Canadian journal of ophthalmology. Journal canadien d'ophtalmologie · 2025
Risk of oculomotor and trochlear nerve palsies following COVID-19 vaccination.
СтатьяМногоцентровое исследованиеНазвание и аннотация: Перевод пока не подготовлен
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Kwok Alexander, Chauhan Muhammad Z, Dihan Qais, Solyman Omar, Phillips Paul H, Elhusseiny Abdelrahman M
Аннотация
OBJECTIVE: To investigate the prevalence and risk of new-onset oculomotor and trochlear nerve palsy following coronavirus disease (COVID-19) vaccination.
DESIGN: This retrospective, cross-sectional study analyzed data from the COVID-19 Research Network of TriNetX.
PARTICIPANTS: We identified patients who received COVID-19, influenza, or tetanus, diphtheria, and pertussis (Tdap) vaccinations or who had COVID-19 infection.
METHODS: We calculated the relative risk (RR) across groups. We performed propensity score matching to balance the cohorts. Significance tests were paired and 2-sided, with 95% confidence intervals (CI) and p < 0.05. The primary outcome was new oculomotor or trochlear nerve palsies within 21 days of vaccination.
RESULTS: Among >6,500,000 vaccinated patients (mean age: 46.7 ± 21.4 years), 11 and 15 developed oculomotor and trochlear nerve palsy, respectively, within 21 days of the first COVID-19 dose. The RR for oculomotor palsy after the first COVID-19 dose was similar to influenza (RR, 1.00, 95% CI, 0.416 - 2.40; p = 0.99), Tdap (RR, 0.99, 95% CI, 0.41 - 2.40; p = 0.99), and second COVID-19 dose vaccinations (RR, 1.00, 95% CI, 0.41- 2.40; p = 0.99), but lower than COVID-19 infection (RR, 0.16, 95% CI, 0.08 - 0.33; p < 0.0001). Trochlear nerve palsy risk was comparable across all groups.
CONCLUSIONS: The risk of oculomotor and trochlear nerve palsies after COVID-19 vaccination is similar to other vaccines. The risk of oculomotor nerve palsy is lower after vaccination than after COVID-19 infection. No evidence suggests a causal relationship between COVID-19 vaccination and these cranial neuropathies.
DESIGN: This retrospective, cross-sectional study analyzed data from the COVID-19 Research Network of TriNetX.
PARTICIPANTS: We identified patients who received COVID-19, influenza, or tetanus, diphtheria, and pertussis (Tdap) vaccinations or who had COVID-19 infection.
METHODS: We calculated the relative risk (RR) across groups. We performed propensity score matching to balance the cohorts. Significance tests were paired and 2-sided, with 95% confidence intervals (CI) and p < 0.05. The primary outcome was new oculomotor or trochlear nerve palsies within 21 days of vaccination.
RESULTS: Among >6,500,000 vaccinated patients (mean age: 46.7 ± 21.4 years), 11 and 15 developed oculomotor and trochlear nerve palsy, respectively, within 21 days of the first COVID-19 dose. The RR for oculomotor palsy after the first COVID-19 dose was similar to influenza (RR, 1.00, 95% CI, 0.416 - 2.40; p = 0.99), Tdap (RR, 0.99, 95% CI, 0.41 - 2.40; p = 0.99), and second COVID-19 dose vaccinations (RR, 1.00, 95% CI, 0.41- 2.40; p = 0.99), but lower than COVID-19 infection (RR, 0.16, 95% CI, 0.08 - 0.33; p < 0.0001). Trochlear nerve palsy risk was comparable across all groups.
CONCLUSIONS: The risk of oculomotor and trochlear nerve palsies after COVID-19 vaccination is similar to other vaccines. The risk of oculomotor nerve palsy is lower after vaccination than after COVID-19 infection. No evidence suggests a causal relationship between COVID-19 vaccination and these cranial neuropathies.