Cargando…

Contralateral Recurrences of Post-vaccination Multiple Evanescent White Dot Syndrome

We report on a case of multiple evanescent white dot syndrome (MEWDS) following the simultaneous administration of the human papillomavirus and meningococcal (conjugate) vaccines and two recurrences of MEWDS following the administration of the second dose of the human papillomavirus (HPV) vaccine an...

Descripción completa

Detalles Bibliográficos
Autores principales: Ramirez Marquez, Estefania, Ayala Rodríguez, Sofía C, Rivera, Laiza, Pappaterra-Rodriguez, Mariella C, Requejo-Figueroa, Guillermo A, Rios, Radames, Rivera-Grana, Erick, Rodríguez-García, Eduardo J, Oliver, Armando L
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9822784/
https://www.ncbi.nlm.nih.gov/pubmed/36628035
http://dx.doi.org/10.7759/cureus.32300
_version_ 1784866026627792896
author Ramirez Marquez, Estefania
Ayala Rodríguez, Sofía C
Rivera, Laiza
Pappaterra-Rodriguez, Mariella C
Requejo-Figueroa, Guillermo A
Rios, Radames
Rivera-Grana, Erick
Rodríguez-García, Eduardo J
Oliver, Armando L
author_facet Ramirez Marquez, Estefania
Ayala Rodríguez, Sofía C
Rivera, Laiza
Pappaterra-Rodriguez, Mariella C
Requejo-Figueroa, Guillermo A
Rios, Radames
Rivera-Grana, Erick
Rodríguez-García, Eduardo J
Oliver, Armando L
author_sort Ramirez Marquez, Estefania
collection PubMed
description We report on a case of multiple evanescent white dot syndrome (MEWDS) following the simultaneous administration of the human papillomavirus and meningococcal (conjugate) vaccines and two recurrences of MEWDS following the administration of the second dose of the human papillomavirus (HPV) vaccine and the COVID-19 vaccine and COVID-19 viral infection. A 17-year-old Hispanic female presented with a one-week history of photopsia and blurred vision in her left eye following the simultaneous administration of the human papillomavirus and meningococcal (conjugate) vaccines. Upon a comprehensive examination, her best-corrected visual acuity was 20/20 in the right eye and 20/100 in the left eye. A left fundus examination revealed multiple white dots in the macula and nasal periphery, consistent with a diagnosis of MEWDS. Ancillary testing, including fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and optical coherence tomography, supported the diagnosis. One month following her initial diagnosis, the patient's symptoms had resolved without any therapy, and a fundus examination revealed multiple relatively ill-defined brown-colored subretinal lesions in the nasal midperiphery, corresponding to the location of the previous MEWDS lesions. Subsequently, she received the second dose of the HPV vaccine and then developed a mild COVID-19 infection. Four months after the initial presentation, she received the first dose of the BNT162b2 COVID-19 vaccine, followed by the second dose a month later. Eight months following her initial presentation, she presented with photopsia in the right eye. Her visual acuity remained 20/20 in the right eye and improved to 20/20 in the left eye, and white dots were identified nasal to the disk and surrounding the peripapillary region; the contralateral MEWDS diagnosis was confirmed by the previously mentioned ancillary tests. At her one-month follow-up, she presented new onset photopsia of the right eye. Her visual acuity remained 20/20 in both eyes, and a fundus examination revealed white lesions suggestive of active MEWDS temporal to the macula and brown-colored spots nasal to the disk, suggestive of recovering MEWDS, nasally. The aforementioned testing confirmed the coexistence of new and resolving lesions; nonetheless, the patient's symptoms resolved without any therapy, and she received the third dose of the BNT162b2 COVID-19 vaccine 11 months after her initial presentation. Our case suggests that vaccines may serve as immunological triggers of MEWDS. Recurrent MEWDS may occur when an individual is exposed to a powerful immune challenge, such as receiving a wide array of vaccinations in a short period of time. We believe this case constitutes a previously undescribed finding of multiple relatively ill-defined brown-colored subretinal lesions present in late MEWDS.
format Online
Article
Text
id pubmed-9822784
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Cureus
record_format MEDLINE/PubMed
