Retinal vein occlusion after COVID-19 vaccinations is very rare

A large cohort study found that there is no association between the first mRNA COVID-19 vaccinations and acute RVO.

An image of a doctor getting ready to give a patient a vaccination. (Image Credit: AdobeStock/guerrieroale)

(Image Credit: AdobeStock/guerrieroale)

A recent study set the record straight on the occurrence of retinal vein occlusions (RVOs) following messenger RNA (mRNA) COVID-19 vaccinations. A large cohort study found that there is no association between the first mRNA COVID-19 vaccinations and acute RVO,1 according to first author Ian Dorney, BS, from Case Western Reserve University School of Medicine, Cleveland.

A few of the recent case reports2-5 on the topic have suggested an association between the development of new-onset retinal vascular occlusion (RVO) and mRNA COVID-19 vaccinations. Because of the negative impact of RVOs on vision, the authors of the study under discussion considered that an epidemiologic investigation was important to determine the impact of the vaccinations on the public health.

The investigators sought to determine how often patients are diagnosed with new RVO acutely after the first mRNA COVID-19 vaccine compared with other very commonly administered vaccines, ie, influenza and tetanus, diphtheria, pertussis (Tdap) vaccines.

The data from the electronic health records of more than 103 million patients were included in this retrospective population-based cohort study. The data were searched for vaccinationCommon Procedural Technology codes and newly diagnosed RVO within 21 days of vaccination, and the relative risks were determined. The primary outcomes was the development of RVO with 21 days of vaccination.

The analysis showed that 0.003% of patients had a new diagnosis of RVO within 21 days after receiving a mRNA COVID-19 vaccination, and the vaccination was not associated with development of RVO.

1. Dorney I, Shaia J, Kaelber DC, et al. Risk of new retinal vascular occlusion after mRNA COVID-19 vaccination within aggregated electronic health record data. JAMA Ophthalmol. Published online April 13, 2023. doi:10.1001/jamaophthalmol.2023.0610
2. Abdin AD, Gärtner BC, Seitz B. Central retinal artery occlusion following COVID-19 vaccine administration. Am J Ophthalmol Case Rep. 2022;26:101430; doi:10.1016/j.ajoc.2022.101430
3. Pur DR, Catherine Danielle Bursztyn LL, Iordanous Y. Branch retinal vein occlusion in a healthy young man following mRNA COVID-19 vaccination. Am J Ophthalmol Case Rep. 2022;26:101445; doi:10.1016/j.ajoc.2022.101445
4. Su CK, Au SCL. Isolated and combined unilateral central retinal artery and vein occlusions after vaccination: a review of the literature. J Stroke Cerebrovasc Dis. 2022;31:106552; doi:10.1016/j.jstrokecerebrovasdis.2022.106552
5. Endo B, Bahamon S, Martínez-Pulgarín DF. Central retinal vein occlusion after mRNA SARS-CoV-2 vaccination: a case report. Indian J Ophthalmol. 2021;69:2865-2866; doi:10.4103/ijo.IJO_1477_21
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