Silva Letícia S C da, Finamor Luciana P S, Andrade Gabriel C, Lima Luiz H, Zett Claudio, Muccioli Cristina, Sarraf Eduardo P, Marinho Paula M, Peruchi Julia, Oliveira Raiza D de L, Giralt Lena, Charcan Ivonne, Fonollosa Alex, Diaz Jose D, Davis Janet L, Nascimento Heloisa, Belfort Rubens
Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, SP, Brazil.
Pontifcia Universidad Católica de Valparaíso, Valparaíso, Chile.
Arq Bras Oftalmol. 2022 Jan 21;85(2):158-165. doi: 10.5935/0004-2749.20220071. eCollection 2022.
The primary purpose of this study was to assess vascular retinal findings temporally related to COVID-19 vaccination. With greater information regarding all possible future adverse events, we hope to understand the real dimension and relevance of what was presented.
Eleven patients with visual complaints after COVID-19 vaccination were enrolled. Data on the following were included: age, sex, vaccine, time of symptom onset, systemic findings, medical history, best-corrected visual acuity, and ocular findings by slit-lamp biomicroscopy as well as multimodal retinal imaging (color fundus, red-free photography, spectral-domain optical coherence tomography, optical coherence tomography angiography, and fluorescein-angiography). Inclusion criteria were the presence of ophthalmologic signs within 30 days after the first or second dose of any COVID-19 vaccine.
Of 11 patients, five had arterial occlusion (45.4%), four had venous occlusion (36.4%), and two (18.2%) had nonspecific vascular alterations suggestive of retinal ischemia such as cotton-wool spots. The mean age was 57 (SD = 16; range: 27-84) years. The mean time of symptoms onset was 10 (SD = 5.4; range: 3-16) days. Nine patients were female (81.8%). Systemic risk factors were observed in 36.4% of patients. Two patients had both neurological and visual symptoms, with arterial occlusion. Overall, 36.4% patients had COVID-19 in the previous year. Seven patients (63.6%) received ChAdOx1 nCoV-19 (AZD1222) vaccine.
Our data suggest that retinal events temporally related to COVID-19 vaccination are possible but are very rare. The relationship of these events with post-COVID-19 vaccination warrants further attention to derive a meaningful conclusion.
本研究的主要目的是评估与新冠病毒疫苗接种在时间上相关的视网膜血管病变情况。随着关于所有可能的未来不良事件的信息增多，我们希望了解所呈现情况的实际规模和相关性。
纳入11例在新冠病毒疫苗接种后出现视觉症状的患者。记录以下数据：年龄、性别、疫苗类型、症状出现时间、全身检查结果、病史、最佳矫正视力，以及通过裂隙灯生物显微镜检查和多模式视网膜成像（彩色眼底照相、无赤光摄影、光谱域光学相干断层扫描、光学相干断层扫描血管造影和荧光素血管造影）获得的眼部检查结果。纳入标准为在接种第一剂或第二剂任何新冠病毒疫苗后30天内出现眼科体征。
11例患者中，5例发生动脉阻塞（45.4%），4例发生静脉阻塞（36.4%），2例（18.2%）出现提示视网膜缺血的非特异性血管改变，如棉絮斑。平均年龄为57岁（标准差 = 16；范围：27 - 84岁）。症状出现的平均时间为10天（标准差 = 5.4；范围：3 - 16天）。9例患者为女性（81.8%）。36.4%的患者存在全身危险因素。2例患者同时出现神经症状和视觉症状，并伴有动脉阻塞。总体而言，36.4%的患者在过去一年感染过新冠病毒。7例患者（63.6%）接种了ChAdOx1 nCoV - 19（AZD1222）疫苗。
我们的数据表明，与新冠病毒疫苗接种在时间上相关的视网膜病变是有可能的，但非常罕见。这些事件与新冠病毒疫苗接种后的关系值得进一步关注，以得出有意义的结论。
