Hwang Sungsoon, Kang Se Woong, Choi Jaehwan, Park Kyung-Ah, Lim Dong Hui, Shin Ju-Young, Kang Danbee, Cho Juhee, Kim Sang Jin
Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Sungkyunkwan University, Seoul, Republic of Korea.
Ophthalmol Sci. 2024 Oct 26;5(2):100638. doi: 10.1016/j.xops.2024.100638. eCollection 2025 Mar-Apr.
This study aimed to assess the risk of ocular adverse events, including retinal artery occlusion (RAO), retinal vein occlusion (RVO), noninfectious uveitis (NIU), noninfectious scleritis (NIS), optic neuritis (ON), ischemic optic neuropathy (ION), and ocular motor cranial nerve palsy (OMCNP), after coronavirus disease 2019 (COVID-19) infection.
Population-based self-controlled case series (SCCS).
The study included patients from the entire Korean population of 52 million who experienced incident RAO, RVO, anterior NIU, nonanterior NIU, NIS, ON, ION, or OMCNP between January 1, 2021, and October 29, 2022.
This nationwide SCCS utilized data from the Korea National Health Insurance Service and the Korea Disease Control and Prevention Agency. The risk period after infection was defined as up to 24 weeks after COVID-19 infection. Conditional Poisson regression was used to calculate the relative incidence rate ratios (IRRs) for RAO, RVO, anterior NIU, nonanterior NIU, NIS, ON, ION, and OMCNP during the designated risk periods.
The IRRs for RAO, RVO, anterior NIU, nonanterior NIU, NIS, ON, ION, and OMCNP during the risk periods.
The study included 9336, 103 362, 201 010, 25 428, 23 744, 3026, 69 933, and 16 335 cases of incident RAO, RVO, anterior NIU, nonanterior NIU, NIS, ON, ION, and OMCNP, respectively. The IRRs (95% confidence interval) during the early risk period (1-8 weeks) were 0.94 (0.83-1.07), 1.01 (0.97-1.04), 1.00 (0.98-1.03), 0.96 (0.90-1.03), 1.00 (0.94-1.07), 0.97 (0.81-1.17), 0.97 (0.93-1.01), and 1.02 (0.94-1.11), respectively. In the late risk period (9-24 weeks), the IRRs were 1.02 (0.92-1.12), 1.01 (0.98-1.04), 1.01 (0.99-1.03), 1.02 (0.97-1.08), 1.02 (0.97-1.08), 0.99 (0.85-1.15), 1.02 (0.99-1.06), and 0.97 (0.90-1.03), respectively. Stratified analyses showed that in patients with a history of cerebro-cardiovascular disease, the risk of RAO increased during the late risk period, with an IRR (95% confidence interval) of 1.19 (1.02-1.40).
The risk of incident RVO, anterior NIU, nonanterior NIU, NIS, ON, ION, or OMCNP did not increase after COVID-19 infection. The risk of incident RAO increased only in individuals with preexisting cardio-cerebrovascular disease.
Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
本研究旨在评估2019冠状病毒病（COVID-19）感染后眼部不良事件的风险，包括视网膜动脉阻塞（RAO）、视网膜静脉阻塞（RVO）、非感染性葡萄膜炎（NIU）、非感染性巩膜炎（NIS）、视神经炎（ON）、缺血性视神经病变（ION）和动眼神经麻痹（OMCNP）。
基于人群的自我对照病例系列研究（SCCS）。
该研究纳入了2021年1月1日至2022年10月29日期间韩国5200万总人口中发生RAO、RVO、前部NIU、非前部NIU、NIS、ON、ION或OMCNP的患者。
这项全国性的SCCS利用了韩国国民健康保险服务中心和韩国疾病控制与预防机构的数据。感染后的风险期定义为COVID-19感染后长达24周。采用条件泊松回归计算指定风险期内RAO、RVO、前部NIU、非前部NIU、NIS、ON、ION和OMCNP的相对发病率比（IRR）。
风险期内RAO、RVO、前部NIU、非前部NIU、NIS、ON、ION和OMCNP的IRR。
该研究分别纳入了9336例、103362例、201010例、25428例、23744例、3026例、69933例和16335例RAO、RVO、前部NIU、非前部NIU、NIS、ON、ION和OMCNP的新发病例。早期风险期（1-8周）的IRR（95%置信区间）分别为0.94（0.83-1.07）、1.01（0.97-1.04）、1.00（0.98-1.03）、0.96（0.90-1.03）、1.00（0.94-1.07）、0.97（0.81-1.17）、0.97（0.93-1.01）和1.02（0.94-1.11）。在晚期风险期（9-24周），IRR分别为1.02（0.92-1.12）、1.01（0.98-1.04）、1.01（0.99-1.03）、1.02（0.97-1.08）、1.02（0.97-1.08）、0.99（0.85-1.15）、1.02（0.99-1.06）和0.97（0.90-1.03）。分层分析显示，在有心血管疾病史的患者中，晚期风险期RAO风险增加，IRR（95%置信区间）为1.19（1.02-1.40）。
COVID-19感染后，RVO、前部NIU、非前部NIU、NIS、ON、ION或OMCNP的发病风险并未增加。仅在已有心脑血管疾病的个体中，RAO的发病风险增加。
本文末尾的脚注和披露中可能会找到专有或商业披露信息。
