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Beurrier M, Conart JB, Antoine ML, Facile A, Bagheri H, Gras-Champel V, Petitpain N. Retinal vascular occlusion after COVID-19 vaccination: Analysis of the French pharmacovigilance database. Therapie 2024:S0040-5957(24)00098-2. [PMID: 39294069 DOI: 10.1016/j.therap.2024.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2024] [Revised: 06/30/2024] [Accepted: 08/29/2024] [Indexed: 09/20/2024]
Abstract
Retinal vein occlusions and central retinal artery occlusions have been reported with coronavirus disease 2019 (COVID-19) vaccines. We aim to provide a descriptive analysis of cases reported in France until mid-2023, and recorded in the French pharmacovigilance database. An independent ophthalmologist reviewed all cases. We analyzed 290 cases (228 retinal vein occlusions, 58 central retinal artery occlusions, and four combinations). Retinal vein occlusions occurred with mRNA vaccines (68.0%) and adenovirus-vectored vaccines (32%), with an 11-day median onset delay. Almost half of the patients had retinal vein occlusion risk factors, mainly hypertension, and five had a positive rechallenge. Considering the lower adenovirus-vectored vaccines exposure in France, their proportion of retinal vein occlusions appears high. Among the 58 central retinal artery occlusion cases, most occurred with mRNA vaccines in patients with retinal artery occlusion risk factors (mainly hypertension), with a 17-day median onset delay. In conclusion, there was a temporal association in almost half of cases, but few cases with positive rechallenge, and many cases were confounded by risk factors (e.g., cardiovascular disorders, diabetes), which are also COVID-19 risk factors. Therefore, the risk of retinal vascular occlusion does not challenge the benefit-risk ratio of the vaccination, especially for mRNA vaccines.
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Affiliation(s)
- Mathilde Beurrier
- Regional Pharmacovigilance Centre, University Hospital of Nancy, 54511 Vandœuvre-lès-Nancy, France
| | - Jean-Bapiste Conart
- Department of Ophtalmology, University Hospital of Nancy, University of Lorraine, 54511 Vandœuvre-lès-Nancy, France
| | - Marie Lauren Antoine
- Regional Pharmacovigilance Centre, University Hospital of Nancy, 54511 Vandœuvre-lès-Nancy, France
| | - Anthony Facile
- Service hôpital-universitaire de pharmacotoxicologie, Hospices civils de Lyon, 69000 Lyon, France
| | - Haleh Bagheri
- Department of Medical and Clinical Pharmacology, Regional Pharmacovigilance Center of Toulouse, Clinical Investigation Centre 1436, Toulouse University Hospital, 31000 Toulouse, France
| | - Valérie Gras-Champel
- Regional Pharmacovigilance Centre, University Hospital of Amiens Picardie, 80000 Amiens, France
| | - Nadine Petitpain
- Regional Pharmacovigilance Centre, University Hospital of Nancy, 54511 Vandœuvre-lès-Nancy, France.
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Parmar UPS, Surico PL, Singh RB, Musa M, Scarabosio A, Surico G, Maniaci A, Lavalle S, D’Esposito F, Longo A, Russo A, Gagliano C, Zeppieri M. Ocular Implications of COVID-19 Infection and Vaccine-Related Adverse Events. J Pers Med 2024; 14:780. [PMID: 39201972 PMCID: PMC11355216 DOI: 10.3390/jpm14080780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 09/03/2024] Open
Abstract
The COVID-19 pandemic, caused by SARS-CoV-2, has significantly impacted various organ systems, including the eyes. Initially considered a primarily respiratory disease, it is now evident that COVID-19 can induce a range of ocular symptoms. Recognizing these ocular manifestations is crucial for eye care practitioners as they can serve as early indicators of the disease. This review consolidates current evidence on the ocular effects of COVID-19, identifying manifestations such as conjunctivitis, scleritis, uveitis, and retinopathy. The increasing prevalence of these symptoms highlights the importance of thorough eye examinations and detailed patient histories in COVID-19 cases. Potential routes of viral entry into ocular tissues and the underlying mechanisms, including direct infection, immune responses, and vascular involvement, are explored. Additionally, this review addresses ocular side effects associated with COVID-19 vaccines, such as corneal graft rejection, uveitis, and retinal issues. These findings emphasize the need for ongoing surveillance and research to ensure vaccine safety.
