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Ocular side effects secondary to COVID-19 vaccination

Author: Shaikah Aljneibi (United Arab Emirates)

Co-authors: Francesco Pichi

Purpose

To present a case series of ocular side effects secondary to COVID-19 inactive vaccine (Sinopharm’s China National Biotec Group)

Setting/Venue

Retrospective consecutive case series of patients presenting at the Retina and Uveitis Service of Cleveland Clinic Abu Dhabi from September 2020 to January 2021.

Methods

Main inclusion criteria were the report of ocular side effects that presented within 15 days from the first dose of Sinopharm COVID-19 vaccine. Each patient underwent Snellen best corrected visual acuity (BCVA) that was then converted to logarithm of the minimal angle of resolution (LogMAR) values, applanation tonometry, biomicroscopic examination with indirect ophthalmoscopy. Color fundus photography was obtained with a conventional 9-field fundus photography (Carl Zeiss Meditec, Dublin, CA) camera or with a wide-field fundus photography system (Optos Panoramic 200MA; Optos PLC, Dunfermline, Scotland, United Kingdom). Optical coherence tomography was obtained with a spectral domain machine (Spectralis HRA OCT; Heidelberg Engineering, Heidelberg, Germany) and swept source PLEX Elite 9000 (Carl Zeiss Meditec, Inc, Dublin, CA) was used for OCTA images.

Results

Ten eyes of 8 patients (3 males) presenting with ocular complaints following COVID-19 vaccine were included in the study. Mean age was 41.4 +/- 9.3 years (range: 30-55); mean BCVA was 0.23 logMAR (range: 0-1). The mean time of ocular side effects manifestations was 5.2 days (range: 1-10). Three patients were diagnosed with episcleritis (Case #1) or anterior scleritis (Case #2 and Case #5) that responded to a tapering dose of topical steroid. Two eyes in our series (Case #3 and Case #4) presented with acute vision loss associated with SD-OCT hyperreflectivity of the outer plexiform/nuclear layer and 1 eye (Case #7) in the inner nuclear layer, compatible respectively with acute macular neuroretinopathy and paracentral acute middle maculopathy. One eye developed transient subretinal fluid (Case #6). One eye presented with multifocal choroiditis (Case #8) 5 days after receiving the first dose of the vaccine, that responded to oral steroidal treatment.

Conlusions

There is an urgent demand for a vaccine for control and prevention of the COVID-19 pandemic. This case series present some ocular inflammatory side effects in otherwise healthy patients that received COVID-19 inactive vaccine. The timing of complications 5.2 days following vaccination, point towards an association between COVID-19 vaccination and the ocular findings in our patients. As the urge for a vaccine against COVID-19 continues, we expect to see an increasing number of ocular side effects from the various candidates similar to those hereby presented that need to be detailed reported.

Financial Disclosure

None

Comments

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