Central Retinal Vein Occlusion Following Bnt162b2 (Pfizer-Biontech) Covid-19 Messenger Rna Vaccine

Abstract

Purpose: Coronavirus disease 2019 has had a wide-ranging public health impact, contributing to at least five million deaths globally at the time of this report. Although thromboembolic events following coronavirus disease 2019 vaccination have been an ongoing concern, only a limited number of ophthalmic manifestations have been reported to date.Methods: A detailed history, hypercoagulable workup, best-corrected visual acuity (BCVA), Humphrey visual field, dilated fundus examination, and multimodal imaging including optical coherence tomography, fundus fluorescein angiography, and fundus photography were obtained.Results: A 27-year-old woman was diagnosed with central retinal vein occlusion a few days after her first dose of the BNT162b2 (Pfizer-BioNTech) coronavirus disease 2019 vaccine. Detailed elicitation of her history and a full hypercoagulable workup did not reveal any primary risk factors that could have explained her disease process. After the patient received the second dose, her symptoms deteriorated significantly and worsening peripapillary hemorrhage were seen on dilated fundus examination. The patient was treated with intravitreal injections of ranibizumab and followed closely, which showed improvement in her central retinal vein occlusion.Conclusion: Given the chronology of the patient's condition, it is believed that the central retinal vein occlusion that occurred as a result of the first dose was exacerbated by an intense immunological reaction after the second dose. The severity of this complication, despite its rarity, must be emphasized and weighed in but should not preclude the extensive benefits of vaccination.

Retinal venous occlusion following COVID-19 vaccination: Report of a case after third dose and review of the literature

“…[ 2 ] The predominant complaint in these patients was blurring or diminution of vision, and some patients complained of associated photopsia,[ 3 ] central scotoma,[ 7 ] headache, and tinnitus. [ 8 ] A few patients developed milder symptoms after vaccinations, which they ignored initially until they suffered a gross diminution of vision. [ 3 11 ] Similarly, a few patients initially presented with a relatively milder clinical picture and later developed RVO.…”

“…A 27-year-old female with a history of idiopathic intra-cranial hypertension developed CRVO 10 days after the first dose of the Pfizer-BioNTech vaccine. [ 8 ] There was further deterioration of her visual acuity when she took the second dose of the vaccine. [ 8 ] Worsening of pre-existing RVO with vaccination has been reported after vaccinations.…”

“…[ 8 ] There was further deterioration of her visual acuity when she took the second dose of the vaccine. [ 8 ] Worsening of pre-existing RVO with vaccination has been reported after vaccinations. [ 10 ] Among the patients >40 years, two patients had a history of hypertension, one had diabetes with features of non-proliferative diabetic retinopathy in the eyes, and another patient was a breast cancer survivor with a history of heart disease.…”

“…[ 1 ] There has been an increase in the report of retinal venous occlusion (RVO) following vaccination for COVID-19 in the past 1 year. [ 2 3 4 5 6 7 8 ] Many such associations could be anecdotal, but one should not ignore the cause-and-effect hypothesis associated with these cases. [ 1 ] We report a case of central retinal vein occlusion (CRVO) and reviewed the literature on RVO following COVID-19 vaccination.…”

Retinal artery/vein occlusion complicating SARS-CoV-2 vaccinations

“…The authors did not include several reports published before the 10 th January 2022 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 . It should be explained why these cases were not included in the review.…”