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Affiliation(s)
- Uday Pratap Singh Parmar
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh 160047, India;
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Pier Luigi Surico
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
- Department of Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy
| | - Rohan Bir Singh
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Nigeria
| | - Anna Scarabosio
- Department of Plastic Surgery, University Hospital of Udine, 33100 Udine, Italy
| | - Giorgio Surico
- Medicine and Surgery Department, University of Bari Aldo Moro, 70126 Bari, Italy
| | - Antonino Maniaci
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
| | - Salvatore Lavalle
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
| | - Fabiana D’Esposito
- Imperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, 153-173 Marylebone Rd., London NW1 5QH, UK
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Antonio Longo
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy
| | - Andrea Russo
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
- Eye Clinic Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Muto T, Machida S, Imaizumi S, Kamoi K. Possible association between vaccination against SARS-CoV-2 and recurrence of macular edema due to branch retinal vein occlusion: a case report. J Int Med Res 2023; 51:3000605231213777. [PMID: 38000009 PMCID: PMC10676065 DOI: 10.1177/03000605231213777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 10/26/2023] [Indexed: 11/26/2023] Open
Abstract
We herein describe a patient who developed recurrence of macular edema (ME) due to branch retinal vein occlusion (BRVO) 3 days after administration of the BNT162b2 vaccine against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A man in his early 50s visited our hospital because of vision loss in his right eye. His logarithmic best-corrected visual acuity (BCVA) was -0.79 in both eyes. ME due to superior temporal BRVO was observed in his right eye, and the central foveal thickness (CFT) was 486 µm. The patient was treated with an intravitreal aflibercept injection with logarithmic BCVA of -0.79, leading to resolution of the ME with a CFT of 299 µm. Three months after the initial visit, he received a fourth dose of an mRNA vaccine. Three days later, he developed vision loss in his right eye. Although the logarithmic BCVA was maintained at -0.79, ME recurred with a CFT of 507 µm. The patient was treated with an additional dose of intravitreal aflibercept injection. The ME resolved and the logarithmic BCVA in the right eye was maintained at -0.79. This case indicates a possible association between vaccination against SARS-CoV-2 and recurrence of ME due to BRVO.
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Affiliation(s)
- Tetsuya Muto
- Department of Ophthalmology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
- Imaizumi Eye Hospital, Koriyama, Japan
- Department of Ophthalmology, Fukushima Medical University, Fukushima, Japan
| | - Shigeki Machida
- Department of Ophthalmology, Dokkyo Medical University Saitama Medical Center, Koshigaya, Japan
| | | | - Koju Kamoi
- Imaizumi Eye Hospital, Koriyama, Japan
- Department of Ophthalmology and Visual Science, Tokyo Medical Dental University, Tokyo, Japan
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Pellegrini M, Carnevali A, Fiore T, Cagini C, De Palma A, Fontana L, Lupardi E, Cassini F, Bacherini D, Giansanti F, Giannaccare G, Scorcia V, Vaccaro S, Ciarmatori N, D'Angelo S, Parmeggiani F, Mura M. Risk of retinal vein occlusion following COVID-19 vaccination: a self-controlled case series. Eye (Lond) 2023; 37:3000-3003. [PMID: 36813998 PMCID: PMC9945824 DOI: 10.1038/s41433-023-02459-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 01/20/2023] [Accepted: 02/15/2023] [Indexed: 02/24/2023] Open
Abstract
