新冠疫苗接种后视网膜血管阻塞：更多是巧合而非因果关系？一项回顾性多中心研究的数据
Retinal Vascular Occlusion after COVID-19 Vaccination: More Coincidence than Causal Relationship? Data from a Retrospective Multicentre Study.
作者信息
Feltgen Nicolas, Ach Thomas, Ziemssen Focke, Quante Carolin Sophie, Gross Oliver, Abdin Alaa Din, Aisenbrey Sabine, Bartram Martin C, Blum Marcus, Brockmann Claudia, Dithmar Stefan, Friedrichs Wilko, Guthoff Rainer, Hattenbach Lars-Olof, Herrlinger Klaus R, Kaskel-Paul Susanne, Khoramnia Ramin, Klaas Julian E, Krohne Tim U, Lommatzsch Albrecht, Lueken Sabine, Maier Mathias, Nassri Lina, Nguyen-Dang Thien A, Radeck Viola, Rau Saskia, Roider Johann, Sandner Dirk, Schmalenberger Laura, Schmidtmann Irene, Schubert Florian, Siegel Helena, Spitzer Martin S, Stahl Andreas, Stingl Julia V, Treumer Felix, Viestenz Arne, Wachtlin Joachim, Wolf Armin, Zimmermann Julian, Schargus Marc, Schuster Alexander K
机构信息
Clinic of Ophthalmology, University Medical Centre Goettingen, 37075 Goettingen, Germany.
Department of Ophthalmology, University Hospital Bonn, 53127 Bonn, Germany.
出版信息
J Clin Med. 2022 Aug 30;11(17):5101. doi: 10.3390/jcm11175101.
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 ( = 221), followed by ChadOx1/AstraZeneca ( = 57), mRNA-1273/Moderna ( = 21), and Ad26.COV2.S/Johnson & Johnson ( = 11; unknown = 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, = 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.
背景
研究接种新型冠状病毒2（SARS-CoV-2）疫苗是否与视网膜血管阻塞性疾病（RVOD）的发病有关。
方法
在这项多中心研究中，根据既定方案，回顾性收集了在2个月索引期（2021年6月1日至7月31日）期间患有视网膜中央静脉阻塞和分支静脉阻塞（CRVO和BRVO）、视网膜中央动脉阻塞和分支动脉阻塞（CRAO和BRAO）以及前部缺血性视神经病变（AION）患者的数据。记录了连续病例系列与之前任何疫苗接种的关系。在逐例分析中调查了RVOD病例数和新冠病毒病疫苗接种情况。使用来自普通人群（古登堡健康研究的研究参与者）的年龄和性别匹配对照进行了病例对照研究，并进行了调整后的条件逻辑回归分析。
结果
在索引期（61天）期间就诊的421名受试者被纳入研究：121例CRVO患者、75例BRVO患者、56例CRAO患者、65例BRAO患者和104例AION患者。332例（78.9%）患者在RVOD发病前已接种疫苗。接种的疫苗为BNT162b2/复必泰/辉瑞（n = 221），其次是ChadOx1/阿斯利康（n = 57）、mRNA-1273/莫德纳（n = 21）和Ad26.COV2.S/强生（n = 11；未知n = 22）。我们整合了来自GHS基于人群数据的病例对照分析没有发现新冠病毒病疫苗接种后（比值比=0.93；95%置信区间：0.60-1.45，P = 0.75）在4周窗口期内接种疫苗相关风险增加的证据。
结论
迄今为止，没有证据表明接种SARS-CoV-2疫苗与更高的RVOD风险之间存在任何关联。
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