COVID-19疫苗接种后视网膜脱离:叙述性文献综述

G. Markov, Y. Zdravkov, A. Oscar
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引用次数: 0

摘要

视网膜脱离(Retinal detachment, RD)是指神经感觉视网膜与视网膜色素上皮的解剖分离,如果不及时治疗,最终会导致视觉功能丧失和失明。根据发病机制可识别出三种主要类型:孔源性,与视网膜撕裂/孔有关;牵引性,视网膜前和/或玻璃体纤维化改变对视网膜产生牵拉;渗出性或浆液性:视网膜下液是由于漏出、渗出或外血-视网膜屏障受损所致。除继发性感染或自身免疫性疾病外,SARS-CoV-2感染与任何类型的RD均无直接关联。在应用各种COVID-19疫苗后很少观察到浆液性视网膜脱离,但仅在中枢性浆液性脉络膜视网膜病变和葡萄膜炎的情况下。单例所谓的孔源性脱离与疫苗接种有极不可能的联系。总而言之,上述并发症极为罕见,通常可以治疗或自行消退,不应阻碍COVID-19疫苗接种。
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Retinal Detachment Following Vaccination against COVID-19: A Narrative Literature Review
Retinal detachment (RD) refers to the anatomical separation of the neurosensory retina from the Retinal pigment epithelium, which, if untreated, ultimately leads to a loss of visual function and blindness. Three main types are recognised based on the pathogenesis: rhegmatogenous, associated with retinal tears/holes; tractional, where there is pulling on the retina from preretinal and/or vitreal fibrotic changes; and exudative or serous, in which the subretinal fluid is due to transudation, exudation, or impaired outer blood-retina barrier. The infection with SARS-CoV-2 has not been directly associated with any type of RD, except in cases of secondary infections or autoimmune conditions. Serous retinal detachment has very rarely been observed following the application of various vaccines against COVID-19, but only in the setting of central serous chorioretinopathy and uveitis. The single case of purported rhegmatogenous detachment has a highly improbable connection with the vaccination. All in all, the described complications have been extremely uncommon, more frequently treatable or self-resolving, and should not discourage COVID-19 vaccination.
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