BACKGROUND To evaluate the association between COVID-19 vaccination and retinal vein occlusion (RVO). METHODS This multicentre self-controlled case series included patients with RVO seen in five tertiary referral centres in Italy. All adults who received at least one dose of the BNT162b2, ChAdOx1 nCoV-19, mRNA-1273 or Ad26.COV2.S vaccine and had a first diagnosis of RVO between January 01, 2021, and December 31, 2021 were included. Incidence rate ratios (IRRs) of RVO were estimated using Poisson regression, comparing rates of events in a 28-day period following each dose of vaccination and in the unexposed control periods. RESULTS 210 patients were included in the study. No increased risk of RVO was observed after the first dose (1-14 days IRR: 0.87, 95% CI: 0.41-1.85; 15-28 days IRR: 1.01, 95% CI: 0.50-2.04; 1-28 days IRR: 0.94, 95% CI: 0.55-1.58) and second dose of vaccination (1-14 days IRR: 1.21, 95% CI: 0.62-2.37; 15-28 days IRR: 1.08, 95% CI: 0.53-2.20; 1-28 days IRR: 1.16, 95% CI: 0.70-1.90). No association between RVO and vaccination was found in subgroup analyses by type of vaccine, gender and age. CONCLUSIONS This self-controlled case series found no evidence of an association between RVO and COVID-19 vaccination.
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Affiliation(s)
- Marco Pellegrini
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy.
- Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", Forlì, Italy.
- Istituto Internazionale per la Ricerca e Formazione in Oftalmologia (IRFO), Forlì, Italy.
| | - Adriano Carnevali
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Tito Fiore
- Department of Biomedical and Surgical Sciences, Section of Ophthalmology, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Carlo Cagini
- Department of Biomedical and Surgical Sciences, Section of Ophthalmology, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Antonella De Palma
- Department of Biomedical and Surgical Sciences, Section of Ophthalmology, S. Maria della Misericordia Hospital, University of Perugia, Perugia, Italy
| | - Luigi Fontana
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Enrico Lupardi
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Federico Cassini
- Ophthalmology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Daniela Bacherini
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
| | - Fabrizio Giansanti
- Eye Clinic, Neuromuscular and Sense Organs Department, Careggi University Hospital, Florence, Italy
| | - Giuseppe Giannaccare
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Vincenzo Scorcia
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Sabrina Vaccaro
- Department of Ophthalmology, University Magna Græcia of Catanzaro, Catanzaro, Italy
| | - Nicolò Ciarmatori
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Sergio D'Angelo
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | | | - Marco Mura
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
- King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia
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Napal B, García-Palacios JD, González-Mesones B, Napal JJ, Hernández JL. Retinal vein occlusion in the general population after COVID-19 vaccination and infection. Med Clin (Barc) 2023; 161:231-237. [PMID: 37263839 PMCID: PMC10167375 DOI: 10.1016/j.medcli.2023.04.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 04/03/2023] [Accepted: 04/09/2023] [Indexed: 06/03/2023]
Abstract
INTRODUCTION Retinal vein occlusion (RVO) is mostly a consequence of vascular risk factors (VRF). COVID-19 vaccines have been related to vascular and thrombotic events (VTE). OBJECTIVE To assess the RVO incidence in the general population in our health area and the possible relation with COVID-19 infection and vaccination. METHODS Demographic features, classic VRF, thrombophilia data, COVID-19 status, and Framingham risk score were collected prospectively. RESULTS 472 consecutive patients studied over 13 years with RVO were included (Valdecilla Cohort). Classic VRFs were present in 90%, antiphospholipid syndrome in 12.3%, and genetic thrombophilia in 13.5%. Ninety-one percent of RVO patients were vaccinated and 6.8% suffered COVID-19 infection. In the cohort, no patient had a new RVO after vaccination or infection. In the general population, 20 subjects had RVO after receiving the vaccine (0.006%). Overall, 8 cases occurred in the first-month post-vaccination and 12 after 30 days. In the early and late groups, there are 3 and 4 patients respectively, with a low-intermediate risk Framingham score. Twenty-nine patients in the cohort suffered SARS-CoV-2 infection, twenty-seven of them had RVO before infection. Two patients with low-risk Framingham scores had RVO after infection, one of them early (<1 month). CONCLUSIONS Vaccination and COVID-19 might be involved in the development of RVO in some cases, mainly in patients without VRF, thrombophilia, or chronic inflammatory conditions and with a lower Framingham score, especially in the first month after vaccination or infection.
