Elnahry Ayman G, Al-Nawaflh Mutaz Y, Gamal Eldin Aisha A, Solyman Omar, Sallam Ahmed B, Phillips Paul H, Elhusseiny Abdelrahman M
Department of Ophthalmology, Faculty of Medicine, Cairo University, Cairo 11956, Egypt.
Division of Epidemiology and Clinical Applications, National Eye Institute, National Institutes of Health, Bethesda, MD 20892, USA.
Vaccines (Basel). 2022 Oct 20;10(10):1758. doi: 10.3390/vaccines10101758.
We provide a systematic review of published cases of optic neuropathy following COVID-19 vaccination. We used Ovid MEDLINE, PubMed, and Google Scholar. Search terms included: “COVID-19 vaccination”, “optic neuropathy”, “optic neuritis”, and “ischemic optic neuropathy”. The titles and abstracts were screened, then the full texts were reviewed. Sixty eyes from forty-five patients (28 females) were included. Eighteen eyes from fourteen patients (31.1%) were diagnosed with anterior ischemic optic neuropathy (AION), while 34 eyes from 26 patients (57.8%) were diagnosed with optic neuritis (ON). Other conditions included autoimmune optic neuropathy and Leber hereditary optic neuropathy. Fifteen patients (33.3%) had bilateral involvement. The mean age of all patients was 47.4 ± 17.1 years. The mean age of AION patients was 62.9 ± 12.2 years and of ON patients was 39.7 ± 12.8 years (p < 0.001). The mean time from vaccination to ophthalmic symptoms was 9.6 ± 8.7 days. The mean presenting visual acuity (VA) was logMAR 0.990 ± 0.924. For 41 eyes with available follow-up, the mean presenting VA was logMAR 0.842 ± 0.885, which improved to logMAR 0.523 ± 0.860 at final follow-up (p < 0.001). COVID-19 vaccination may be associated with different forms of optic neuropathy. Patients diagnosed with ON were more likely to be younger and to experience visual improvement. More studies are needed to further characterize optic neuropathies associated with COVID-19 vaccination.
我们对已发表的新冠病毒疫苗接种后视神经病变病例进行了系统综述。我们使用了Ovid MEDLINE、PubMed和谷歌学术搜索。检索词包括：“新冠病毒疫苗接种”、“视神经病变”、“视神经炎”和“缺血性视神经病变”。先筛选标题和摘要，然后对全文进行审阅。纳入了45例患者（28名女性）的60只眼。14例患者（31.1%）的18只眼被诊断为前部缺血性视神经病变（AION），而26例患者（57.8%）的34只眼被诊断为视神经炎（ON）。其他情况包括自身免疫性视神经病变和Leber遗传性视神经病变。15例患者（33.3%）为双侧受累。所有患者的平均年龄为47.4±17.1岁。AION患者的平均年龄为62.9±12.2岁，ON患者的平均年龄为39.7±12.8岁（p<0.001）。从接种疫苗到出现眼部症状的平均时间为9.6±8.7天。平均初始视力（VA）为logMAR 0.990±0.924。对于41只可进行随访的眼睛，平均初始视力为logMAR 0.842±0.885, 在末次随访时改善至logMAR 0.523±0.860（p<0.001）。新冠病毒疫苗接种可能与不同形式的视神经病变有关。被诊断为ON的患者更可能较年轻且视力有所改善。需要更多研究来进一步明确与新冠病毒疫苗接种相关的视神经病变。
