In a recent publication in the Journal of the American Medical Association Ophthalmology, researchers gathered data and conducted a retrospective population-based cohort design using the TriNetX Analytics platform, a federated, aggregated electronic health record (EHR) research network containing the deidentified EHR data of more than 103 million patients. Data were collected and analyzed on October 20, 2022.

Propensity score matching based on demographic characteristics (age, gender, race, and ethnicity) and comorbidities (diabetes, hypertension, and hyperlipidemia) was conducted between vaccination groups for assessment of relative risks (RRs).

The primary outcomes and measures for the study included a new-encounter diagnosis of RVO within 21 days of the mRNA COVID-19 vaccination and historical comparison cohorts of patients receiving influenza and Tdap vaccinations allowed for evaluation of the RRs for RVO. Individuals with diagnoses of RVO at any time prior to vaccination were excluded.

Data were obtained for 3,108,829 patients who received mRNA COVID-19 vaccines. The mean (SD) age was documented as 50.7 (20.4) years, 56.4% were women, and 104 (0.003%; 95% CI, 0.003%-0.004%) patients had a new diagnosis of RVO within 21 days of vaccination. After propensity score matching, the RR for new RVO diagnosis after the first dose of COVID-19 vaccination was not significantly different from that after vaccinations with influenza (RR, 0.74; 95% CI, 0.54-1.01) or Tdap (RR, 0.78; 95% CI, 0.44-1.38), but was greater when compared with the second dose of the COVID-19 vaccination (RR, 2.25; 95% CI, 1.33-3.81).

The authors wrote, "The results of this study do not support the presence of an increased risk for diagnosed RVO occurring acutely after mRNA COVID-19 vaccination compared with two historically used vaccinations (influenza and Tdap)."

They also indicated that the results of the post hoc analysis additionally implied that the risk for a new-encounter RVO diagnosis is greater acutely after COVID-19 infection itself than after the mRNA COVID-19 vaccine.

The authors concluded, "No evidence suggesting an association between mRNA COVID-19 vaccination and new-encounter diagnoses of RVO was found. Further detailed research on patients experiencing RVO after vaccination is necessary to elucidate risk factors for this vision-threatening condition."

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