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Affiliation(s)
- Beatriz Napal
- Depto. de Medicina y Psiquiatría. Universidad de Cantabria, Santander, Spain
| | | | | | | | - José Luis Hernández
- Depto. de Medicina y Psiquiatría. Universidad de Cantabria, Santander, Spain; Department of Internal Medicine, Spain; Instituto de Investigación Valdecilla (IDIVAL), Spain.
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Rachman MJ, Kalanjati VP, Rimbun R, Khadijah F. Retinal Vein Occlusion Amongst People Vaccinated by mRNA- and Viral Vector- COVID-19 Vaccines: A Systematic Review. Clin Ophthalmol 2023; 17:2825-2842. [PMID: 37794952 PMCID: PMC10545804 DOI: 10.2147/opth.s426428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 09/18/2023] [Indexed: 10/06/2023] Open
Abstract
Vaccines are highly effective in lowering the mortality due to COVID-19. Although several suspected adverse events or side effects after vaccination including retinal vein occlusion (RVO) have been reported. We conducted a systematic review using PRISMA methods to analyze the occurrence of RVO among people vaccinated by COVID-19 mRNA- vs viral vector- vaccines on 4 databases from 1-1-2021 to 31-12-2022 using specified MeSH terms. All included studies were assessed using JBI critical appraisal tools for eligibility. The final included studies are 31 studies (n=78 cases from 75 patients; 3 of these patients suffered twice). The median age of the patients was 61 years (28 to 96 years old) and most of them were female (52.00%). Thirty-nine patients received the mRNA vaccine (52.00%), while 36 patients received the viral vector vaccine (48.00%) before the event. The RVO diagnoses are based on physical examination confirmed by Fluorescein Angiography (FA), and/or Optical Coherence Tomography (OCT). The median time interval between vaccination and RVO was 6 days in the mRNA vaccine group and 4 days in the viral vector vaccine group. Central retinal vein occlusion (CRVO) and Branch Retinal Vein Occlusion (BRVO) were tied as the most common diagnosis in the mRNA vaccine group (20.51% and 20.51%), whilst in the viral vector vaccine group CRVO was the most common diagnosis (17.94%). Most of these cases had good outcomes with improved visual impairment in one or both eyes. From this review, we could not ascertain that the RVO occurs due to the type of COVID-19 vaccines because of the detailed data on the dosage and the history of illness of each patient. However, the awareness that the RVO could develop after COVID-19 vaccination must be taken into consideration, even though it is rare.
