Vascular retinal findings after COVID-19 vaccination in 11 cases: a coincidence or consequence?

• Published in: Arquivos brasileiros de oftalmologia Vol. 85; no. 2; p. 158
• Main Authors: Silva, Letícia S C da, Finamor, Luciana P S, Andrade, Gabriel C, Lima, Luiz H, Zett, Claudio, Muccioli, Cristina, Sarraf, Eduardo P, Marinho, Paula M, Peruchi, Julia, Oliveira, Raiza D de L, Giralt, Lena, Charcan, Ivonne, Fonollosa, Alex, Diaz, Jose D, Davis, Janet L, Nascimento, Heloisa, Belfort, Jr, Rubens
• Format: Journal Article
• Language: English
• Published: Brazil 2022
• Subjects: ChAdOx1 nCoV-19; COVID-19 - prevention & control; COVID-19 Vaccines - adverse effects; Female; Fluorescein Angiography - methods; Humans; Male; Middle Aged; Tomography, Optical Coherence - methods; Vaccination - adverse effects; Vaccines
• ISSN: 0004-2749; 1678-2925
• DOI: 10.5935/0004-2749.20220017

The primary purpose of this study was to assess vascular retinal findings temporally related to COVID-19 vaccination. With greater information regarding all possible future adverse events, we hope to understand the real dimension and relevance of what was presented. Eleven patients with visual complaints after COVID-19 vaccination were enrolled. Data on the following were included: age, sex, vaccine, time of symptom onset, systemic findings, medical history, best-corrected visual acuity, and ocular findings by slit-lamp biomicroscopy as well as multimodal retinal imaging (color fundus, red-free photography, spectral-domain optical coherence tomography, optical coherence tomography angiography, and fluorescein-angiography). Inclusion criteria were the presence of ophthalmologic signs within 30 days after the first or second dose of any COVID-19 vaccine. Of 11 patients, five had arterial occlusion (45.4%), four had venous occlusion (36.4%), and two (18.2%) had nonspecific vascular alterations suggestive of retinal ischemia such as cotton-wool spots. The mean age was 57 (SD = 16; range: 27-84) years. The mean time of symptoms onset was 10 (SD = 5.4; range: 3-16) days. Nine patients were female (81.8%). Systemic risk factors were observed in 36.4% of patients. Two patients had both neurological and visual symptoms, with arterial occlusion. Overall, 36.4% patients had COVID-19 in the previous year. Seven patients (63.6%) received ChAdOx1 nCoV-19 (AZD1222) vaccine. Our data suggest that retinal events temporally related to COVID-19 vaccination are possible but are very rare. The relationship of these events with post-COVID-19 vaccination warrants further attention to derive a meaningful conclusion.