Ischemic Optic Neuropathy After Administration of a SARS-CoV-2 Vaccine: A Report of 2 Cases

Case series Patients: Male, 53-year-old • Male, 65-year-old Final Diagnosis: Ischemic optic neuropathy Symptoms: Visual acuity loss • visual field defect Medication: — Clinical Procedure: — Specialty: Ophthalmology OBJECTIVE: Rare coexistence of disease or pathology BACKGROUND: Since the start of vaccination efforts against COVID-19, several presumed secondary ocular events have been described. We present 2 cases of non-arteritic anterior ischemic optic neuropathy (NA-AION) in patients whose symptoms appeared in the first 2 weeks after administration of the Pfizer-BioNTech COVID-19 mRNA BNT162b2/ Cominarty vaccine. CASE REPORTS: The first patient was a 53-year-old man who presented visual field disturbance in the right eye 7 days after the first vaccine dose, and who consulted a physician 10 days after the second dose, when he experienced loss of vision in the left eye. After a full examination, bilateral anterior optic disc neuropathy was diagnosed. The second patient was a 65-year-old man who presented anterior optic disc neuropathy 12 days after his first vacci-nation. In both cases, arteritic origin was ruled out due to absence of systemic symptoms and because of normal levels of C-reactive protein and erythrocyte sedimentation rates. CONCLUSIONS: Ischemic optic neuropathy is a rare adverse ocular secondary effect of COVID-19 vaccines. Further basic and clinical research is needed to elucidate the pathogenic mechanisms and better characterize the clinical picture of this entity.