Retinal venous occlusion following COVID-19 vaccination: Report of a case after third dose and review of the literature

Abstract

A 28-year-old, healthy male presented with blurring of vision in the right eye following third dose of the AstraZeneca/COVISHIELD vaccine. Further examination revealed ischemic central retinal vein occlusion, and subsequent laboratory investigations were inconclusive for his eye disease. He responded to pulse corticosteroid and tapering doses of oral corticosteroids without requiring any intra-vitreal injection. Twelve articles were identified with the help of a PubMed literature search, and a short review of these patients was performed. Retinal vein occlusion can occur because of inflammation-induced thrombosis after coronavirus disease 2019 vaccination and may respond to anti-inflammatory therapy.

Keywords: Anti-inflammatory therapy; COVID-19; COVID-19 vaccine; retinal vein occlusion.

Figure 1

Fundus photographs of the right eye (a) At presentation, (b) After pulse corticosteroid (3 days) therapy, and (c) after a month

Figure 2

Fundus fluorescein angiography (FFA) of the right eye showing hypofluorescence with delay in venous filling in the early phase of the angiogram and blocked fluorescence corresponding to areas of hemorrhages

Figure 3

SS-OCT of the right eye (a) At presentation showing macular edema with sub-retinal fluid with a foveal thickness of 823 microns, (b) After 3 days of the pulse corticosteroid (intravenous methylprednisolone 1 gram daily) showing reduction of macular edema with a foveal thickness of 257 microns, and (c) At 1 month follow-up with a foveal thickness of 166 microns