tetano
Editor, Senior Moderator
J Korean Med Sci
. 2023 Mar 27;38(12):e95.
doi: 10.3346/jkms.2023.38.e95.
Non-Arteritic Ischemic Optic Neuropathy Following COVID-19 Vaccination in Korea: A Case Series
Yeji Moon[SUP] 1 [/SUP], Jae Ho Jung[SUP] 2 [/SUP], Hyun Jin Shin[SUP] 3 [/SUP], Dong Gyu Choi[SUP] 4 [/SUP], Kyung-Ah Park[SUP] 5 [/SUP], Hyeshin Jeon[SUP] 6 [/SUP], Byung Joo Lee[SUP] 1 [/SUP], Seong-Joon Kim[SUP] 7 [/SUP], Sei Yeul Oh[SUP] 5 [/SUP], Hyosook Ahn[SUP] 1 [/SUP], Seung Ah Chung[SUP] 8 [/SUP], Ungsoo Samuel Kim[SUP] 9 [/SUP], Haeng-Jin Lee[SUP] 10 [/SUP], Joo Yeon Lee[SUP] 11 [/SUP], Youn Joo Choi[SUP] 12 [/SUP]; Korean Neuro-Ophthalmology Society
Affiliations
Abstract
Background: To report the clinical manifestations of non-arteritic anterior ischemic optic neuropathy (NAION) cases after coronavirus disease 2019 (COVID-19) vaccination in Korea.
Methods: This multicenter retrospective study included patients diagnosed with NAION within 42 days of COVID-19 vaccination. We collected data on vaccinations, demographic features, presence of vascular risk factors, ocular findings, and visual outcomes of patients with NAION.
Results: The study included 16 eyes of 14 patients (6 men, 8 women) with a mean age of 63.5 ± 9.1 (range, 43-77) years. The most common underlying disease was hypertension, accounting for 28.6% of patients with NAION. Seven patients (50.0%) had no vascular risk factors for NAION. The mean time from vaccination to onset was 13.8 ± 14.2 (range, 1-41) days. All 16 eyes had disc swelling at initial presentation, and 3 of them (18.8%) had peripapillary intraretinal and/or subretinal fluid with severe disc swelling. Peripapillary hemorrhage was found in 50% of the patients, and one (6.3%) patient had peripapillary cotton-wool spots. In eight fellow eyes for which we were able to review the fundus photographs, the horizontal cup/disc ratio was less than 0.25 in four eyes (50.0%). The mean visual acuity was logMAR 0.6 ± 0.7 at the initial presentation and logMAR 0.7 ± 0.8 at the final visit.
Conclusion: Only 64% of patients with NAION after COVID-19 vaccination have known vascular and ocular risk factors relevant to ischemic optic neuropathy. This suggests that COVID-19 vaccination may increase the risk of NAION. However, overall clinical features and visual outcomes of the NAION patients after COVID-19 vaccination were similar to those of typical NAION.
Keywords: Coronavirus Disease 2019 (COVID-19); Non-Arteritic Anterior Ischemic Optic Neuropathy; Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2); Vaccination.
. 2023 Mar 27;38(12):e95.
doi: 10.3346/jkms.2023.38.e95.
Non-Arteritic Ischemic Optic Neuropathy Following COVID-19 Vaccination in Korea: A Case Series
Yeji Moon[SUP] 1 [/SUP], Jae Ho Jung[SUP] 2 [/SUP], Hyun Jin Shin[SUP] 3 [/SUP], Dong Gyu Choi[SUP] 4 [/SUP], Kyung-Ah Park[SUP] 5 [/SUP], Hyeshin Jeon[SUP] 6 [/SUP], Byung Joo Lee[SUP] 1 [/SUP], Seong-Joon Kim[SUP] 7 [/SUP], Sei Yeul Oh[SUP] 5 [/SUP], Hyosook Ahn[SUP] 1 [/SUP], Seung Ah Chung[SUP] 8 [/SUP], Ungsoo Samuel Kim[SUP] 9 [/SUP], Haeng-Jin Lee[SUP] 10 [/SUP], Joo Yeon Lee[SUP] 11 [/SUP], Youn Joo Choi[SUP] 12 [/SUP]; Korean Neuro-Ophthalmology Society
Affiliations
- PMID: 36974402
- DOI: 10.3346/jkms.2023.38.e95
Abstract
Background: To report the clinical manifestations of non-arteritic anterior ischemic optic neuropathy (NAION) cases after coronavirus disease 2019 (COVID-19) vaccination in Korea.
Methods: This multicenter retrospective study included patients diagnosed with NAION within 42 days of COVID-19 vaccination. We collected data on vaccinations, demographic features, presence of vascular risk factors, ocular findings, and visual outcomes of patients with NAION.
Results: The study included 16 eyes of 14 patients (6 men, 8 women) with a mean age of 63.5 ± 9.1 (range, 43-77) years. The most common underlying disease was hypertension, accounting for 28.6% of patients with NAION. Seven patients (50.0%) had no vascular risk factors for NAION. The mean time from vaccination to onset was 13.8 ± 14.2 (range, 1-41) days. All 16 eyes had disc swelling at initial presentation, and 3 of them (18.8%) had peripapillary intraretinal and/or subretinal fluid with severe disc swelling. Peripapillary hemorrhage was found in 50% of the patients, and one (6.3%) patient had peripapillary cotton-wool spots. In eight fellow eyes for which we were able to review the fundus photographs, the horizontal cup/disc ratio was less than 0.25 in four eyes (50.0%). The mean visual acuity was logMAR 0.6 ± 0.7 at the initial presentation and logMAR 0.7 ± 0.8 at the final visit.
Conclusion: Only 64% of patients with NAION after COVID-19 vaccination have known vascular and ocular risk factors relevant to ischemic optic neuropathy. This suggests that COVID-19 vaccination may increase the risk of NAION. However, overall clinical features and visual outcomes of the NAION patients after COVID-19 vaccination were similar to those of typical NAION.
Keywords: Coronavirus Disease 2019 (COVID-19); Non-Arteritic Anterior Ischemic Optic Neuropathy; Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2); Vaccination.