Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report

被引:4
|
作者
Liu, Ching-Chih [1 ,2 ]
Lee, Wan-Ju Annabelle [1 ,3 ]
机构
[1] Chi Mei Med Ctr, Dept Ophthalmol, Tainan 71004, Taiwan
[2] Kaohsiung Med Univ, Coll Med, Grad Inst Med, Kaohsiung 80708, Taiwan
[3] Natl Cheng Kung Univ, Coll Med, Sch Pharm, Inst Clin Pharm & Pharmaceut Sci, Tainan 70101, Taiwan
关键词
COVID-19; vaccine; AZ vaccine; ChAdOx1; optic neuritis; RISK;
D O I
10.3390/vaccines10111889
中图分类号
R392 [医学免疫学]; Q939.91 [免疫学];
学科分类号
100102 ;
摘要
Background: Neuro-ophthalmic manifestations after vaccines are rare, with optic neuritis (ON) being the most common presentation. Patients with vaccine-related ON are similar to those with idiopathic ON. The temporal relationship between vaccination against and the occurrence of ON is vital. Here, we report a case of bilateral ON after the administration of the ChAdOx1-S nCoV-19 SARS-CoV-2 vaccine. Case: A 49-year-old healthy Asian female presented with sudden onset of bilateral blurred vision within 2 days. She complained of photophobia and extraocular pain upon movement over 3 days. Upon examination, her best corrected visual acuity (BCVA) was 20/30 in the right eye and 20/200 in the left eye. Anterior segment findings were unremarkable, with normal intraocular pressure. Fundoscopic examination revealed bilateral disc edema with vessel engorgement. Visual field examination revealed profound visual field defect in both eyes. She denied any trauma, use of new medication or medical history. She had received the ChAdOx1 nCoV-19 SARS-CoV-2 vaccine 14 days prior. Under suspicion of vaccine-related optic neuritis, she was given intravenous methylprednisolone 1 gm/day for 3 days, shifting to oral prednisolone under gradual tapering for 2 weeks. Conclusions: Typically presenting with sudden-onset visual decline and extraocular pain during movement, acute ON is generally idiopathic. Bilateral ON is rare, but quick identification is important because it can potentially lead to permanent loss of vision if left untreated. Vaccination-induced ON is even rarer but not difficult to treat. However, such patients require further evaluation and long-term follow-up because they may be prone to other neurological disorders in the future.
引用
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页数:7
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