Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus Vaccination

Purpose: To evaluate the cases of retinal artery occlusion (RAO) and retinal vein occlusion (RVO) after severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease 2019 vaccination. Design: Retrospective study of the cases reported to the Centers for Disease Control and Prevention Vaccine Adv...

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Main Authors: Rohan Bir Singh, MD, Uday Pratap Singh Parmar, MD, Rudraksh Gupta, MD, Antonio Jacobo Vega Garcia, MD, Wonkyung Cho, MD, Kanwar Partap Singh, MD, Aniruddha Agarwal, MD
Format: Article
Language:English
Published: Elsevier 2024-01-01
Series:Ophthalmology Science
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666914523000866
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author Rohan Bir Singh, MD
Uday Pratap Singh Parmar, MD
Rudraksh Gupta, MD
Antonio Jacobo Vega Garcia, MD
Wonkyung Cho, MD
Kanwar Partap Singh, MD
Aniruddha Agarwal, MD
author_facet Rohan Bir Singh, MD
Uday Pratap Singh Parmar, MD
Rudraksh Gupta, MD
Antonio Jacobo Vega Garcia, MD
Wonkyung Cho, MD
Kanwar Partap Singh, MD
Aniruddha Agarwal, MD
author_sort Rohan Bir Singh, MD
collection DOAJ
description Purpose: To evaluate the cases of retinal artery occlusion (RAO) and retinal vein occlusion (RVO) after severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease 2019 vaccination. Design: Retrospective study of the cases reported to the Centers for Disease Control and Prevention Vaccine Adverse Events Reporting System between December 11, 2020 and July 1, 2022. Participants: Patients diagnosed with RVO after vaccination with BNT162b2, mRNA-1273, and Ad26.COV2.S, globally. Methods: We performed a descriptive analysis of the demographics and presentation in patients with RVO. The correlations between the vaccines and continuous and categorical variables were assessed. We performed the post hoc analysis to evaluate the association between RAO, RVO onset postvaccination, and vaccine and dosage. A 30-day reverse Kaplan-Meier analysis was conducted for RAO and RVO onset after vaccination. Main Outcome Measures: The crude reporting rate of RVO after SARS-CoV-2 vaccine. The ocular and systemic presentations, onset duration, and short-term risk of RAO and RVO after vaccination. Results: One thousand three hundred and fifty-one RVO cases were reported globally. The crude reporting rates for BNT162b2, mRNA-1273, and Ad26.COV2.S were 0.36, 0.41, and 0.69, respectively. The majority of the cases were reported after BNT162b2 (n = 606, 74.17%). The mean age of patients with RVO and RAO was 58.54 ± 16.06 years and 64.63 ± 16.16 years, respectively. Most cases of RVO (41.12%) and RAO (48.27%) were reported within the first week. The mean onset interval for RVO was significantly longer in patients who received Ad26.Cov2.S (54.07 ± 88.98 days) compared with BNT162b2 (18.07 ± 28.66 days) and mRNA-1273 (22.85 ± 38.13 days) vaccines (P < 0.0001). This was confirmed by post hoc analysis (P < 0.0001). The reverse Kaplan-Meier 30-day risk analysis showed a significant a higher risk of RVO onset after BNT162b2 compared with other vaccines (P < 0.0001). Conclusions: The low crude reporting rate highlights a low safety concern for RVO after SARS-CoV-2 vaccination. This study provides insights into possible temporal association between reported RVO events with SARS-CoV-2 vaccines; however, further insights are needed to understand the underlying immunopathologic mechanisms that promote thrombosis of retinal vasculature on vaccine administration. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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spelling doaj.art-d8afcbdb114a45749ad47887e95c143f2023-10-17T04:07:26ZengElsevierOphthalmology Science2666-91452024-01-0141100354Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus VaccinationRohan Bir Singh, MD0Uday Pratap Singh Parmar, MD1Rudraksh Gupta, MD2Antonio Jacobo Vega Garcia, MD3Wonkyung Cho, MD4Kanwar Partap Singh, MD5Aniruddha Agarwal, MD6Massachusetts Eye and Ear, Harvard Medical School, Boston, Massachusetts; Department of Ophthalmology, Leiden University Medical Center, Leiden, the Netherlands; Discipline of Ophthalmology and Visual Sciences, Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, AustraliaDepartment of Ophthalmology, Government Medical College and Hospital, Chandigarh, IndiaDiscipline