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. 2022 Aug 30;11(17):5101.
doi: 10.3390/jcm11175101.

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

Nicolas Feltgen  1 , Thomas Ach  2 , Focke Ziemssen  3   4 , Carolin Sophie Quante  5 , Oliver Gross  6 , Alaa Din Abdin  7 , Sabine Aisenbrey  8 , Martin C Bartram  9 , Marcus Blum  10 , Claudia Brockmann  11 , Stefan Dithmar  12 , Wilko Friedrichs  13 , Rainer Guthoff  14 , Lars-Olof Hattenbach  15 , Klaus R Herrlinger  16 , Susanne Kaskel-Paul  17 , Ramin Khoramnia  18 , Julian E Klaas  19 , Tim U Krohne  20 , Albrecht Lommatzsch  21 , Sabine Lueken  22 , Mathias Maier  23 , Lina Nassri  24 , Thien A Nguyen-Dang  25 , Viola Radeck  26 , Saskia Rau  27 , Johann Roider  28 , Dirk Sandner  29 , Laura Schmalenberger  30 , Irene Schmidtmann  31 , Florian Schubert  32 , Helena Siegel  33 , Martin S Spitzer  34 , Andreas Stahl  35 , Julia V Stingl  36 , Felix Treumer  37 , Arne Viestenz  38 , Joachim Wachtlin  39   40 , Armin Wolf  41 , Julian Zimmermann  42 , Marc Schargus  43   44 , Alexander K Schuster  36
Affiliations

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

Nicolas Feltgen et al. J Clin Med. .

Abstract

Background: To investigate whether vaccination against SARS-CoV-2 is associated with the onset of retinal vascular occlusive disease (RVOD).

Methods: In this multicentre study, data from patients with central and branch retinal vein occlusion (CRVO and BRVO), central and branch retinal artery occlusion (CRAO and BRAO), and anterior ischaemic optic neuropathy (AION) were retrospectively collected during a 2-month index period (1 June-31 July 2021) according to a defined protocol. The relation to any previous vaccination was documented for the consecutive case series. Numbers of RVOD and COVID-19 vaccination were investigated in a case-by-case analysis. A case-control study using age- and sex-matched controls from the general population (study participants from the Gutenberg Health Study) and an adjusted conditional logistic regression analysis was conducted.

Results: Four hundred and twenty-one subjects presenting during the index period (61 days) were enrolled: one hundred and twenty-one patients with CRVO, seventy-five with BRVO, fifty-six with CRAO, sixty-five with BRAO, and one hundred and four with AION. Three hundred and thirty-two (78.9%) patients had been vaccinated before the onset of RVOD. The vaccines given were BNT162b2/BioNTech/Pfizer (n = 221), followed by ChadOx1/AstraZeneca (n = 57), mRNA-1273/Moderna (n = 21), and Ad26.COV2.S/Johnson & Johnson (n = 11; unknown n = 22). Our case-control analysis integrating population-based data from the GHS yielded no evidence of an increased risk after COVID-19 vaccination (OR = 0.93; 95% CI: 0.60-1.45, p = 0.75) in connection with a vaccination within a 4-week window.

Conclusions: To date, there has been no evidence of any association between SARS-CoV-2 vaccination and a higher RVOD risk.

Keywords: COVID-19; SARS-CoV-2; anterior ischaemic optic neuropathy; infection; retinal artery occlusion; retinal vein occlusion; vaccination.

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Conflict of interest statement

Please refer to financial disclosures and participating centres in Supplementary Materials.

Figures

Figure 1
Figure 1
Flow chart of the included patients. CRVO = Central Retinal Vein Occlusion; BRVO = Branch Retinal Vein Occlusion; CRAO = Central Retinal Artery Occlusion; BRAO = Branch Retinal Artery Occlusion; AION = Anterior Ischaemic Optic Neuropathy.
Figure 2
Figure 2
Frequency distribution of the time points of symptom onset after vaccination in the RVOD subgroups. CRVO = Central Retinal Vein Occlusion; BRVO = Branch Retinal Vein Occlusion; CRAO = Central Retinal Artery Occlusion; BRAO = Branch Retinal Artery Occlusion; AION = Anterior Ischaemic Optic Neuropathy.
Figure 3
Figure 3
Forest plot of the association analysis between the SARS-CoV-2 vaccination status in subjects with RVOD (4 weeks prior to diagnosis) compared to population-based age- and sex-matched controls from the Gutenberg Health Study. A conditional logistic regression analysis with adjustment for diabetes, obesity, arterial hypertension, smoking, and the use of anticoagulation. CRVO = Central Retinal Vein Occlusion; BRVO = Branch Retinal Vein Occlusion; CRAO = Central Retinal Artery Occlusion; BRAO = Branch Retinal Artery Occlusion; AION = Anterior Ischaemic Optic Neuropathy.
See this image and copyright information in PMC

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