EURETINA 2024: Ocular involvement among patients with COVID-19 infection or vaccination
A case series illuminates neuro-ophthalmologic manifestations, retinal vascular involvement and other pathologies
(Image credit: AdobeStock/Pormezz)
The COVID-19 infection or vaccination may be associated with numerous ocular manifestations of which ophthalmologists should be aware, according to Nesrine Abroug, MD, and colleagues, who reported their findings at the 24th Euretina Congress in Barcelona. Dr Abroug is from the University of Monastir, Monastir, Tunisia.
The investigators conducted a single-centre descriptive study that included patients in the Department of Ophthalmology, Fattouma Bourguiba University Hospital, Monastir.
All of the patients who had been examined between January 1, 2021, and December 31, 2022, had presented with ocular manifestations within 30 days of either developing a COVID-19 infection or receiving a vaccination. All patients had tested negative for other possible aetiologies.
The authors reported that 16 eyes of 13 patients (mean age, 47.5 years) had ocular manifestations that were associated with generally a mild-to-moderate COVID-19 infection. The manifestations appeared at an average of 11 days after the initial symptoms.
Dr Abroug reported that neuro-ophthalmologic manifestations were the most common ocular involvement, ie, optic neuropathy (n = 3) and oculomotor palsies (n = 3).
The next most frequent were retinal vascular involvement, ie, retinal microangiopathy (n = 1, central retinal artery occlusion (n = 1), and mixed vascular occlusion (n = 1); inflammatory manifestations, ie, intermediate uveitis (n = 1), acute posterior multifocal placoid pigment epitheliopathy (n = 1), and conjunctivitis (n = 2).
Regarding COVID-19 vaccinations, 13 eyes of 11 patients (mean age, 47.4 years) had ocular manifestations that may have been associated with the vaccination. The affected patients had received the following vaccines: Pfizer-BioNTech (5 cases), Oxford-AstraZeneca (3 cases), Janssen (2 cases), and Moderna (1 case).
The results showed that the eye became involved after the first vaccine dose in 9 patients and after the second dose in 2 patients. The average time from the vaccination to the development of ocular symptoms was 9 days. Ocular inflammatory involvement was the most common manifestation, and included 3 cases, ie, anterior uveitis, foveolitis, Vogt-Koyanagi-Harada disease and one case of scleritis. Other manifestations were anterior ischemic optic neuropathy (n = 3), central retinal vein occlusion (n = 2), herpetic keratitis (n = 1) and herpes zoster ophthalmicus (n =1).
The authors concluded, “An array of ocular manifestations may be associated with COVID-19 infection or vaccination. Ophthalmologists and generalists should be aware of these possible, albeit rare, manifestations after COVID-19 infection or vaccination.”
