Retinal vascular occlusions in COVID-19 infection and vaccination: a literature review

Yeo, Suji; Kim, Hanju; Lee, Jiwon; Yi, Jeonghyun; Younghae, Chung

doi:10.1007/s00417-022-05953-7

Cited by 31 publications

(29 citation statements)

References 84 publications

(135 reference statements)

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“…Some research shows reduced vascular density in both superficial and deep capillary plexuses (DCP) at foveal and parafoveal levels among patients with COVID-19, whereas other studies find these changes mainly in peripheral areas. Some research also shows an enlarged foveal avascular zone and increased choroidal capillary plexus blood flow, likely due to hypoxia and inflammation-induced vasodilation 48 …”

Section: Vitreoretinal Manifestations Of Coronavirus Disease 2019mentioning

confidence: 99%

“…This condition may arise from inflammation, viral damage to endothelial cells, and a cytokine-induced prothrombotic state. Interestingly, 36%–50% of COVID-19–related retinal vein occlusion (RVO) cases had no other health issues, and their average age was 39, younger than prepandemic RVO cases 48 . In 75% of retinal artery occlusion cases, patients displayed no notable abnormalities on the brain or Doppler sonography of the carotid artery.…”

Section: Vitreoretinal Manifestations Of Coronavirus Disease 2019mentioning

confidence: 99%

“…In 75% of retinal artery occlusion cases, patients displayed no notable abnormalities on the brain or Doppler sonography of the carotid artery. However, some exhibited vascular complications, such as carotid occlusions, cavernous sinus thrombosis, and simultaneous strokes 48 . Most RVO cases were nonischemic central RVO, often complicated by macular edema.…”

Section: Vitreoretinal Manifestations Of Coronavirus Disease 2019mentioning

confidence: 99%

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Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

Lin,

Sen,

Gupta

et al. 2023

Asia-Pacific Journal of Ophthalmology

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The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 was one of the most devastating public health issues in recent decades. The ophthalmology community is as concerned about the COVID-19 pandemic as the global public health community is, as COVID-19 was recognized to affect multiple organs in the human body, including the eyes, early in the course of the outbreak. Ophthalmic manifestations of COVID-19 are highly variable and could range from mild ocular surface abnormalities to potentially sight and life-threatening orbital and neuro-ophthalmic diseases. Furthermore, ophthalmic manifestations may also be the presenting or the only findings in COVID-19 infections. Meanwhile, global vaccination campaigns to attain herd immunity in different populations are the major strategy to mitigate the pandemic. As novel vaccinations against COVID-19 emerged, so were reports on adverse ophthalmic reactions potentially related to such. As the world enters a post-pandemic state where COVID-19 continues to exist and evolve as an endemic globally, the ophthalmology community ought to be aware of and keep abreast of the latest knowledge of ophthalmic associations with COVID-19 and its vaccinations. This review is a summary of the latest literature on the ophthalmic manifestations of COVID-19 and the adverse ophthalmic reactions related to its vaccinations.

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Section: Vitreoretinal Manifestations Of Coronavirus Disease 2019mentioning

confidence: 99%

Section: Vitreoretinal Manifestations Of Coronavirus Disease 2019mentioning

confidence: 99%

Section: Vitreoretinal Manifestations Of Coronavirus Disease 2019mentioning

confidence: 99%

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Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

Lin,

Sen,

Gupta

et al. 2023

Asia-Pacific Journal of Ophthalmology

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“…Acute respiratory syndrome coronavirus 2 (SARS-CoV-2) affects various parts of the eye [5][6][7][8] . AMN has been reported to be associated with SARS-CoV-2 in the literatures [9][10] . Recently, with the increasing number of patients infected with SARS-CoV-2, we reviewed forthteen patients infected with SARS-CoV-2 combined with AMN and took multimodal images for observation, in order to provide more data for clinical management of infection with SARS-CoV-2 combined with AMN.…”

Section: Introductionmentioning

confidence: 99%

Clinical and multimodal imaging features of acute macular neuroretinopathy lesions following recent SARS-CoV-2 infection

