the longitudinal alterations of retinal microvasculature in patients with primary coronavirus disease 2019 (COVID-19) infection.MethodsA cohort of participants, who had never been infected with COVID-19, was recruited between December 2022 and May 2023 at Peking Union Medical College Hospital in Beijing, China. Participants underwent comprehensive ophthalmologic examinations and fundus imaging, which included color fundus photography, autofluorescence photography, swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA). If participants were infected with COVID-19 during the study, follow-ups with consistent imaging modality were conducted within one week and two months after recovery from the infection.Results31 patients (61 eyes), with a mean age of 31.0 ± 7.2 years old, were eligible for this study. All participants contracted mild COVID-19 infection within one month of baseline data collection. The average period was 10.9 ± 2.0 days post-infection for the first follow-up and 61.0 ± 3.5 days for the second follow-up. No clinical retinal microvasculopathy features were observed during the follow-ups. However, SS-OCTA analysis showed a significant increase in macular vessel density (MVD) from 60.76 ± 2.88% at baseline to 61.59 ± 3.72%(p=0.015) at the first follow-up, which subsequently returned to the baseline level of 60.23 ± 3.33% (p=0.162) at the two-month follow-up. The foveal avascular zone (FAZ) remained stable during the follow-ups with areas of 0.339 ± 0.097mm2, 0.342 ± 0.093mm2, and 0.344 ± 0.098mm2 at the baseline, first follow-up (p=0.09) and second follow-up (p=0.052), respectively. Central macular thickness, cube volume and ganglion cell-inner plexiform layer showed a transient decrease at the first follow-up(p<0.001, p=0.039, p=0.002, respectively), and increased to baseline level at the two-month follow-up(p=0.401, p=0.368, p=0.438, respectively).ConclusionMild COVID-19 infection may temporarily and reversibly impact retinal microvasculature, characterized by a transient increase in retinal blood flow during the early recovery phase, which returns to the pre-infection level two months post-infection.

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AZD-1222/elasomeran/tozinameran

2024

Reactions Weekly

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Retinal vein occlusion in the general population after COVID-19 vaccination and infection

Cited by 7 publications

References 31 publications

Recovery From Central Retinal Artery Occlusion Accompanying Paracentral Acute Middle Maculopathy After COVID-19 Vaccination

Recovery From Central Retinal Artery Occlusion Accompanying Paracentral Acute Middle Maculopathy After COVID-19 Vaccination

New findings on retinal microvascular changes in patients with primary COVID-19 infection: a longitudinal study

AZD-1222/elasomeran/tozinameran

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