Can ocular adverse events present after inactivated COVID-19 vaccine?
In a retrospective case series, 9 patients presented with ocular complaints 5.2 days after administration of an inactivated COVID-19 vaccine. One patient was diagnosed with episcleritis, 2 with anterior scleritis, 2 with acute macular neuroretinopathy, 1 with paracentral acute middle maculopathy, and 1 with subretinal fluid.
Mild, reversible ocular adverse events, both in the anterior and posterior segment, were noted after patients received the inactivated COVID-19 vaccine, although a causal relationship cannot be established from this case series.
As vaccinations against COVID-19 continue, potential ocular adverse events should be reported in detail to increase awareness among the medical community, although typically, a causal relationship cannot be established definitively.
To describe ocular adverse events that occur soon after receiving an inactivated COVID-19 vaccination (Sinopharm).
Design, Setting, and Participants
This case series took place from September 2020 to January 2021 at Cleveland Clinic Abu Dhabi, a tertiary referral center. Patients who reported ocular adverse events and presented within 15 days from the first of 2 doses of an inactivated COVID-19 vaccine were analyzed.
Main Outcomes and Measures
Each patient underwent Snellen best-corrected visual acuity that was then converted to logMAR, applanation tonometry, and biomicroscopic examination with indirect ophthalmoscopy. Color fundus photography was obtained with a conventional 9-field fundus photography camera or with a widefield fundus photography system. Optical coherence tomography and optical coherence tomographic angiography images were obtained. Sex, race, age, and clinical data were self-reported.
Nine eyes of 7 patients (3 male individuals) presenting with ocular complaints following COVID-19 vaccine were included in the study. The mean (SD) age was 41.4 (9.3) years (range, 30-55 years); the mean best-corrected visual acuity was 0.23 logMAR (range, 0-1 logMAR; approximate Snellen equivalent, 20/32). The mean time of ocular adverse event manifestations was 5.2 days (range, 1-10 days). One patient was diagnosed with episcleritis, 2 with anterior scleritis, 2 with acute macular neuroretinopathy, 1 with paracentral acute middle maculopathy, and 1 with subretinal fluid.
Conclusions and Relevance
In this case series study of 7 patients, the timing of transient and ocular complications 5.2 days after vaccination with an inactivated COVID-19 vaccine supported an association with the ocular findings, but a causal relationship cannot be established from this study design.
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CME Disclosure Statement: Unless noted, all individuals in control of content reported no relevant financial relationships. If applicable, all relevant financial relationships have been mitigated.
Corresponding Author: Francesco Pichi, MD, Eye Institute, Cleveland Clinic Abu Dhabi, PO Box 112412, Al Maryah Island, Abu Dhabi, United Arab Emirates (firstname.lastname@example.org).
Accepted for Publication: May 24, 2021.
Published Online: September 2, 2021. doi:10.1001/jamaophthalmol.2021.3477
Author Contributions: Drs Pichi and Ghazi had full access to all of the data in the study and take responsibility for the integrity of the data and the accuracy of the data analysis.
Concept and design: Pichi, Neri, Ghazi.
Acquisition, analysis, or interpretation of data: All authors.
Drafting of the manuscript: Pichi, Aljneibi, Neri, Hay.
Critical revision of the manuscript for important intellectual content: Neri, Dackiw, Ghazi.
Statistical analysis: Pichi, Neri.
Administrative, technical, or material support: Aljneibi, Hay, Dackiw.
Supervision: Pichi, Neri, Ghazi.
Conflict of Interest Disclosures: None reported.
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