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Affiliation(s)
- Maria Jessica Rachman
- Master Program of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
- Faculty of Medicine, Universitas Ciputra, Surabaya, East Java, Indonesia
| | - Viskasari P Kalanjati
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Rimbun Rimbun
- Department of Anatomy, Histology, and Pharmacology, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
| | - Fira Khadijah
- Master Program of Basic Medical Science, Faculty of Medicine, Universitas Airlangga, Surabaya, East Java, Indonesia
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Leung HM, Au SCL. Retinal Vein Occlusion after COVID-19 Vaccination-A Review. Vaccines (Basel) 2023; 11:1281. [PMID: 37631850 PMCID: PMC10459858 DOI: 10.3390/vaccines11081281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 07/12/2023] [Accepted: 07/17/2023] [Indexed: 08/27/2023] Open
Abstract
Background Retinal vein occlusion (RVO) occurring after COVID-19 vaccination has been reported worldwide. Such a sight-threatening condition occurring after COVID-19 vaccination is a menace to ophthalmic health. This article reviews current evidence related to post-COVID-19 vaccination RVO. Method A total of 29 relevant articles identified on PubMed in January 2023 were selected for review. Observation All cases presented to ophthalmologists with visual loss shortly after COVID-19 vaccination. Mean and median age were both 58. No sex predominance was observed. RVO was diagnosed from findings on dilated fundal examination and ophthalmic imaging. AstraZeneca and BNT vaccines accounted for most cases. Vascular risk factors, e.g., diabetes mellitus and hypertension, were common. Most laboratory tests requested came back unremarkable. Most patients responded well to standard treatment, except those with ophthalmic comorbidities. Visual prognosis was excellent on short-term follow-up. Discussion The causality between RVO and COVID-19 vaccination is undeterminable because of the nature of articles, heterogenous reporting styles, contradicting laboratory findings and co-existing vascular risk factors. Vaccine-induced immune thrombotic thrombocytopenia, retinal vasculitis and homocysteinaemia were proposed to explain post-vaccination RVO. Large-scale studies have demonstrated that the incidence of RVO following COVID vaccination is very low. Nevertheless, the effects of boosters on retinal vasculature and ophthalmic health are still unclear. Conclusions The benefits of COVID-19 vaccination are believed to outweigh its ophthalmic risks. To ensure safe vaccination, the prior optimisation of comorbidities and post-vaccination monitoring are important. COVID-19 vaccines (including boosters) should be offered with reasonable confidence. Further studies are warranted to elucidate the ophthalmic impact of vaccines.
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Affiliation(s)
- Ho-Man Leung
- Hospital Authority, Ma Tau Wai 999077, Hong Kong
| | - Sunny Chi-Lik Au
- Department of Ophthalmology, Tung Wah Eastern Hospital, So Kon Po 999077, Hong Kong
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Sung SY, Jenny LA, Chang YC, Wang NK, Liu PK. Central Retinal Vein Occlusion in a Young Woman with Diabetes and Hypertension after mRNA-Based COVID-19 Vaccination-A Case Report and Brief Review of the Literature. Vaccines (Basel) 2023; 11:365. [PMID: 36851242 PMCID: PMC9960341 DOI: 10.3390/vaccines11020365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/30/2023] [Accepted: 01/31/2023] [Indexed: 02/09/2023] Open
Abstract
A 25-year-old female with diabetes and hypertension presented with progressive painless blurred vision in her left eye ten days after she received her third dose of the SARS-CoV-2 mRNA vaccine BNT162b2 (Pfizer-BioNTech). The clinical examination confirmed the diagnosis of Central Retinal Vein Occlusion (CRVO) complicated with macular edema. Three doses of anti-vascular endothelial growth factor (VEGF) were injected intravitreally. Visual acuity was improved from 20/100 to 20/30, but recurrence was noted at 6 months. Several cases of retinal vein occlusion (RVO) after COVID-19 vaccination have been reported. However, the present case is the youngest female individual documented to have CRVO after SARS-CoV-2 vaccination. This case demonstrates that the macular edema might be recurrent in patients with risk factors for CRVO who receive SARS-CoV-2 vaccination, suggesting the need for careful consideration of the treatment strategy and close follow-up. Although the definite pathogenesis still needs to be carefully determined, this report highlights the possible association between RVO and mRNA-based COVID-19 vaccination, even in young individuals.
