Vascular retinal findings after COVID-19 vaccination in 11 cases: a coincidence or consequence?

PURPOSE: The primary purpose of this study was to assess vascular retinal findings temporally related to COVID-19 vaccination. With greater information regarding all possible future adverse events, we hope to understand the real dimension and relevance of what was presented. METHODS: Eleven patients with visual complaints after COVID-19 vaccination were enrolled. Data on the following were included: age, sex, vaccine, time of symptom onset, systemic findings, medical history, best-corrected visual acuity, and ocular findings by slit-lamp biomicroscopy as well as multimodal retinal imaging (color fundus, red-free photography, spectral-domain optical coherence tomography, optical coherence tomography angiography, and fluorescein-angiography). Inclusion criteria were the presence of ophthalmologic signs within 30 days after the first or second dose of any COVID-19 vaccine. RESULTS: Of 11 patients, five had arterial occlusion (45.4%), four had venous occlusion (36.4%), and two (18.2%) had nonspecific vascular alterations suggestive of retinal ischemia such as cotton-wool spots. The mean age was 57 (SD = 16; range: 27-84) years. The mean time of symptoms onset was 10 (SD = 5.4; range: 3-16) days. Nine patients were female (81.8%). Systemic risk factors were observed in 36.4% of patients. Two patients had both neurological and visual symptoms, with arterial occlusion. Overall, 36.4% patients had COVID-19 in the previous year. Seven patients (63.6%) received ChAdOx1 nCoV-19 (AZD1222) vaccine. CONCLUSIONS: Our data suggest that retinal events temporally related to COVID-19 vaccination are possible but are very rare. The relationship of these events with post-COVID-19 vaccination warrants further attention to derive a meaningful conclusion.

Comfort: Context for the Study Abroad Faculty Role.

Universities are increasingly undertaking student study abroad programs led by nursing faculty. The authors launched an inaugural study abroad nursing course. They proposed that the significance of the faculty trip role extends beyond the operational tasks required for international programs. Comfort theory was chosen as a good fit, since it offered a context for the significance of nursing faculty leading study abroad trips. It was consistent with the authors' experiences. Nurse faculty members applying technical and coaching interventions to relieve needs can strengthen students facing the demands of international experiences. It was concluded that comfort theory provided meaningful context for the international trip leader role.

Culturally Congruent Evidence-Based Practice in an International Outreach Course for Prelicensure Nursing Students.

The PICO (Population/Problem, Intervention, Comparison, Outcome) framework is widely accepted for posing evidence-based practice questions. This framework offers prelicensure nursing students a structured process for synthesizing nursing knowledge with the best available evidence to make decisions for practice. However, students in an international outreach course may find that evidence-based practice is not available in-country; furthermore, it may not be congruent with a population's culture. Faculty guidance helps students enrolled in international outreach courses to integrate cultural competence into the PICO structure. A case study illustrates how the framework was applied during an undergraduate nursing outreach course to Nicaragua.