Non-arteritic anterior ischaemic optic neuropathy (NA-AION) and COVID-19 vaccination

Abstract

A woman in her 50s presented with diminution of vision in her left eye (OS) 4 days after COVISHIELDTM vaccination. She had been diagnosed with non-arteritic anterior ischaemic optic neuropathy (NA-AION) of right eye (OD) 8 months earlier. The present episode revealed a best-corrected visual acuity (BCVA) of 20/50 in OD and 20/20 in OS with grade 1 relative afferent pupillary defect. Fundus evaluation showed pale disc in OD and temporal disc oedema in OS. Humphrey’s visual field analysis showed incomplete inferior altitudinal defect in OD and a centro-caecal scotoma in OS. Systemic investigations were normal. OS was diagnosed with NA-AION. She was started on oral aspirin 75 mg. At 1-month follow-up, disc oedema of OS had resolved with BCVA maintaining at 20/20. The patient was lost to follow-up later. The relationship between the vaccine and the ocular event is temporal with no causal association.

Three Cases of Arteritic Anterior Optic Neuropathy Several Months after COVID-19 Vaccination

“…It has also been reported that after COVID-19 vaccination, platelets are activated, the coagulation system is markedly stimulated, and serious thromboembolic complications may be triggered [ 6 , 7 , 19 ], which may have been the cause of retinal artery occlusion in the first case. After COVID-19 vaccination, neutralising antibody levels reached a maximum at approximately two weeks and then declined.…”

“…AAION accounts for 5-10% of all anterior ischaemic optic neuropathies but is very rare in Japan [2,3]. Many vaccines have been approved worldwide to control the coronavirus disease-19 (COVID- 19) pandemic. In Japan, the Pfizer and Moderna vaccines are mainly used, and vaccination is recommended.…”

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

“…Optic neuropathy is suspected as one of adverse events of the COVID-19 vaccine, which includes ON associated with or without demyelinating CNS diseases [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], NA-AION [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], and NMOSD [ 8 , 9 ]. Lotan et al reviewed 14 case reports and 2 case series by electronic searches of the published literature regarding neuro-ophthalmological complications of COVID-19 vaccines and reported that optic neuritis was the most common, occurring in 61 of 76 cases (80.3%) [ 25 ].…”

Unilateral recurrent central serous chorioretinopathy (CSCR) following COVID-19 vaccination- A multimodal imaging study

“…Ocular adverse effects observed following administration of COVID-19 vaccines include episcleritis, scleritis, anterior uveitis, acute macular neuroretinopathy, paracentral acute middle maculopathy, central serous chorioretinopathy (CSCR), ophthalmic vein thrombosis, Vogt-Koyanagi-Harada disease (VKH), acute zonal occult outer retinopathy (AZOOR), multifocal choroiditis, arteritic anterior ischemic optic neuropathy (AAION), non- arteritic anterior ischemic optic neuropathy (NA-AION), Graves disease, cranial nerve palsies like facial or abducens nerve palsies, acute zoster ophthalmicus (HZO), acute retinal necrosis and multiple evanescent white dot syndrome(MEWDS). 10 , 11 , 12 , 13 , 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 …”