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International Ophthalmology

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11-07-2023 | COVID-19 Vaccination | Review

Ocular posterior segment complications following COVID-19 vaccination

Authors: Elham Sadeghi, Raziyeh Mahmoudzadeh, Sunir J. Garg, M. Hossein Nowroozzadeh

Published in: International Ophthalmology | Issue 11/2023

Abstract

Background

The SARS-CoV-2 pandemic has had a significant impact on healthcare, including eye care, worldwide. Effective and safe vaccines have been developed using both conventional and novel technologies to combat SARS-CoV-2 infection. While vaccination has been shown to be remarkably effective in reducing the spread and associated morbidity and mortality of COVID-19 disease, there have been reports of complications to the posterior segment of the eye.

Methods

We present a case-based analysis of reported complications of COVID-19 vaccination to the posterior segment of the eye. The study aims to highlight the diversity of possible complications and discuss the plausible involved pathophysiologic mechanisms.

Results

The most significant complications reported were retinal macro or microvascular occlusions, uveitis, and central serous chorioretinopathy. These complications are rare but require prompt diagnosis and management to prevent serious visual morbidity.

Conclusions

Our study highlights the need for ophthalmologists to be aware of possible complications related to COVID-19 vaccination and the importance of prompt diagnosis and management. The findings of this study may help ophthalmologists to better understand and manage these rare complications.

Zenker S, Kock F (2020) The coronavirus pandemic—a critical discussion of a tourism research agenda. Tour Manag 81:104164PubMedPubMedCentralCrossRef

Tregoning JS, Flight KE, Higham SL, Wang Z, Pierce BF (2021) Progress of the COVID-19 vaccine effort: viruses, vaccines and variants versus efficacy, effectiveness and escape. Nat Rev Immunol 21(10):626–636PubMedPubMedCentralCrossRef

Ozonoff A, Nanishi E, Levy O (2021) Bell’s palsy and SARS-CoV-2 vaccines. Lancet Infect Dis 21(4):450–452PubMedPubMedCentralCrossRef

Rallis KI, Ting DSJ, Said DG, Dua HS (2022) Corneal graft rejection following COVID-19 vaccine. Eye 36(6):1319–1320. https://doi.org/10.1038/s41433-021-01671-2CrossRefPubMed

Saraceno JJF et al (2021) Vogt-Koyanagi-Harada syndrome following COVID-19 and ChAdOx1 nCoV-19 (AZD1222) vaccine. Int J Retina Vitreous 7(1):1–7CrossRef

Bayas A et al (2021) Bilateral superior ophthalmic vein thrombosis, ischaemic stroke, and immune thrombocytopenia after ChAdOx1 nCoV-19 vaccination. The Lancet 397(10285):e11CrossRef

Khani E, Entezari-Maleki T (2022) Hypertensive crisis following COVID-19 vaccination

Angeli F, Reboldi G, Trapasso M, Verdecchia P (2022) Hypertension after COVID-19 vaccination. G Ital Cardiol 23(1):10–14. https://doi.org/10.1714/3715.37055CrossRef

Oniszczuk J et al (2021) Scleroderma renal crisis following mRNA vaccination against SARS-CoV-2. Kidney Int 100(4):940PubMedPubMedCentralCrossRef

10.

Paulsen F-O et al (2021) Immune thrombocytopenic purpura after vaccination with COVID-19 vaccine (ChAdOx1 nCov-19). J Am Soc Hematol 138(11):996–999

11.

Park HS et al (2021) Retinal hemorrhage after SARS-CoV-2 vaccination. J Clin Med 10(23):5705PubMedPubMedCentralCrossRef

12.

Merritt LD (2021) Reports of bleeding and thrombocytopenia reported to VAERS after Moderna and Pfizer COVID-19 Vaccinations. J Am Phys Surg 26(2):51–54

13.

Amin MA, Nahin S, Dola TA, Afrin S, Hawlader MDH (2022) Retinal hemorrhage of late post-COVID-19 and post-vaccine-related pathogenic mechanisms: a new challenge for ophthalmologist in COVID era. Clin Case Rep 10(2):e05471PubMedPubMedCentralCrossRef

14.

Mechleb N, Khoueir Z, Assi AJ (2022) Bilateral multifocal central serous retinopathy following mRNA COVID-19 vaccine. J Fr Ophtalmol 45:603–607PubMedPubMedCentralCrossRef

15.

