Recent vaccination exposure and central serous chorioretinopathy

Central serous chorioretinopathy (CSCR) is characterised by choroidal hyperpermeability and potential dysregulation of inflammatory cytokines. Because vaccination transiently activates cytokine pathways, we assessed whether vaccination is associated with incident CSCR.

We performed a case-control study in the Mass General Brigham database among adults 18-60 years. CSCR cases were matched 4:1 to controls by demographics, systemic conditions relevant to vaccination likelihood or infection susceptibility, CSCR risk factors, healthcare utilisation and index month/year. Vaccination within 90 days before index was evaluated overall, by vaccine category, and by time window (1-10, 11-45, and 46-90 days before index); odds ratios (ORs) were estimated.

Among 3 205 CSCR cases, 66 (2.1%) had recorded vaccination within 90 days before index compared with 232 (1.8%) of 12 753 controls (OR 1.14, 95% CI 0.86-1.50; P = 0.37). No associations were observed for influenza (OR 1.09, 95% CI 0.74-1.60; P = 0.67), COVID-19 (OR 1.00, 95% CI 0.37-2.66; P = 0.99), or tetanus-containing vaccines (OR 1.20, 95% CI 0.73-1.95; P = 0.48). Vaccination within 1-10 days before index was associated with higher odds of CSCR (OR 2.00, 95% CI 1.02-3.89; P = 0.043). Case-crossover analysis showed similar temporal clustering (OR 3.25, 95% CI 1.06-9.97; P = 0.039).

Vaccination within 1-10 days before index was associated with higher odds of CSCR, although vaccination within 90 days was not. These findings do not support changes to vaccination practice for patients at risk of CSCR, but highlight the need for larger studies with complete vaccine capture to evaluate CSCR risk during the acute post-vaccination period.