spelling pubmed-98227842023-01-09 Contralateral Recurrences of Post-vaccination Multiple Evanescent White Dot Syndrome Ramirez Marquez, Estefania Ayala Rodríguez, Sofía C Rivera, Laiza Pappaterra-Rodriguez, Mariella C Requejo-Figueroa, Guillermo A Rios, Radames Rivera-Grana, Erick Rodríguez-García, Eduardo J Oliver, Armando L Cureus Ophthalmology We report on a case of multiple evanescent white dot syndrome (MEWDS) following the simultaneous administration of the human papillomavirus and meningococcal (conjugate) vaccines and two recurrences of MEWDS following the administration of the second dose of the human papillomavirus (HPV) vaccine and the COVID-19 vaccine and COVID-19 viral infection. A 17-year-old Hispanic female presented with a one-week history of photopsia and blurred vision in her left eye following the simultaneous administration of the human papillomavirus and meningococcal (conjugate) vaccines. Upon a comprehensive examination, her best-corrected visual acuity was 20/20 in the right eye and 20/100 in the left eye. A left fundus examination revealed multiple white dots in the macula and nasal periphery, consistent with a diagnosis of MEWDS. Ancillary testing, including fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and optical coherence tomography, supported the diagnosis. One month following her initial diagnosis, the patient's symptoms had resolved without any therapy, and a fundus examination revealed multiple relatively ill-defined brown-colored subretinal lesions in the nasal midperiphery, corresponding to the location of the previous MEWDS lesions. Subsequently, she received the second dose of the HPV vaccine and then developed a mild COVID-19 infection. Four months after the initial presentation, she received the first dose of the BNT162b2 COVID-19 vaccine, followed by the second dose a month later. Eight months following her initial presentation, she presented with photopsia in the right eye. Her visual acuity remained 20/20 in the right eye and improved to 20/20 in the left eye, and white dots were identified nasal to the disk and surrounding the peripapillary region; the contralateral MEWDS diagnosis was confirmed by the previously mentioned ancillary tests. At her one-month follow-up, she presented new onset photopsia of the right eye. Her visual acuity remained 20/20 in both eyes, and a fundus examination revealed white lesions suggestive of active MEWDS temporal to the macula and brown-colored spots nasal to the disk, suggestive of recovering MEWDS, nasally. The aforementioned testing confirmed the coexistence of new and resolving lesions; nonetheless, the patient's symptoms resolved without any therapy, and she received the third dose of the BNT162b2 COVID-19 vaccine 11 months after her initial presentation. Our case suggests that vaccines may serve as immunological triggers of MEWDS. Recurrent MEWDS may occur when an individual is exposed to a powerful immune challenge, such as receiving a wide array of vaccinations in a short period of time. We believe this case constitutes a previously undescribed finding of multiple relatively ill-defined brown-colored subretinal lesions present in late MEWDS. Cureus 2022-12-07 /pmc/articles/PMC9822784/ /pubmed/36628035 http://dx.doi.org/10.7759/cureus.32300 Text en Copyright © 2022, Ramirez Marquez et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Ophthalmology
Ramirez Marquez, Estefania
Ayala Rodríguez, Sofía C
Rivera, Laiza
Pappaterra-Rodriguez, Mariella C
Requejo-Figueroa, Guillermo A
Rios, Radames
Rivera-Grana, Erick
Rodríguez-García, Eduardo J
Oliver, Armando L
Contralateral Recurrences of Post-vaccination Multiple Evanescent White Dot Syndrome
title Contralateral Recurrences of Post-vaccination Multiple Evanescent White Dot Syndrome
title_full Contralateral Recurrences of Post-vaccination Multiple Evanescent White Dot Syndrome
title_fullStr Contralateral Recurrences of Post-vaccination Multiple Evanescent White Dot Syndrome
title_full_unstemmed Contralateral Recurrences of Post-vaccination Multiple Evanescent White Dot Syndrome
title_short Contralateral Recurrences of Post-vaccination Multiple Evanescent White Dot Syndrome
title_sort contralateral recurrences of post-vaccination multiple evanescent white dot syndrome
topic Ophthalmology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9822784/
https://www.ncbi.nlm.nih.gov/pubmed/36628035
http://dx.doi.org/10.7759/cureus.32300
work_keys_str_mv AT ramirezmarquezestefania contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome
AT ayalarodriguezsofiac contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome
AT riveralaiza contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome
AT pappaterrarodriguezmariellac contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome
AT requejofigueroaguillermoa contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome
AT riosradames contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome
AT riveragranaerick contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome
AT rodriguezgarciaeduardoj contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome
AT oliverarmandol contralateralrecurrencesofpostvaccinationmultipleevanescentwhitedotsyndrome