*Case Report* **Bilateral Branch Retinal Vein Occlusion after mRNA-SARS-CoV-2 Booster Dose Vaccination**

**Matteo Gironi 1,2,†, Rossella D'Aloisio 2,\*,†, Tommaso Verdina 1, Benjamin Shkurko 3, Lisa Toto <sup>2</sup> and Rodolfo Mastropasqua <sup>2</sup>**


**Abstract:** Purpose: We report a case of a patient with a bilateral branch retinal vein occlusion (BRVO) 24 h after a booster vaccination with the mRNA-1237 vaccine. Observations: Fluorescein angiography, performed at three weeks follow-up, showed vascular leakage and blockage, corresponding to hemorrhage areas associated with ischemic areas in the macula and along the arcades involved in the occlusion. Conclusions: The patient was scheduled for urgent injections of intravitreal ranibizumab and laser photocoagulation of the ischemic areas. To the best of our knowledge, this is the first case described of concomitant bilateral RVO after COVID-19 vaccination. The rapid onset of the side effects in a patient with multiple risk factors for thrombotic events suggests that vulnerable microvascular conditions require detailed investigations before administration of a COVID-19 vaccine.

**Keywords:** COVID; SARS-CoV-2; retinal vein occlusion; RVO; vaccination; branch retinal vein occlusion
