Vision-Threatening Ocular Adverse Events after Vaccination against Coronavirus Disease 2019

Abstract

A single-center retrospective observational case series was conducted. This case series enrolled patients who showed ophthalmic manifestations within one week after COVID-19 vaccination at Korea University Guro Hospital in Seoul, Korea, from May 2021 to January 2022. The medical records of patients who complained of ocular symptoms and showed ophthalmic adverse events within one week after COVID-19 vaccination were reviewed. Seventeen eyes from 16 patients with a mean age of 63.8 (range 33–83) years were included in the case series, and all symptoms developed within 1–7 days following inoculation. Retinal vein occlusion in nine eyes (52.9%), retinal artery occlusion in one eye (5.9%), newly developed anterior uveitis in one eye (5.9%), exacerbation of previously diagnosed panuveitis in two eyes (11.8%), and angle-closure attack with high intraocular pressure in four eyes (23.5%) were included. Twelve patients (75%) had been vaccinated with the AstraZeneca (AZD1222) and four (25%) with the Pfizer (BNT162b2) vaccines. Of these, 10 patients (62.5%) experienced ocular disease exacerbation after the first dose, 4 (25%) after the second dose, and 2 (12.5%) after the third dose (booster shot). Eleven patients (64.7%) underwent tests for hematological abnormalities, and three of them tested positive for anti-PF4 antibodies, but no abnormal findings were noted. A causal relationship between vaccination and the ocular manifestations could not be determined, which is a limitation of this study. However, clinicians should consider the effect of COVID-19 vaccination on ophthalmic disease. Further studies are required to elucidate the possible effects of COVID-19 vaccination on the eye.

Shot in the dark

“…Ten of the 16 patients developed ocular side effects following administration of an initial vaccine dose. 7 …”

Retinal Vascular Occlusion after COVID-19 Vaccination: More Coincidence than Causal Relationship? Data from a Retrospective Multicentre Study

“…However, it cannot be ruled out that late-onset side effects may also occur after vaccination. While several case series suggested a causal mechanism between RVOD and COVID-19 vaccination [ 3 , 4 , 20 , 21 , 22 ], the mechanisms behind it are not understood and highly speculative. Our data, however, failed to indicate any relationship between COVID-19 vaccination and RVOD incidence.…”

“…A survey among neurologists reported a higher number of cerebral sinus and venous thromboses after SARS-CoV-2 vaccination [ 1 ], while ophthalmological case reports and small case series described numerous complications in the anterior and posterior eye segments [ 2 , 3 , 4 ]. The retinal findings cover uveitis, central serous chorioretinopathy, acute retinal necrosis, and retinal vascular alterations.…”

Glaucoma Cases Following SARS-CoV-2 Vaccination: A VAERS Database Analysis

“…Similar ocular disorders have also been observed in patients infected by the SARS-CoV-2 virus [ 24 , 25 , 26 ]. Recently, Choi and colleagues reported vision-threatening ocular adverse events in sixteen patients following SARS-CoV-2 vaccination [ 27 ]. Among these patients, the authors reported four cases of angle-closure glaucoma following the ChAdOx1 nCoV-19 vaccine and attributed it to the inflammation of the ciliary body due to vaccine-associated uveitis.…”