Jamali H, Sadeghi E, Nowroozzadeh MH (2022) Suprachoroidal hemorrhage during phacoemulsification surgery associated with recent COVID-19: a report of two cases, vol 10. Wiley, New York, p e6204

16.

Mechleb N, Khoueir Z, Assi A (2022) Bilateral multifocal central serous retinopathy following mRNA COVID-19 vaccine. J Fr Ophtalmol 45(6):603–607. https://doi.org/10.1016/j.jfo.2022.02.001CrossRefPubMedPubMedCentral

17.

de Bruijn S et al (2021) First report of a de novo iTTP episode associated with an mRNA-based anti-COVID-19 vaccination. J Thromb Haemost 19(8):2014–2018PubMedPubMedCentralCrossRef

18.

Pichi F et al (2021) Association of ocular adverse events with inactivated COVID-19 vaccination in patients in Abu Dhabi. JAMA Ophthalmol 139(10):1131–1135PubMedPubMedCentralCrossRef

19.

Fowler N, Martinez NRM, Pallares BV, Maldonado RS (2021) Acute-onset central serous retinopathy after immunization with COVID-19 mRNA vaccine. Am J Ophthalmol Case Rep 23:101136PubMedPubMedCentralCrossRef

20.

Lee DY, Wu HJ, Cheng KC, Chang YC (2021) Disc edema in one eye and central serous chorioretinopathy in the other eye shortly after AstraZeneca COVID-19 vaccination. Kaohsiung J Med Sci 38:283PubMedPubMedCentralCrossRef

21.

Bolletta E et al (2021) Uveitis and other ocular complications following COVID-19 vaccination. J Clin Med 10(24):5960PubMedPubMedCentralCrossRef

22.

Jampol LM, Tauscher R, Schwarz HP (2021) COVID-19 vaccinations, and subsequent abnormalities in the retina: causation or coincidence? JAMA Ophthalmol 139(10):1135–1136PubMedCrossRef

23.

Girbardt C et al (2021) Retinal vascular events after mRNA and adenoviral-vectored COVID-19 vaccines—a case series. Vaccines 9(11):1349PubMedPubMedCentralCrossRef

24.

Pur DR, Catherine Danielle Bursztyn LL, Iordanous Y (2022) Branch retinal vein occlusion in a healthy young man following mRNA COVID-19 vaccination. Am J Ophthalmol Case Rep 26:101445. https://doi.org/10.1016/j.ajoc.2022.101445CrossRefPubMedPubMedCentral

25.

Kang MS, Kim SY, Kwon HJ (2022) Case report: recanalization of branch retinal artery occlusion due to microthrombi following the first dose of SARS-CoV-2 mRNA vaccination. Front Pharmacol 13:837CrossRef

26.

Abdin AD, Gärtner BC, Seitz B (2022) Central retinal artery occlusion following COVID-19 vaccine administration. Am J Ophthalmol Case Rep 26:101430. https://doi.org/10.1016/j.ajoc.2022.101430CrossRefPubMedPubMedCentral

27.

Peters MC, Cheng SSH, Sharma A, Moloney TP (2022) Retinal vein occlusion following COVID-19 vaccination. Clin Exp Ophthalmol 50(4):459–461. https://doi.org/10.1111/ceo.14056CrossRefPubMed

28.

Ikegami Y et al (2022) Combined central retinal artery and vein occlusion shortly after mRNA-SARS-CoV-2 vaccination. QJM 114(12):884–885. https://doi.org/10.1093/qjmed/hcab287CrossRefPubMed

29.

Lee S, Sankhala KK, Bose S, Gallemore RP (2022) Combined central retinal artery and vein occlusion with ischemic optic neuropathy after COVID-19 vaccination. Int Med Case Rep J 157:7–14CrossRef

30.

Invernizzi A et al (2020) Retinal findings in patients with COVID-19: results from the SERPICO-19 study. EClin Med 27:100550

31.

Da Silva LS et al (2022) Vascular retinal findings after COVID-19 vaccination in 11 cases: a coincidence or consequence? Arq Bras Oftalmol 85:158–165PubMedCrossRef

32.

