Combined Central Retinal Artery and Vein Occlusion with Ischemic Optic Neuropathy After COVID-19 Vaccination

Sol Lee,1 Kamalesh K Sankhala,2 Swaraj Bose,3 Ron P Gallemore1 1Department of Clinical Research, Retina Macula Institute, Torrance, CA, USA; 2Cedars-Sinai Medical Center, Beverly Hills, CA, USA; 3NeuroOphthalmology & Orbital Surgery, Cedars-Sinai Medical Towers, NeuroEyeOrbit Institute, Los Angeles, CA, USACorrespondence: Ron P GallemoreDepartment of Clinical Research, Retina Macula Institute, 4201 Torrance Blvd, Suite 220, Torrance, CA, 90503, USATel +1 310-413-7020Email rongallemoremd@gmail.comPurpose: To report a case of combined central retinal vein and artery occlusion that evolved into ischemic optic neuropathy following the Pfizer COVID-19 vaccination.Methods: Patient was followed with optical coherence tomography (OCT), fluorescein angiography, and Humphrey visual field.Results: Patient was able to recover vision from count fingers to 20/30 on a combination of aflibercept, steroidal and non-steroidal anti-inflammatories, a diuretic (acetazolamide), antiplatelet agents (aspirin and pentoxifylline), and an anticoagulant (apixaban).Conclusion: COVID-19 vaccination may be associated with a myriad of sight-threatening ocular thrombotic conditions, which may respond to a combination of anti-inflammatory and anticoagulant therapies.Keywords: COVID-19 vaccine, Pfizer, vascular thrombosis, NAION