The following transcript has been edited for clarity. 

Hi, I’m Nirojini Sivachandran, MD, PhD, FRCSC. I’m a retina physician at Toronto Retina Institute. And here at Retina World Congress, I’ve just presented on a correlation between COVID-19 vaccine, infection, and retinal and macular presentations.

So it all started out with a young female, 22 years old, who came in with what appeared to be Crohn’s disease, a diagnosis of exclusion. She had COVID-19 infection 2 weeks prior, which then prompted us to ask, “Well, what are other clinical presentations?” So we performed a systematic review of 173 studies—13.8 million people across the globe, over 38 countries.

What we found was that both COVID-19 infection and vaccination were most commonly associated with retinal vascular occlusions. However, retinal artery occlusion and optic neuritis were more common with the infection itself, whereas retinal vein occlusion (RVO) was more commonly associated with the vaccination. We also found that the mRNA vaccine platform was associated with a statistically significantly higher rate of ocular adverse events—0.0073 per million doses—compared with adenoviral vector, attenuated, or protein subunit vaccines.

And furthermore, doing a meta-analysis, we found that the pooled relative risk for retinal vein occlusion was 2.4. However, due to the wide confidence interval as well as study heterogeneity, the relative raised risk was statistically inconclusive.

The real takeaway is that as retina physicians, we need to broaden our differential to include RVO and white dot syndrome as well when it comes to COVID-19 infection and vaccination and also to emphasize the global ongoing need for vaccine surveillance.

Thank you. RP