Valenzuela DA, Groth S, Taubenslag KJ, Gangaputra S (2021) Acute macular neuroretinopathy following Pfizer-BioNTech COVID-19 vaccination. Am J Ophthalmol Case Rep 24:101200. https://doi.org/10.1016/j.ajoc.2021.101200CrossRefPubMedPubMedCentral

33.

Azar G et al (2021) Did the COVID-19 pandemic increase the incidence of acute macular neuroretinopathy? J Clin Med 10(21):5038PubMedPubMedCentralCrossRef

34.

Mambretti M et al (2021) Acute macular neuroretinopathy following coronavirus disease 2019 vaccination. Ocul Immunol Inflamm 29(4):730–733PubMedCrossRef

35.

Drüke D, Pleyer U, Hoerauf H, Feltgen N, Bemme S (2021) Acute macular neuroretinopathy (AMN) following COVID-19 vaccination. Am J Ophthalmol Case Rep 24:101207PubMedPubMedCentralCrossRef

36.

Goyal M, Murthy SI, Annum S (2021) Retinal manifestations in patients following COVID-19 infection: a consecutive case series. Indian J Ophthalmol 69(5):1275PubMedPubMedCentralCrossRef

37.

Scharf J, Freund KB, Sadda S, Sarraf DJ (2021) Sarraf DJ (2021) Paracentral acute middle maculopathy and the organization of the retinal capillary plexuses. Prog Retin Eye Res 81:100884PubMedCrossRef

38.

Vinzamuri S, Pradeep TG, Kotian RJ (2021) Bilateral paracentral acute middle maculopathy and acute macular neuroretinopathy following COVID-19 vaccination. Indian J Ophthalmol 69(10):2862PubMedPubMedCentralCrossRef

39.

Maleki A, Look-Why S, Manhapra A, Foster CS (2021) Research v. COVID-19 recombinant mRNA vaccines and serious ocular inflammatory side effects: Real or coincidence? J Ophthalmic Vis Res 16(3):490PubMedPubMedCentral

40.

Testi I, Brandão-de-Resende C, Agrawal R, Pavesio CJ (2022) Ocular inflammatory events following COVID-19 vaccination: a multinational case series. J Ophthalmic Inflamm Infect 12(1):1–6CrossRef

41.

Mishra SB, Mahendradas P, Kawali A, Sanjay S, Shetty R (2021) Reactivation of varicella zoster infection presenting as acute retinal necrosis post COVID 19 vaccination in an Asian Indian male. Eur J Ophthalmol 33(1):NP32–NP36. https://doi.org/10.1177/11206721211046485

42.

Rabinovitch T et al (2021) Uveitis after the BNT162b2 mRNA vaccination against SARS-CoV-2 infection: a possible association. Retina 41(12):2462–2471PubMedCrossRef

43.

Tomishige KS, Novais EA, Finamor LP, Nascimento HM, Belfort R Jr (2022) Multiple evanescent white dot syndrome (MEWDS) following inactivated COVID-19 vaccination (Sinovac-CoronaVac). Arq Bras Oftalmol 85:186–189PubMedCrossRef

44.

Atas F, Kaya M, Saatci AO (2021) Acute multifocal placoid pigment epitheliopathy-like presentation following the first dose of BNT162B2 COVID-19 vaccination. Ocul Immunol Inflamm 31:220–223PubMedCrossRef

45.

Chen X, Wang B, Li X (2022) Acute-onset Vogt–Koyanagi–Harada like uveitis following COVID-19 inactivated virus vaccination. Am J Ophthalmol Case Rep 26:101404PubMedPubMedCentralCrossRef

46.

Murtaza F, Pereira A, Mandelcorn MS, Kaplan AJ (2022) Vogt–Koyanagi–Harada disease following influenza vaccination. Am J Ophthalmol Case Rep 26:101516. https://doi.org/10.1016/j.ajoc.2022.101516CrossRefPubMedPubMedCentral

47.

Campos WR, Cenachi SPF, Soares MS, Goncalves PF, Vasconcelos-Santos DV (2021) Vogt–Koyanagi–Harada-like disease following yellow fever vaccination. Ocul Immunol Inflamm 29(1):124–127. https://doi.org/10.1080/09273948.2019.1661498CrossRefPubMed

48.

Sood AB, O’Keefe G, Bui D, Jain N (2019) Vogt–Koyanagi–Harada disease associated with hepatitis B vaccination. Ocul Immunol Inflamm 27(4):524–527. https://doi.org/10.1080/09273948.2018.1483520CrossRefPubMed

49.