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Affiliation(s)
- Shao-Yu Sung
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Laura A. Jenny
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Yo-Chen Chang
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
| | - Nan-Kai Wang
- Department of Ophthalmology, Edward S. Harkness Eye Institute, Columbia University Irving Medical Center, New York, NY 10032, USA
| | - Pei-Kang Liu
- Department of Ophthalmology, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
- School of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 807, Taiwan
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Abu Serhan H, Abdelaal A, Abuawwad MT, Taha MJJ, Irshaidat S, Abu Serhan L, Abu-Ismail L, Abu Salim QF, Abdelazeem B, Elnahry AG. Ocular Vascular Events following COVID-19 Vaccines: A Systematic Review. Vaccines (Basel) 2022; 10:2143. [PMID: 36560553 PMCID: PMC9786009 DOI: 10.3390/vaccines10122143] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 12/10/2022] [Accepted: 12/11/2022] [Indexed: 12/16/2022] Open
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.
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Affiliation(s)
- Hashem Abu Serhan
- Department of Ophthalmology, Hamad Medical Corporations, Doha 3050, Qatar
- Tanta Research Team, El-Gharbia 31511, Egypt
| | - Abdelaziz Abdelaal
- Tanta Research Team, El-Gharbia 31511, Egypt
- Harvard Medical School, Postgraduate Medical Education, Boston, MA 02115, USA
- Doheny Eye Institute, University of California, Los Angeles, CA 94720, USA
| | - Mohammad T. Abuawwad
- Department of Clinical Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Mohammad J. J. Taha
- Department of Clinical Medicine, Kasr Alainy Faculty of Medicine, Cairo University, Cairo 11562, Egypt
| | - Sara Irshaidat
- Department of Pediatrics, King Hussein Cancer Centre, Amman 11941, Jordan
| | - Leen Abu Serhan
- Faculty of Medicine, Hashemite University, Zarqa 13133, Jordan
| | - Luai Abu-Ismail
- Department of Ophthalmology, Islamic Hospital, Amman 11190, Jordan
| | | | - Basel Abdelazeem
- Tanta Research Team, El-Gharbia 31511, Egypt
- Department of Internal Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Ayman G. Elnahry
- Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo 11591, Egypt
- Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA
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10
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Nagasato D, Tanaka H, Mitamura Y, Tabuchi H. Authors' comments on "branch retinal vein occlusion post severe acute respiratory syndrome coronavirus 2 vaccination". Taiwan J Ophthalmol 2022; 12:502. [PMID: 36660126 PMCID: PMC9843560 DOI: 10.4103/2211-5056.361973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 09/03/2022] [Indexed: 11/27/2022] Open
Affiliation(s)
- Daisuke Nagasato
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Hyogo, Japan,Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan,Department of Technology and Design Thinking for Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan,Address for correspondence: Dr. Daisuke Nagasato, 68-1 Waku, Aboshi-ku, Himeji, Hyogo 671-1227, Japan. E-mail:
| | - Hayato Tanaka
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Hyogo, Japan
| | - Yoshinori Mitamura
- Department of Ophthalmology, Institute of Biomedical Sciences, Tokushima University Graduate School, Tokushima, Japan
| | - Hitoshi Tabuchi
- Department of Ophthalmology, Tsukazaki Hospital, Himeji, Hyogo, Japan,Department of Technology and Design Thinking for Medicine, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan
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Fernández-Vigo J, Perálvarez Conde C, Burgos-Blasco B, Fernández-Vigo J. Bilateral retinal vein occlusion after two doses of SARS-CoV-2 adenovirus vector-based vaccine. J Fr Ophtalmol 2022; 45:e397-e399. [PMID: 36150989 PMCID: PMC9257142 DOI: 10.1016/j.jfo.2022.05.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 05/13/2022] [Indexed: 12/01/2022]
Affiliation(s)
- J.I. Fernández-Vigo
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain,Centro Internacional de Oftalmología Avanzada, Madrid, Spain
| | - C. Perálvarez Conde
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain
| | - B. Burgos-Blasco
- Department of Ophthalmology, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria (IdISSC), Madrid, Spain,Corresponding author. Calle Profesor Martin Lagos s/n, 28040 Madrid, Spain
| | - J.A. Fernández-Vigo
