Bilateral choroidal effusion following vaccination against SARS-CoV-2 virus.

An 80-year-old systemically stable female presented with sudden blurring of vision post the first dose of CovishieldTM, a non-replicating viral vector vaccine. On examination, she was found to have bilateral serous choroidal effusions. A thorough systemic and ocular workup was performed to rule out other causes of choroidal effusion. The effusions resolved with tapering doses of oral and systemic steroids. To the best of our knowledge, at the time of submission, this is the first case of choroidal effusion being reported after the coronavirus disease 2019 (COVID-19) vaccine.

Suprachoroidal Retinal prostheses, longterm stability and safety results

Purpose : To report the longterm safety and stability of two suprachoroidal retinal prosthesis trials (NCT01603576, NCT03406416), comprising of seven patients, with followup ranging from two to nine years. Methods : Three patients with retinitis pigmentosa were implanted with our prototype 24 channel suprachoroidal retinal prosthesis in May-August 2012. One patient had the entire device removed following the trial in 2014 for a medical reason unrelated to the device. The other two patients had the intraocular array left in situ and the percutaneous connector removed, as planned. Ocular followup has continued since that time, albeit interrupted due to the Covid 19 pandemic. Four patients with retinitis pigmentosa were implanted with our second generation 44 channel fully implantable device in February to August 2018. They continue to use the device in the home enviroment. Ocular assessments including clinical examination, colour fundus photographs and optical coherence tomography (OCT) have been used to assess stability of the devices and retinal health longitudinally in patients (P) 1-7. Results : Electrode to retina distance OCT measurements over two to nine years, calculated by comparing group means, showed an increase over time. (Wilcoxon, p=0.03) In the prototype trial, the increase appeared linked to fibrosis and stimulation, with no progression once devices were inactivated, in the second generation trial, it seemed primarily due to passive fibrosis. Retinal thickness OCT measurements showed a slow reduction in central retinal thickness, as expected, due to progression of dystrophic disease. (Wilcoxon, p=0.11) Device position compared to the optic nerve head (ONH) was calculated and three patients demonstrated some temporal movement. P1 position returned to baseline over seven years, P2 stabilised over three months and P6 had a temporary choroidal effusion event which settled spontaneously. Function of the four Generation two fully implantable devices remains stable. Conclusions : Using fundus photography and OCT measurements we demonstrate that retinal prostheses implanted in the suprachoroidal space for up to nine years are overall stable in position and cause mild progressive fibrosis in the suprachoroidal space. Longterm assessment of the changes in the retina are all consistent with the underlying retinal dystrophy. This provides further evidence of the safety of the suprachoroidal surgical approach for retinal prostheses.

Transient myopia due to choroidal effusion: A novel ocular complication of COVID-19 infection.

COVID-19 was declared as a global pandemic by the WHO in 2020. Although it is a respiratory virus, ocular complications and manifestations of the infection have been reported in different forms. We report a case of transient myopia and narrow angles due to choroidal effusion following infection by the SARS-COV-2 virus. We propose that the ability of the virus to incite an inflammatory response in the host body may be the mechanism behind the disease entity. This is a novel, previously undocumented ocular complication in case of a COVID-19 infection.