of Ophthalmology and Visual Sciences, Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, AustraliaDiscipline of Ophthalmology and Visual Sciences, Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, AustraliaMassachusetts Eye and Ear, Harvard Medical School, Boston, MassachusettsDepartment of Radiology, Yale School of Medicine, New Haven, ConnecticutEye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates; Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, Ohio; Department of Ophthalmology, Maastricht University Medical Center+, Maastricht, the Netherlands; Correspondence: Aniruddha Agarwal, MD, C-07 249, Eye Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates (UAE).Purpose: To evaluate the cases of retinal artery occlusion (RAO) and retinal vein occlusion (RVO) after severe acute respiratory syndrome coronavirus (SARS-CoV-2) disease 2019 vaccination. Design: Retrospective study of the cases reported to the Centers for Disease Control and Prevention Vaccine Adverse Events Reporting System between December 11, 2020 and July 1, 2022. Participants: Patients diagnosed with RVO after vaccination with BNT162b2, mRNA-1273, and Ad26.COV2.S, globally. Methods: We performed a descriptive analysis of the demographics and presentation in patients with RVO. The correlations between the vaccines and continuous and categorical variables were assessed. We performed the post hoc analysis to evaluate the association between RAO, RVO onset postvaccination, and vaccine and dosage. A 30-day reverse Kaplan-Meier analysis was conducted for RAO and RVO onset after vaccination. Main Outcome Measures: The crude reporting rate of RVO after SARS-CoV-2 vaccine. The ocular and systemic presentations, onset duration, and short-term risk of RAO and RVO after vaccination. Results: One thousand three hundred and fifty-one RVO cases were reported globally. The crude reporting rates for BNT162b2, mRNA-1273, and Ad26.COV2.S were 0.36, 0.41, and 0.69, respectively. The majority of the cases were reported after BNT162b2 (n = 606, 74.17%). The mean age of patients with RVO and RAO was 58.54 ± 16.06 years and 64.63 ± 16.16 years, respectively. Most cases of RVO (41.12%) and RAO (48.27%) were reported within the first week. The mean onset interval for RVO was significantly longer in patients who received Ad26.Cov2.S (54.07 ± 88.98 days) compared with BNT162b2 (18.07 ± 28.66 days) and mRNA-1273 (22.85 ± 38.13 days) vaccines (P < 0.0001). This was confirmed by post hoc analysis (P < 0.0001). The reverse Kaplan-Meier 30-day risk analysis showed a significant a higher risk of RVO onset after BNT162b2 compared with other vaccines (P < 0.0001). Conclusions: The low crude reporting rate highlights a low safety concern for RVO after SARS-CoV-2 vaccination. This study provides insights into possible temporal association between reported RVO events with SARS-CoV-2 vaccines; however, further insights are needed to understand the underlying immunopathologic mechanisms that promote thrombosis of retinal vasculature on vaccine administration. Financial Disclosure(s): The author(s) have no proprietary or commercial interest in any materials discussed in this article.http://www.sciencedirect.com/science/article/pii/S2666914523000866Retinal artery occlusionRetinal vein occlusionRetinal vessel occlusionSARS-CoV-2
spellingShingle Rohan Bir Singh, MD
Uday Pratap Singh Parmar, MD
Rudraksh Gupta, MD
Antonio Jacobo Vega Garcia, MD
Wonkyung Cho, MD
Kanwar Partap Singh, MD
Aniruddha Agarwal, MD
Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus Vaccination
Ophthalmology Science
Retinal artery occlusion
Retinal vein occlusion
Retinal vessel occlusion
SARS-CoV-2
title Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus Vaccination
title_full Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus Vaccination
title_fullStr Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus Vaccination
title_full_unstemmed Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus Vaccination
title_short Retinal Vascular Occlusion after Severe Acute Respiratory Syndrome Coronavirus Vaccination
title_sort retinal vascular occlusion after severe acute respiratory syndrome coronavirus vaccination
topic Retinal artery occlusion
Retinal vein occlusion
Retinal vessel occlusion
SARS-CoV-2
url http://www.sciencedirect.com/science/article/pii/S2666914523000866
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