Purpose Abnormal hypercoagulability and increased thromboembolic risk are common in patients with coronavirus disease (COVID-19). COVID-19 has been suggested to cause retinal vascular damage, with several studies on COVID-19 patients with retinal vascular occlusions. We reviewed and investigated studies on retinal vascular occlusions in patients diagnosed with COVID-19 and in those vaccinated for COVID-19. Methods Studies that reported retinal vascular occlusion in COVID-19 patients or in vaccinated people were identified using the terms “retinal occlusion,” together with “severe acute respiratory syndrome coronavirus 2”, “SARS-CoV-2,” “COVID-19,” “coronavirus,” and “vaccine,” through systematic searches of PubMed and Google Scholar databases until January 7, 2022. Results Thirteen cases of retinal artery occlusion (RAO) and 14 cases of retinal vein occlusion (RVO) were identified among patients diagnosed with COVID-19. Half of the patients with RAO or RVO revealed no systemic disorders except current or past COVID-19, and ocular symptoms were the initial presentation in five cases. Among patients with RAO, most presented with central RAO at 1–14 days of COVID-19 diagnosis, with abnormal coagulation and inflammatory markers. Among those with RVO, two-thirds presented with central RVO and one-third with RVO. Eleven cases with acute macular neuroretinopathy (AMN) and/or paracentral acute middle maculopathy (PAMM) were reported among patients with COVID-19, presenting scotoma resolved spontaneously in most cases. Among the 26 cases vaccinated with either mRNA or adenoviral vector vaccines for COVID-19 and presenting retinal vascular occlusions, there were more RVO cases than RAO cases, and ocular symptoms mostly occurred within 3 weeks after vaccination. One case presented bilateral AMN and PAMM after COVID-19 vaccination. Conclusion Retinal vascular occlusions might be a manifestation of COVID-19, although rare, especially in patients at risk of systemic hypercoagulability and thromboembolism. For COVID-19 vaccines, the causal relationship is controversial because there are few case reports of retinal vascular occlusions after COVID-19 vaccination.

To compare the refractive outcomes after cataract surgery between patients with and without pseudoexfoliation, and to evaluate the risk factors of refractive error. Methods:Retrospective review of 210 eyes with pseudoexfoliation (study group) and 510 normal eyes (control) that underwent uneventful phacoemulsification with intraocular lens implantation. The study group included pseudoexfoliation syndrome (PXS) and pseudoexfoliation glaucoma (PXG) subgroups. The main outcome measure was refractive error, defined as the difference between the target refraction and postoperative refraction in diopter (D). A refractive error >± 1.0 D was identified as a large-magnitude refractive error. The frequency of the large-magnitude refractive error was compared between study and control groups, and also between each subgroups and normal eyes. The factors influencing refractive error were analyzed by logistic regression.Results: There was a significantly higher frequency of a refractive error >± 1.0D and hyperopic error >1.0 D in the study group than in the control group (p=0.001, p=0.003; respectively). In the multivariate logistic regression analysis, PXG and poor preoperative visual acuity were related with a large-magnitude refractive error (p=0.001 and p=0.02, respectively) Refractive error >± 1.0 D and hyperopic error >1.0 D were noted more often in PXG eyes that had an intraocular pressure (IOP) spike >25 mmHg at postoperative first 24 hours (p=0.01, p=0.03; respectively). Conclusions:The eyes with pseudoexfoliation were at high risk for refractive error, especially in the presence of glaucoma. In PXG, the only significant risk factor for refractive error was observed to be the presence of an IOP spike.

Background To investigate the safety of vitrectomy with laser photocoagulation in eyes with small peripheral retinal breaks without air or gas tamponade. Methods Among patients who underwent vitrectomy for various retinal disorders, those with small peripheral retinal breaks treated by laser photocoagulation without air or gas tamponade were included in this study. Their medical records were assessed retrospectively, and we investigated the characteristics of small peripheral retinal breaks and the incidence of postoperative retinal detachment (RD). Results Thirty-one eyes of 31 patients who presented with small peripheral retinal breaks requiring endolaser photocoagulation during vitrectomy were included in this analysis. There were two cases of iatrogenic retinal breaks that occurred during vitrectomy, while others were preexisting lesions, including retinal tears, atrophic retinal holes, and retinal holes with lattice degeneration. There were no cases of RD during the follow-up period of at least 6 months. Conclusions Adequate laser treatment without gas or air tamponade may be sufficient during vitrectomy in cases with small peripheral retinal breaks without concurrent RD, along with complete removal of vitreoretinal traction.

Purpose: To investigate ocular asymmetry status 5 years after cranioplasty in children with unilateral coronal craniosynostosis.Methods: The medical records of 41 children who underwent cranioplasty at a mean age of 11.7 months were retrospectively reviewed. The cranial vault asymmetry index (CVAI) and the amount of head tilt were measured on images obtained before cranioplasty. Presence of anisometropia, aniso-astigmatism, amblyopia, and strabismus was evaluated at a mean age of 6.8 years. Correlations among the CVAI, direction of synostotic suture and ocular asymmetries were analyzed.Results: Before cranioplasty, the CVAI was 4.5%; 31 of 41 patients (75.6%) exhibited head tilting, which was contralateral to the synostotic suture site in 29 of these patients. At a mean of 5.6 years after cranioplasty, anisometropia of ≥ 1.00 diopters on the spherical equivalent was present in 9 patients (22.0%) and aniso-astigmatism of ≥ 1.00 diopters in 10 patients (24.4%). Amblyopia was in 15 patients (36.6%); the eye contralateral to the synostotic suture was more frequently affected, and anisometropic amblyopia was the most common subtype. Strabismus was present in 28 patients (68.3%); exodeviation and vertical deviation were the most common subtypes. The non-dominant eye was the eye ipsilateral to the synostotic suture in 12 of 13 patients (92.3%) with simulated superior oblique palsy and in 7 of 10 patients (70.0%) with dissociated vertical deviation. In children with CVAI of ≥ 5%, anisometropia was significantly more common than in other children (<i>p</i> = 0.04), but we found no relationship between any other type of ocular asymmetry and a high CVAI.Conclusions: Ocular asymmetries including anisometropia, aniso-astigmatism, amblyopia, and strabismus were observed even 5 years after successful cranioplasty treatment for unilateral coronal craniosynostosis, emphasizing the need for continuous ophthalmic follow-up.

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