COVID-19 Vaccination and Ocular Adverse Events: a Self-Controlled Case Series Study from the Entire South Korean Population

Purpose This study aimed to assess the risk of ocular adverse events, including retinal artery occlusion (RAO), retinal vein occlusion (RVO), non-infectious uveitis (NIU), non-infectious scleritis (NIS), optic neuritis (ON), ischemic optic neuropathy (ION), and ocular motor cranial nerve palsy (OMCNP), following coronavirus disease 2019 (COVID-19) vaccination. Design Population-based self-controlled case series Methods This study utilized nationwide claims and vaccination data provided by the Korea National Health Insurance Service and Korea Disease Control and Prevention Agency. From the entire South Korean population of 52 million individuals, patients with incident RAO, RVO, anterior NIU, non-anterior NIU, NIS, ON, ION, or OMCNP between January 2021 and March 2022 were included. The post-vaccination risk period was defined as up to 56 days after COVID-19 vaccination. The relative incidence rate ratios (IRRs) for RAO, RVO, anterior NIU, non-anterior NIU, NIS, ON, ION, and OMCNP during the risk periods were measured using conditional Poisson regression. Results The study included 6,590, 70,120, 137,958, 17,921, 15,492, 2,039, 49,089, and 11,312 cases of incident RAO, RVO, anterior NIU, non-anterior NIU, NIS, ON, ION, and OMCNP, respectively. The IRRs (95% confidence interval) during the early risk period (0–28 days) were 0.95 (0.88–1.01), 0.96 (0.94–0.98), 0.93 (0.91–0.94), 0.93 (0.89–0.96), 0.96 (0.92–1.01), 1.04 (0.92–1.18), 0.98 (0.95–1.00), and 0.91 (0.86–0.96), respectively. In the late risk period (29–56 days), the IRRs were 0.96 (0.89–1.03), 0.93 (0.91–0.96), 0.96 (0.95–0.98), 1.00 (0.95–1.04), 0.96 (0.91–1.01), 1.00 (0.87–1.15), 1.01 (0.98–1.04), and 0.95 (0.90–1.01), respectively. Conclusion COVID-19 vaccination did not increase the risk of incident RAO, RVO, anterior NIU, non-anterior NIU, NIS, ON, ION, or OMCNP during the post-vaccination period.