• Yeji Moon, Jae Ho Jung, Hyun Jin Shin, Dong Gyu Choi, Kyung-Ah Park, Hyeshin Jeon, Byung Joo Lee, Seong-Joon Kim, Sei Yeul Oh, Hyosook Ahn, Seung Ah Chung, Ungsoo Samuel Kim, Haeng-Jin Lee, Joo Yeon Lee, Youn Joo Choi, and Korean Neuro-Ophthalmology Society.
• Department of Ophthalmology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
• J. Korean Med. Sci. 2023 Mar 27; 38 (12): e95e95.

BackgroundTo report the clinical manifestations of non-arteritic anterior ischemic optic neuropathy (NAION) cases after coronavirus disease 2019 (COVID-19) vaccination in Korea.MethodsThis 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.ResultsThe 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.ConclusionOnly 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.© 2023 The Korean Academy of Medical Sciences.

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