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

COVID-19, post-acute COVID-19 syndrome (PACS, “long COVID”) and post-COVID-19 vaccination syndrome (PCVS, “post-COVIDvac-syndrome”): Similarities and differences

“…In case of COVID-19 vaccination, vaccine-induced immune thrombotic thrombocytopenia (VITT), which can lead to cerebral venous sinus thrombosis, has been found to be particularly associated with the adenovirus vector-based COVID-19 vaccines [234] , [235] , [236] , [237] , [238] , [239] , [240] , [241] , [242] . Another example are retinal artery/vein occlusions induced by SARS-CoV-2 infection [243] , [244] , [245] , [246] , [247] , [248] , [249] , [250] , [251] , [252] , [253] , [254] , [255] , [256] , [257] , [258] , [259] , [260] , [261] , [262] and COVID-19 vaccination [263] , [264] , [265] , [266] , [267] , [268] , [269] , [270] , [271] , [272] , [273] , [274] , [275] , [276] , [277] , [278] , [279] , [280] , [281] , [282] , [283] , [284] , [285] , [286] , [287] , [288] , [289] , [290] , [291] , [292] , which can thus can be considered part of the symptoms of COVID-19 and PCVS. Noteworthy, induced retinal artery/vein occlusions induced COVID-19 vaccination were found to be “more common than anticipated” [263] .…”

Central retinal vein occlusion post ChAdOx1 nCoV-19 vaccination – can it be explained by the two-hit hypothesis?

“…Although CRVO is not a life-threatening thrombotic phenomenon, it is important for ophthalmologists to be aware of a possible causal and temporal association with COVID-19 vaccination, particularly in young patients with no known systemic risk factors or comorbidities. It is difficult to prove with certainty a direct cause-effect relationship between the vaccination and thrombotic event, as has also been noted in multiple recent reports [ 6 , 7 ]. Further research in patients with a comparable clinical course, including correlation of thrombotic complications with IgG antibody titres post-vaccination, are essential in order to better understand the pathogenesis of such events.…”

“…Though there are case reports and series [ 2 – 7 ] of vascular occlusions occurring post vaccination against SARS-CoV-2, very few patients had a history of prior clinical COVID-19 infection. We report a case of central retinal vein occlusion (CRVO) in a young male, occurring one week post the first dose of ChAdOx1 nCoV-19 vaccination.…”

SARS-CoV-2 Infection, Vaccination, and Neuro-Ophthalmic Complications

“…There have been reports of both retinal vein and/or retinal artery occlusions in patients without classic systemic vascular risk factors ( 8 9 10 11 ).…”

“…There is also a challenge in establishing an outcome, identification of which may be confounded by where care was sought and what expertise was involved. These issues were overcome by using records of a closed medical system to study the temporal association between COVID-19 infection or immunization and retinal vascular occlusion ( 8 , 44 ). For rare outcomes, such as many neuro-ophthalmic diseases, case–control designs are attractive because cases can be identified.…”