Frosted branch angiitis after smallpox vaccination

PURPOSE: To describe a patient presenting with frosted branch angiitis soon after small-pox vaccination. OBSERVATIONS: Frosted branch angiitis (FBA) is an acute onset retinal vasculitis featuring prominent perivascular sheathing in otherwise healthy individuals. FBA has been associated with noninfectious and infectious etiologies. This report describes a twenty-year-old African American female who developed bilateral frosted branch angiitis one week after small-pox vaccination. At presentation, the patient had bilateral, para-central visual field defects and subjective visual disturbances. On dilated exam, the patient demonstrated diffuse vasculitis bilaterally. The patient's field defects and clinical exam responded dramatically to oral prednisone therapy. CONCLUSIONS AND IMPORTANCE: Acute idiopathic frosted branch angiitis is a rare condition which was temporally associated with small-pox vaccination.