Liu¹,

Wang²,

Chen³

2023

Int J Ophthalmol

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AIM: To describe the clinical characteristics of eyes using multimodal imaging features with acute macular neuroretinopathy (AMN) lesions following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. METHODS: Retrospective case series study. From December 18, 2022 to February 14, 2023, previously healthy cases within 1-week infection with SARS-CoV-2 and examined at Tianjin Eye Hospital to confirm the diagnosis of AMN were included in the study. Totally 5 males and 9 females [mean age: 29.93±10.32 (16-49)y] were presented for reduced vision, with or without blurred vision. All patients underwent best corrected visual acuity (BCVA), intraocular pressure, slit lamp microscopy, indirect fundoscopy. Simultaneously, multimodal imagings fundus photography (45° or 200° field of view) was performed in 7 cases (14 eyes). Near infrared (NIR) fundus photography was performed in 9 cases (18 eyes), optical coherence tomography (OCT) in 5 cases (10 eyes), optical coherence tomography angiography (OCTA) in 9 cases (18 eyes), and fundus fluorescence angiography (FFA) in 3 cases (6 eyes). Visual field was performed in 1 case (2 eyes). RESULTS: Multimodal imaging findings data from 14 patients with AMN were reviewed. All eyes demonstrated different extent hyperreflective lesions at the level of the inner nuclear layer and/or outer plexus layer on OCT or OCTA. Fundus photography (45° or 200° field of view) showed irregular hypo-reflective lesion around the fovea in 7 cases (14 eyes). OCTA demonstrated that the superficial retinal capillary plexus (SCP) vascular density, deep capillary plexus (DCP) vascular density and choriocapillaris (CC) vascular density was reduced in 9 case (18 eyes). Among the follow-up cases (2 cases), vascular density increased in 1 case with elevated BCVA; another case has vascular density decrease in one eye and basically unchanged in other eye. En face images of the ellipsoidal zone and interdigitation zone injury showed a low wedge-shaped reflection contour appearance. NIR image mainly show the absence of the outer retinal interdigitation zone in AMN. No abnormal fluorescence was observed in FFA. Corresponding partial defect of the visual field were visualized via perimeter in one case. CONCLUSION: The morbidity of SARS-CoV-2 infection with AMN is increased. Ophthalmologists should be aware of the possible, albeit rare, AMN after SARS-CoV-2 infection and focus on multimodal imaging features. OCT, OCTA, and infrared fundus phase are proved to be valuable tools for detection of AMN in patients with SARS-CoV-2.

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“…Also, several studies have reported RVO after the second dose or booster of the mRNA COVID-19 vaccination, while other reports of vaccine-related occlusion of the central retinal artery/vein have presented no difference between the first and second dose of the COVID-19 vaccination . Dorney et al reported a higher risk of RVO after the first dose of the mRNA COVID-19 vaccination compared with the second dose.…”

mentioning

confidence: 98%

Risk of New Retinal Vascular Occlusion After Messenger RNA COVID-19 Vaccination Within Aggregated Electronic Health Record Data

Chen,

Wei

2023

JAMA Ophthalmol

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To the Editor We have several comments regarding the article by Dorney et al. 1 First, the study investigated the potential link between messenger RNA (mRNA) COVID-19 vaccination and the risk of retinal vein occlusion (RVO) through a retrospective cohort design involving 4 cohort groups.Of note, group 3 and group 4 were queried for influenza vaccine and the tetanus, diphtheria, and pertussis vaccine between 2018 to 2019, while group 1 and group 2 were queried for COVID-19 vaccination between 2020 and 2022. These different times could represent a confounding factor that might be addressed if the authors 1 could confirm their findings with alternative designs, such as a self-controlled case series or an analysis of time-varying covariates using a Cox model to try to minimize time bias. 2,3 Also, several studies have reported RVO after the second dose or booster of the mRNA COVID-19 vaccination, 4,5 while other reports of vaccine-related occlusion of the central retinal artery/vein have presented no difference between the first and second dose of the COVID-19 vaccination. 2,3 Dorney et al 1 reported a higher risk of RVO after the first dose of the mRNA COVID-19 vaccination compared with the second dose. This potential inconsistency with previous studies can weaken confidence in their conclusions.In addition, the authors 1 have presumed a hyperviscous state related to RVO after the first dose of a COVID-19 vaccination. However, other studies have not shown hypercoagulable status after receiving mRNA COVID-19 vaccination. Hence, it might be better to match and adjust coagulation parameters at baseline.Lastly, the study does not appear to have distinguished between symptomatic and asymptomatic SARS-CoV-2 infections, which again could contribute to confounding factors. Perhaps individuals with a positive history of a polymerase chain reaction test positive for SARS-CoV-2 based on ICD-10 International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes should be excluded. The authors 1 are to be congratulated for their investigations and perhaps clarifying these weaknesses could improve the study and strengthen the conclusion.

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Retinal vascular occlusions in COVID-19 infection and vaccination: a literature review

Cited by 31 publications

References 84 publications

Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

Clinical and multimodal imaging features of acute macular neuroretinopathy lesions following recent SARS-CoV-2 infection

Risk of New Retinal Vascular Occlusion After Messenger RNA COVID-19 Vaccination Within Aggregated Electronic Health Record Data

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