Shariati MM et al (2022) Uveitis including Vogt–Koyanagi–Harada syndrome following inactive covid-19 vaccination: a case series. J Ophthalmic Inflamm Infect 13:1–8

50.

Koong LR et al (2021) Vogt-Koyanagi-Harada disease associated with COVID-19 mRNA vaccine. Ocul Immunol Inflamm 29(6):1212–1215PubMedCrossRef

51.

Reddy Y, Pandey A, Ojha A, Ramchandani S (2022) Harada-like syndrome post-Covishield vaccination: a rare adverse effect. Indian J Ophthalmol 70(1):321PubMedCrossRef

52.

Kim SY, Kang MS, Kwon HJ (2022) Bilateral panuveitis mimicking Vogt–Koyanagi–Harada disease following the first dose of ChAdOx1 nCoV-19 vaccine. Ocul Immunol Inflamm 30:1–4CrossRef

53.

Ishay Y et al (2021) Autoimmune phenomena following SARS-CoV-2 vaccination. Int Immunopharmacol 99:107970PubMedPubMedCentralCrossRef

54.

Mudie LI, Zick JD, Dacey MS, Palestine AG (2021) Panuveitis following vaccination for COVID-19. Ocul Immunol Inflamm 29(4):741–742PubMedCrossRef

55.

Lee BA et al (2022) Presumed panuveitis following COVID-19 vaccination in a patient with granulomatous tattoo inflammation. Ret Cases Brief Rep. https://doi.org/10.1097/ICB.0000000000001248

56.

Khochtali S et al (2021) Multimodal imaging of acute foveolitis following COVID-19 vaccination. Ocul Immunol Inflamm 30(5):1214–1217PubMedCrossRef

57.

Hasegawa T, Sannomiya Y, Toyoda M, Maruko I, Iida T (2022) Acute idiopathic maculopathy after COVID-19 vaccination. Am J Ophthalmol Case Rep 26:101479. https://doi.org/10.1016/j.ajoc.2022.101479CrossRefPubMedPubMedCentral

58.

Goyal M, Murthy SI, Annum S (2021) Bilateral multifocal choroiditis following COVID-19 vaccination. Ocul Immunol Inflamm 29(4):753–757PubMedCrossRef

59.

Younus O, Mulla U (2022) Posterior scleritis following COVID-19 vaccination: a case report. Ocul Immunol Inflamm 31:1–3

60.

Chen PJ, Chang YS, Lim CC, Lee YK (2022) Susac syndrome following COVID-19 vaccination: a case report. Vaccines. https://doi.org/10.3390/vaccines10030363CrossRefPubMedPubMedCentral

61.

Papasavvas I, Herbort CP (2021) Reactivation of Vogt–Koyanagi–Harada disease under control for more than 6 years, following anti-SARS-CoV-2 vaccination. J Ophthalmic Inflamm Infect 11(1):1–6CrossRef

62.

Xu Y, Shen W (2021) Presumed recurrent MEWDS following Covid-19 vaccination. Ocul Immunol Inflamm 29(6):1234–1237. https://doi.org/10.1080/09273948.2021.1985524CrossRefPubMed

63.

Pang K, Pan L, Guo H, Wu X (2022) Case report: associated ocular adverse reactions with inactivated COVID-19 vaccine in China. Front Med 8:823346CrossRef

64.

Achiron A, Tuuminen R (2022) Severe panuveitis with iridis rubeosis activation and cystoid macular edema after BioNTech-Pfizer COVID-19 vaccination in a 17-year-old. Am J Ophthalmol Case Rep 25:101380PubMedPubMedCentralCrossRef

Title: Ocular posterior segment complications following COVID-19 vaccination
Authors: Elham Sadeghi
Raziyeh Mahmoudzadeh
Sunir J. Garg
M. Hossein Nowroozzadeh
Publication date: 11-07-2023
Publisher: Springer Netherlands
Keywords: COVID-19 Vaccination
Uveitis
Vaccination
COVID-19
Published in: International Ophthalmology / Issue 11/2023
Print ISSN: 0165-5701
Electronic ISSN: 1573-2630
DOI: https://doi.org/10.1007/s10792-023-02795-y

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Ocular posterior segment complications following COVID-19 vaccination

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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