- Centro Internacional de Oftalmología Avanzada, Madrid, Spain,Centro Internacional de Oftalmología Avanzada, Badajoz, Spain,Department of Ophthalmology, Universidad de Extremadura, Badajoz, Spain
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12
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Katerini D, Markakis MZ, Kounali V, Koulotsiou K, Dimopoulos D, Nodarakis M, Zacharioudakis A, Koutentakis P. Paracentral Acute Middle Maculopathy Associated With Cilioretinal Artery Insufficiency Following COVID-19 Vaccination in a Young Patient. Cureus 2022; 14:e28739. [PMID: 36211091 PMCID: PMC9531696 DOI: 10.7759/cureus.28739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2022] [Indexed: 12/02/2022] Open
Abstract
We aim to present a unique case of unilateral paracentral acute middle maculopathy (PAMM) associated with cilioretinal artery insufficiency following the coronavirus disease 2019 (COVID-19) vaccination. A 28-year-old male complained of a sudden blurring of vision in his left eye 40 days after receiving the second dose of COVID-19 immunization. The optical coherence tomography revealed a diffuse paracentral area of hyper-reflective change in the inner plexiform layer and an increase in the inner nuclear layer volume, consistent with PAMM along the course of the cilioretinal artery. PAMM has been connected to an assortment of retinal vasculature anomalies. Considering COVID-19 vaccination, we hypothesize that the immunogenic cascade following vaccination dysregulated coagulation and led to retinal vascular thrombosis. However, the link between COVID-19 vaccination and retinal vascular occlusion disease remains unknown.
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13
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Dutta Majumder P, Prakash VJ. Retinal venous occlusion following COVID-19 vaccination: Report of a case after third dose and review of the literature. Indian J Ophthalmol 2022; 70:2191-2194. [PMID: 35648014 PMCID: PMC9359265 DOI: 10.4103/ijo.ijo_592_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A 28-year-old, healthy male presented with blurring of vision in the right eye following third dose of the AstraZeneca/COVISHIELD vaccine. Further examination revealed ischemic central retinal vein occlusion, and subsequent laboratory investigations were inconclusive for his eye disease. He responded to pulse corticosteroid and tapering doses of oral corticosteroids without requiring any intra-vitreal injection. Twelve articles were identified with the help of a PubMed literature search, and a short review of these patients was performed. Retinal vein occlusion can occur because of inflammation-induced thrombosis after coronavirus disease 2019 vaccination and may respond to anti-inflammatory therapy.
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Affiliation(s)
| | - Vadivelu Jaya Prakash
- Department of Vitreoretina, Medical and Vision Research Foundations, Sankara Nethralaya, Sankara Nethralaya, Chennai, Tamil Nadu, India
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14
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Finsterer J. Retinal artery/vein occlusion complicating SARS-CoV-2 vaccinations. J Stroke Cerebrovasc Dis 2022; 31:106617. [PMID: 35786536 PMCID: PMC9234003 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 06/23/2022] [Indexed: 11/12/2022] Open
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15
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Momenaei B, Cheraqpour K, Soleimani M, Tabatabaei SA, Shahriari M, Etesali H, Hussein A, Vaseghi Y, Ramezani B, Djalilian AR. Ophthalmic side effects of COVID-19 vaccines. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2066523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bita Momenaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Seyed Ali Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoor Shahriari
- Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Etesali
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmed Hussein
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Vaseghi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Ramezani
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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16
