"Introduction
... Retinal vein occlusion (RVO) is the second most prevalent cause of visual loss related to retinal vascular diseases, after diabetic retinopathy. RVO is related to thromboembolism caused by vessel compression, vasospasm, or degeneration of vascular walls. Retinal artery occlusion (RAO) is caused by vasospasm, vasculitis, reduced arterial perfusion, and thromboembolism of the retinal arteries originating from the ipsilateral carotid artery, aortic arch, or heart chambers. Based on the location of the occlusion, RAO and RVO can be further classified into central and branch forms. SARS-CoV-2 infection can precipitate retinal vascular events. RVO following COVID-19 vaccination is uncommon. However, there is growing literature including case reports on retinal vascular occlusion following vaccination. Intriguingly, some studies on retinal vascular occlusion have been related to mRNA COVID-19 vaccination; the vaccines implicated include mRNA vaccines, mRNA-1273 and BNT162b2, as well as the viral vector-based vaccine ChAdOx1. However, the quality of these data was insufficient to establish a causal relationship between retinal vascular occlusion and COVID-19 vaccination.
This study aimed to determine whether COVID-19 vaccines are related to an increased risk of retinal vascular occlusion and to raise awareness about the probability of retinal vascular events due to an increased thrombotic inflammatory state associated with COVID-19 vaccinations...
Results
Brand of vaccines: ... The risk of retinal vascular occlusion increased significantly after the first and second doses of BNT162b2 or mRNA-1273 in a 2-year period. The risks were not different between BNT162b2 and mRNA-1273 recipients. Though the risk of retinal vascular occlusion was elevated following the first dose of Ad26.COV2.S, the risk was not significant. Twelve weeks after vaccination of all brands of vaccines, the risk of retinal vascular occlusion increased non-significantly...
Risk of retinal vascular occlusion at 2 years and 12 weeks: ... The overall risk of retinal vascular occlusion in the vaccinated cohort was 2.19 times higher than that in the unvaccinated cohort at 2 years (95% Cl 2.00–2.39). Two years after vaccination, the chances of all subtypes (BRAO, BRVO, CRAO and BRVO) of retinal vascular occlusion increased significantly in the vaccinated cohort. The hazards of retinal vascular occlusion and its subtypes were higher within 12 weeks than those at 2 years...
Discussion
We demonstrated a higher risk and incidence rate of retinal vascular occlusion following COVID-19 vaccination, after adjusting for potential confounding factors. The risk of retinal vascular occlusion, except for CRAO [central retinal artery occlusion], has been promptly observed in individuals receiving vaccines against SARS-CoV-2. The risk factors for retinal vascular occlusion include diabetes, hypertension, obesity, coronary artery disease, and stroke. To ensure the reliability of the results, we appropriately balanced the baseline characteristics in both cohorts before analysis."
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