Ophthalmic complications associated with COVID-19: a large US national database analysis

Vaccinated COVID-19 patients had significantly lower odds of retinal oedema (OR 0.68; 99.5% CI, 0.54-0.85), vitreous haemorrhage (OR 0.55; 99.5% CI, 0.44-0.68), and optic neuritis (OR 0.60; 99.5% CI, 0.43-0.85) compared to unvaccinated COVID-19 patients. There were no significant differences in the incidence of RAO, RVO, or retinal haemorrhage between vaccinated and unvaccinated cohorts. COVID-19 patients exhibited higher odds of diplopia (OR 1.89; 99.5% CI, 1.53-2.32) and cranial nerve VI palsy (OR 3.19; 99.5% CI, 1.82-5.59) compared to influenza patients, while rates of optic neuritis, RAO, RVO, retinal oedema, vitreous haemorrhage, and retinal haemorrhage were similar between the groups CONCLUSIONS: Vaccination was associated with a lower incidence of retinal oedema, vitreous haemorrhage, and optic neuritis. Compared to influenza, COVID-19 was associated with diplopia and CN VI palsy, while other neuro-ophthalmic and retinal pathologies had similar risk. Further research is needed to clarify these associations and underlying mechanisms.