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

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, w...

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Autores principales: Liu, Ching-Chih, Lee, Wan-Ju Annabelle
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694496/
https://www.ncbi.nlm.nih.gov/pubmed/36366396
http://dx.doi.org/10.3390/vaccines10111889
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author Liu, Ching-Chih
Lee, Wan-Ju Annabelle
author_facet Liu, Ching-Chih
Lee, Wan-Ju Annabelle
author_sort Liu, Ching-Chih
collection PubMed
description 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.
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spelling pubmed-96944962022-11-26 Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report Liu, Ching-Chih Lee, Wan-Ju Annabelle Vaccines (Basel) Case Report 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. MDPI 2022-11-09 /pmc/articles/PMC9694496/ /pubmed/36366396 http://dx.doi.org/10.3390/vaccines10111889 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Liu, Ching-Chih
Lee, Wan-Ju Annabelle
Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report
title Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report
title_full Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report
title_fullStr Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report
title_full_unstemmed Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report
title_short Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report
title_sort bilateral optic neuritis after covid-19 vaccination: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9694496/
https://www.ncbi.nlm.nih.gov/pubmed/36366396
http://dx.doi.org/10.3390/vaccines10111889
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