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Roncati L, Manenti A, Corsi L. A Three-Case Series of Thrombotic Deaths in Patients over 50 with Comorbidities Temporally after modRNA COVID-19 Vaccination. Pathogens 2022; 11:pathogens11040435. [PMID: 35456110 PMCID: PMC9032304 DOI: 10.3390/pathogens11040435] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2022] [Revised: 03/29/2022] [Accepted: 04/02/2022] [Indexed: 01/04/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is the most dramatic pandemic of the new millennium; to counteract it, specific vaccines have been launched in record time under emergency use authorization or conditional marketing authorization by virtue of a favorable risk/benefit balance. Among the various technological platforms, there is that exploiting a nucleoside-modified messenger RNA (modRNA), such as Comirnaty®, and that which is adenoviral vector-based. In the ongoing pharmacovigilance, the product information of the latter has been updated about the risk of thrombotic thrombocytopenia, venous thromboembolism without thrombocytopenia and immune thrombocytopenia without thrombosis. However, from an in-depth literature review, the same adverse events can rarely occur with modRNA vaccines too. In support of this, we here report a three-case series of thrombotic deaths in patients over 50 with comorbidities temporally after Comirnaty®, investigated by means of post-mortem histopathology and immunohistochemistry. In two out of three cases, the cause of death is traced back to pulmonary microthromboses rich in activated platelets, quite similar morphologically to those described in patients who died from severe COVID-19. Even if remote in the face of millions of administered doses, clinicians should be aware of the possible thrombotic risk also after Comirnaty®, in order to avoid a misdiagnosis with potentially lethal consequences. Since COVID-19 vaccines are inoculated in subjects to be protected, maximum attention must be paid to their safety, and prophylactic measures to increase it are always welcome. In light of the evidence, the product information of modRNA COVID-19 vaccines should be updated about the thrombotic risk, as happened for adenoviral vector-based vaccines.
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Affiliation(s)
- Luca Roncati
- Institute of Pathology, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy
- Correspondence: or or
| | - Antonio Manenti
- Unit of Surgery, Department of Surgery, Medicine, Dentistry and Morphological Sciences with Interest in Transplantation, Oncology and Regenerative Medicine, University of Modena and Reggio Emilia, 41125 Modena, Italy;
| | - Lorenzo Corsi
- Department of Life Sciences, Section of Pharmacology, University of Modena and Reggio Emilia, 41125 Modena, Italy;
- National Institute of Biostructures and Biosystems, Inter-University Consortium, 00136 Rome, Italy
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17
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Ocular Complications Following Vaccination for COVID-19: A One-Year Retrospective. Vaccines (Basel) 2022; 10:vaccines10020342. [PMID: 35214800 PMCID: PMC8875181 DOI: 10.3390/vaccines10020342] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/24/2022] Open
Abstract
Vaccination efforts as a mitigation strategy in the corona virus disease 2019 (COVID-19) pandemic are fully underway. A vital component of understanding the optimal clinical use of these vaccines is a thorough investigation of adverse events following vaccination. To date, some limited reports and reviews have discussed ocular adverse events following COVID-19 vaccination, but a systematic review detailing these reports with manifestations and clinical courses as well as proposed mechanisms has yet to be published. This comprehensive review one-year into vaccination efforts against COVID-19 is meant to furnish sound understanding for ophthalmologists and primary care physicians based on the existing body of clinical data. We discuss manifestations categorized into one of the following: eyelid, orbit, uveitis, retina, vascular, neuro-ophthalmology, ocular motility disorders, and other.
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18
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Tozinameran. REACTIONS WEEKLY 2022. [PMCID: PMC8813491 DOI: 10.1007/s40278-022-09772-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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19
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Nagasato D, Tanaka H, Nakakura S, Nagasawa T, Wakuda H, Kurusu A, Mitamura Y, Tabuchi H. Branch retinal vein occlusion post severe acute respiratory syndrome coronavirus 2 vaccination. Taiwan J Ophthalmol 2022; 12:202-205. [PMID: 35813793 PMCID: PMC9262010 DOI: 10.4103/tjo.tjo_24_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Accepted: 04/16/2022] [Indexed: 11/04/2022] Open
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