Acute abducens nerve palsy following COVID-19 vaccination

Reyes-Capó, Daniela P.; Stevens, Shanlee M.; Cavuoto, Kara M.

doi:10.1016/j.jaapos.2021.05.003

Cited by 79 publications

(64 citation statements)

References 10 publications

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“…[105][106][107] Acute macular neuroretinopathy has been reported following the ChAdOx1 nCoV-19 vaccination, 108,109 and CNVI palsy has been reported 2 days after BNT162b2 mRNA vaccine (Pfizer), which resolved after 3 months. 110 Fan et al reported a case of branched retinal artery occlusion with features of paracentral acute middle maculopathy in a pediatric patient after BNT162b2 vaccination (personal communication). As of May 2021, the Royal College of Ophthalmology has issued a safety alert soliciting reports of vaccine-related retinal vascular occlusions due to an increased incidence of central venous sinus thrombosis and other anecdotal reports of RVO after vaccination.…”

Section: Potential Systemic and Ocular Side Effectsmentioning

confidence: 99%

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Leung¹,

Fan²,

Flynn³

et al. 2022

OPTH

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There is increasing information available about the effects of the SARS-CoV-2 virus on the systemic and ocular health of patients, as well as the effects of delayed health care. This mini-review summarizes the potential complications and treatments of COVID-19. Systemic findings include respiratory illness, risk of thromboembolic events, and neurologic findings. Some patients may develop persistent symptoms even after the infection resolves. Effective treatment options include glucocorticoids, antivirals, interleukin-6 antagonists, monoclonal antibodies, Janus kinase inhibitors and vaccines. Potential ocular findings of COVID-19 include conjunctivitis, cranial nerve palsies, and microvascular changes in the retina; most symptoms resolved over time. During the lockdown periods, teleophthalmology was utilized to triage non-urgent issues; patients who did present to emergency departments tended to have more severe disease with worse visual prognoses. While transient delays in outpatient ophthalmic care may be tolerated in some patients, others experienced significant vision loss with interruptions in treatments. Resumption of ophthalmic care as soon as possible may help mitigate the effects of delayed care due to the pandemic.

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Section: Potential Systemic and Ocular Side Effectsmentioning

confidence: 99%

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Leung¹,

Fan²,

Flynn³

et al. 2022

OPTH

View full text Add to dashboard Cite

show abstract

“…Similarly, antibodies against spike proteins and activated Th1 cells can cross-react with proteins and antigens in the outer retinal layers, retinal pigment epithelial cells, and large arteries, which may induce AZOOR and AAION [26]. Other possible effects induced by mRNA vaccines include microangiopathy, localized vasculitis, and demyelination, which cause the presence of eyelid purpuric and ecchymotic lesions and abducens nerve palsy [11,30].…”

Section: Mrna Vaccinesmentioning

confidence: 99%

“…MRI of the brain and orbit was unremarkable. The patient was diagnosed with right abducens nerve palsy [30].…”

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confidence: 99%

Ocular Manifestations after Receiving COVID-19 Vaccine: A Systematic Review

Lee

Huang

2021

Vaccines

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The coronavirus disease 2019 (COVID-19) pandemic has had profound and lasting consequences since 2019. Although vaccines against COVID-19 have been developed and approved under emergency use authorization, various adverse events have also been reported after COVID-19 vaccination. This review was undertaken to help clinicians recognize the possible manifestations and systemic pathogenesis, especially those related to the eye, after receiving COVID-19 vaccination. A systemic search was performed on 22 August 2021 through Embase, Medline, and Cochrane Library for publications on ocular manifestations after COVID-19 vaccination. Two case-control studies/retrospective cohort studies, one cross-sectional study, three case series, sixteen case reports, two images, and seven letters were included. Ocular manifestations after receiving COVID-19 vaccines may appear on the eyelid, cornea and ocular surface, retina, uvea, nerve, and vessel. The ocular manifestations occurred up to forty-two days after vaccination, and vaccine-induced immunologic responses may be responsible. Although the incidence rate of ocular symptoms is considerably lower in the vaccinated subjects than in COVID-19 patients, physicians should be aware of the possible associations between COVID-19 vaccines and ocular symptoms for the early diagnosis and treatment of vision problems or life-threatening complications.

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“…A healthy female who received the BNT162b2 vaccine and presented with isolated abducens nerve palsy 2 days post-vaccination was reported [ 54 ]. No details on the persistence of the palsy were provided in the report.…”

Section: Covid-19 Vaccine-associated Ocular Inflammationmentioning

confidence: 99%

The Eye of the Storm: COVID-19 Vaccination and the Eye

Betzler

Ng³

et al. 2021

Ophthalmol Ther

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The COVID-19 pandemic has galvanized the global response towards the development of new vaccines based on novel technologies at an unprecedented pace. Since the widespread implementation of vaccination campaigns, case reports on vaccines' systemic side effects, including ocular manifestations, have emerged. Since administered vaccines are generally not able to cause the disease in the recipient, or induce an immune response against the pathogen, we hypothesize that the development of ocular phenomena post-COVID-19 vaccination may occur via an immune response elicited by the vaccine. Of many, the most common ocular adverse events include facial nerve palsy, central venous sinus thrombosis and acute anterior uveitis. These COVID-19 vaccine-induced ocular (CVIO) adverse events could resemble the ocular findings in some of the COVID-19 patients. This review will provide a comprehensive overview of published ocular side effects potentially associated with COVID-19 vaccination and serve as a springboard for further research into CVIO adverse events.

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Acute abducens nerve palsy following COVID-19 vaccination

Cited by 79 publications

References 10 publications

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Ocular Manifestations after Receiving COVID-19 Vaccine: A Systematic Review

The Eye of the Storm: COVID-19 Vaccination and the Eye

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