Risk Assessment of Retinal Vascular Occlusion following COVID-19 Vaccination: A TriNetX Global Network Multicenter Retrospective Cohort Study
Purpose
COVID-19 vaccines are associated with several ocular manifestations, including retinal vascular occlusion. We aimed to investigate the risk of retinal vascular occlusion after COVID-19 vaccination.
Methods
This retrospective cohort study used the TriNetX global network. Individuals received COVID-19 vaccines between January 2020 and December 2022 were included. Individuals with a history of retinal vascular occlusion within six months prior to vaccination or use of any systemic medication that may alter blood coagulation within four weeks prior to vaccination were excluded. We used a 1:1 propensity score matching for age, sex, race, comorbidities, medications and previous hospitalization to balance the vaccinated and unvaccinated cohorts.
Results
Individuals with COVID-19 vaccination had a higher risk of all forms of retinal vascular occlusion in two years after vaccination, with an overall hazard ratio of 2.19 (95% confidence interval 2.00−2.39). The cumulative incidence of retinal vascular occlusion was significantly higher in the vaccinated cohort 2 years and 12 weeks after vaccination. The risk of retinal vascular occlusion was considerably elevated within two weeks after vaccination, which persisted for 12 weeks. Additionally, individuals with first and second dose of BNT162b2 and mRNA-1273 had significantly increased risk of retinal vascular occlusion 2 years following vaccination, while no disparity was detected between brand and dose of vaccines.
Conclusion
This large multicenter study strengthens the findings of a previous case series. Retinal vascular occlusion may not be a coincidental finding after COVID-19 vaccination.
Conflict of interest
No
Authors 1
Last name
LIN
Initials of first name(s)
CJ
Department
Department of Ophthalmology
City
Taichung
Country
Taiwan
Authors 2
Last name
Li
Initials of first name(s)
JX
Department
Department of General Medicine
City
Taichung
Country
Taiwan
Authors 3
Last name
Wang
Initials of first name(s)
YH
Department
Department of Medical Research
City
Taichung
Country
Taiwan
Authors 4
Last name
Wei
Initials of first name(s)
CC
Department
Department of Medical Research
City
Taichung
Country
Taiwan
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