Título / Title

CENTRAL RETINAL ARTERY OCCLUSION AFTER MRNA-SARS-COV-2 VACCINATION.

Introdução / Purpose

Report a case of central retinal artery occlusion (CRAO) after the patient received the third dose of coronavirus disease 2019 vaccine.

Material e Método / Methods

Case report

Resultados / Results

A 42-year-old woman presented with visual acuity loss in the LE for 1 day. She denied any systemic or ocular medical history.Through clinical evaluation, the presence of cardiovascular disease, diabetes and rheumatologic diseases was excluded.She reported having been immunized for COVID-19 with mRNA vaccine one month before symptoms started. At presentation, her best-corrected visual acuity in LE was hand motion. The examination of her LE revealed relative afferent pupillary defect, intraocular pressure of 8 mmHg and slit-lamp biomicroscopy was unremarkable. Posterior segment examination presented with mild macular pallor and cherry macula. Spectral domain OCT demonstrated a hyperreflective change and thickening at the level of the inner retinal layers associated with posterior acoustic shadowing. The diagnosis of CRAO related to the COVID-19 vaccine was presumed.

Discussão e Conclusões / Conclusion

The main causes of occlusion are thromboembolic events, inflammation or mechanical compression. In cases of involvement of the central retinal artery, it is essential to exclude temporal arteritis. In the present case, the patient underwent an investigation and clinical pathologies were ruled out as a cause for the vascular event. Considering the short period between the onset of symptoms and vaccination in a patient without previous risk factors, a causal relationship between the ocular pathology and vaccination for COVID19 was established. To date, several cases of unusual thromboembolic events, including arterial or venous thrombosis and related eye diseases, have been reported after vaccination with COVID19. Most cases are venous thrombosis and are more associated with mRNA vaccines.Although vaccination is an essential tool to prevent the high mortality and morbidity associated with COVID-19 this study shows the importance of monitoring adverse ocular events.

Palavras Chave

central retinal artery occlusion, covid19 vaccine, adverse events covid vaccine.

Area

CLINICAL RETINA