A review of neuro-ophthalmic sequelae following COVID-19 infection and vaccination

Abstract

BackgroundIt has become increasingly clear that the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can affect most organs in the human body, including the neurologic and ophthalmic systems. Vaccination campaigns have been developed at rapid pace around the world to protect the population from the fast-mutating virus. This review seeks to summarise current knowledge of the neuro-ophthalmic manifestations of both COVID-19 infection and vaccination.Evidence acquisitionElectronic searches for published literature were conducted using EMBASE and MEDLINE on the 30th of July 2023. The search strategy comprised of controlled vocabulary and free-text synonyms for the following terms in various combinations: “coronavirus, COVID-19, SARS-CoV-2, 2019-nCoV, vaccination, vaccine, immunisation and neuro-ophthalmology”. No time range limits were set for the literature search. Published English abstracts for articles written in a different language were screened if available.ResultsA total of 54 case reports and case series were selected for use in the final report. 34 articles documenting neuro-ophthalmic manifestations following COVID-19 infection and 20 articles with neuro-ophthalmic complications following COVID-19 vaccination were included, comprising of 79 patients in total. The most commonly occurring condition was optic neuritis, with 25 cases following COVID-19 infection and 27 cases following vaccination against COVID-19.ConclusionsThe various COVID-19 vaccines that are currently available are part of the global effort to protect the most vulnerable of the human population. The incidence of neuro-ophthalmic consequences following infection with COVID-19 is hundred-folds higher and associated with more harrowing systemic effects than vaccination against the virus.

Causal effect of COVID-19 on optic nerve and visual pathway disorders: genetic evidence of lung-brain axis

“…The COVID-19 pandemic has triggered a worldwide health emergency with far-reaching repercussions, surpassing the initial respiratory symptoms to include prolonged neurological complications, often termed ‘long COVID’ ( 1 ). Observational studies have potentially shown that COVID-19 can lead to disorders of optic nerve and visual pathways, including uveitis, optic neuritis, macular degeneration, and retinal vascular diseases ( 2 , 3 ). These conditions may manifest as a variety of symptoms, such as vision loss, visual field defects, reduced sensitivity to light and contrast, as well as alterations in color perception ( 4 ).…”