Título / Title

CILIORETINAL ARTERY OCCLUSION COMBINED WITH CENTRAL VEIN OCCLUSION AFTER ADMINISTRATION OF SARS-COV-2 VACCINE

Introdução / Purpose

The purpose of this e-poster is to present a case of combined cilioretinal artery and central retinal vein occlusion in a patient who previously received an AstraZeneca’s COVID-19 vaccine dose, describing the propaedeutics to confirm this rare etiology.

Material e Método / Methods

RSV, male, 37y, with no comorbidities, sought care with a complaint of sudden visual loss in his right eye. He received the first dose of AstraZeneca vaccine ten days before symptom onset. BCVA was counting fingers (OD) and 20/20 (OS). Biomicroscopy (OU) was normal, including photomotor reflexes. IOP was 20 mmHg (OU). Fundoscopic examination of OD showed an area of retinal pallor in the papilomacular bundle and parafoveal region, with a "cherry red spot" macula, and intraretinal hemorrhages in the posterior pole and periphery. On FA, there was a delay in circulatory times, hypofluorescence due to vascular filling defect in the papillomacular bundle and hypofluorescent areas due to blockage corresponding to hemorrhages. The OCT showed an increase in the reflectivity of the inner retina, with an increase in retinal thickness not associated with intraretinal cysts or exudates. Fundoscopy and complementary exams were normal in OS. The patient underwent extensive clinical investigation of diseases predisposing to thromboembolic events, and was instructed to subsequently use another immunizing agent for COVID-19.

Resultados / Results

Images1, 2 and 3

Discussão e Conclusões / Conclusion

Combined central vein and cilioretinal artery occlusions generally result from a sudden increase of pressure in the retinal venous system. Since the venous occlusion was apparently fleeting, the cause is most likely due to the decrease in retinal arterial perfusion, causing venous stasis and thrombosis, or to the simultaneous occlusion of systems. A known vaccine prothrombotic disorder is caused by platelet-activating antibodies that bind to multimolecular complexes between cationic PF4 and anionic heparin. Thus, the likely etiology derived from the hypercoagulable state related to the vaccine.

Palavras Chave

CENTRAL RETINAL VEIN OCCLUSION / CILIORETINAL ARTERY OCCLUSION / VACCINE / COVID

Area

CLINICAL RETINA