Investigators Detail 6 Retinal Abnormality Cases Seen After COVID-19 Vaccination

Branch Retinal Artery Occlusion
Branch retinal artery occlusion (BRAO)
A case series may offer details into the injection’s possible associations with BRAO, PAMM, and acute macular neuroretinopathy.

Although rare, some retinal abnormalities have the potential to present after a COVID-19 vaccination, according to a retrospective 6-case series published in Clinical Ophthalmology. The researchers report that the relatively uncommon findings occurred shortly after the administration of the Pfizer-BioNTech vaccine and that no patients with the same findings presented during a control period from 2018.

The researchers presented data from records from 2 Japanese hospitals between July and October 2021. 

Patients (N=6, age range between 30-86 years, 50% men, 50% women), presented with 1 of 3 rare retinal abnormalities, branch retinal artery occlusion (BRAO) (4 cases), paracentral acute middle maculopathy (PAMM) (1 case), or acute macular neuroretinopathy (AMN) (1 case). All occurred after administration of the Pfizer-BioNTech COVID-19 vaccine. Half of the affected eyes were right and half left eyes, best corrected visual acuity ranged between 20/13 and 20/29 logMAR, and all but 1 patient presented after receiving the second dose of vaccine. The patients had histories of hypertension (n=3), diabetes (n=1), and Alport syndrome with end-stage renal disease requiring regular hemodialysis (n=1).

The average time from vaccination to onset of symptoms was 22.8±23.3 days. 

One of the cases was a 38-year-old woman who had lower visual field defects of the right eye for 1 day. The patient had received the first dose of vaccine 16 days previously. Fundus examination found superotemporal retinal whitening, consistent with BRAO.

Another case was a 62-year-old man who experienced visual field defects for 25 days before presenting. The patient had received the second dose of vaccine 22 days previously. The patient had inferonasal parafoveal retinal whitening and a parafoveal hyperreflective band at the inner nuclear layer consistent with PAMM.

This study was limited by not including any follow-up.

These data indicate that 6 individuals presented with retinal abnormalities shortly after receiving the Pfizer-BioNTech COVID-19 vaccine. Additional, larger studies are needed to determine whether vaccination could be connected with these rare retinal abnormalities.


Ishibashi K, Yatsuka H, Haruta M, Kimoto K, Yoshida S, Kubota T. Branch retinal artery occlusions, paracentral acute middle maculopathy and acute macular neuroretinopathy after COVID-19 vaccinations. Clin Ophthalmol. 2022;16:987-992. doi:10.2147/OPTH.S357359