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Yorgun MA, Sarıtaş Ö, Özkan E, Taşçı YY, Ünal Ö, Toklu Y. Early Effects of Inactivated (CoronaVac) SARS-CoV-2 Vaccine on Retrobulbar Vascular Blood Flow and Retinal Vascular Density. Photodiagnosis Photodyn Ther 2023; 42:103584. [PMID: 37094610 PMCID: PMC10122555 DOI: 10.1016/j.pdpdt.2023.103584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/04/2023] [Accepted: 04/21/2023] [Indexed: 04/26/2023]
Abstract
AIMS We aimed to investigate the early effects of inactivated SARS-CoV-2 vaccine on retrobulbar vascular blood flow and retinal vascular density in healthy subjects. METHODS Thirty-four eyes of 34 healthy volunteers who received the CoronaVac (Sinovac Life Sciences, China) were included in this prospective study. Resistive index (RI), pulsatility index (PI) and peak systolic velocity (PSV) of the ophthalmic artery (OA), central retinal artery (CRA), and the temporal and nasal posterior ciliary arteries (PCA) were evaluated with color Doppler ultrasonography (CDUS) before vaccination, at the 2nd and 4th weeks after vaccination. Superficial capillary plexus (SCP) and deep capillary plexus (DCP) vessel density (VD), foveal avascular zone (FAZ), and choriocapillaris blood flow (CCF) measurements were made using optical coherence tomography angiography (OCTA). RESULTS When compared to the pre-vaccination values, there was no significant change in OA-PSV, temporal-nasal PCA-PSV, CRA-EDV, temporal-nasal PCA-EDV at 2nd and 4th weeks after vaccination. However statistically significant reductions were found in the OA-RI, OA-PI, CRA-RI, CRA-PI, temporal-nasal PCA-RI, temporal-nasal PCA-PI values, CRA-PSV at post-vaccination 2nd week (p<0.05 for all). While there was sustained reduction in OA-RI, OA-PI, CRA-PSV, and nasal PCA-RI values at 4th week after vaccination, the change in CRA-RI, CRA-PI, temporal PCA-RI, temporal-nasal PCA-PI values were not significant compared to pre-vaccination values. There was no statistically significant difference in the SCP-VD, DCP-VD, FAZ and CCF measurements. CONCLUSIONS Our findings demonstrating that CoronaVac vaccine did not affect retinal vascular density in the early period, but it caused alterations in the retrobulbar blood flow.
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Affiliation(s)
- Mücella Arıkan Yorgun
- Ankara Yıldırım Beyazıt University, Department of Ophthalmology, Ankara, Turkey; Ankara City Hospital, Department of Ophthalmology, Ankara, Turkey.
| | - Özge Sarıtaş
- Ankara Yıldırım Beyazıt University, Department of Ophthalmology, Ankara, Turkey; Ankara City Hospital, Department of Ophthalmology, Ankara, Turkey
| | - Erdem Özkan
- Ankara Yıldırım Beyazıt University, Department of Radiology, Ankara, Turkey
| | | | - Özlem Ünal
- Ankara Yıldırım Beyazıt University, Department of Radiology, Ankara, Turkey
| | - Yasin Toklu
- Ankara Yıldırım Beyazıt University, Department of Ophthalmology, Ankara, Turkey; Ankara City Hospital, Department of Ophthalmology, Ankara, Turkey
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Dağ Y, Acet Y. Evaluation of the Effect of İnfection and İmmunity on the Tear Film by Scheimpflug-Placido Disc Topography- A Case Control Study. Photodiagnosis Photodyn Ther 2023; 41:103216. [PMID: 36470405 PMCID: PMC9719847 DOI: 10.1016/j.pdpdt.2022.103216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/19/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE We aimed to compare the tear film stability of individuals who had recovered from coronavirus disease (COVID-19), that of individuals vaccinated against COVID-19 and that of healthy individuals in a control group. METHODS This study included 61 eyes of 61 post-COVID-19 patients, 63 eyes of 63 participants who had received at least two doses of the SARS-CoV-2 mRNA BNT162b2 (Pfizer-BioNTech) vaccine, and 57 eyes of healthy individuals in a control group. We compared the groups' tear film stability. RESULTS The mean non-invasive first tear break-up time (NIF-BUT) value was 4.1±2.7 seconds in the post-COVID-19 group, 4.7±2.9 seconds in the vaccinated group, and 5.8±2.8 seconds in the control group. This value was statistically significantly lower in the post-COVID-19 and vaccinated groups than in the control group (p= 0.007). The rate of superotemporal (ST) quadrant breakup, statistically significantly higher in the vaccinated group than in the other two groups (p=0.001). According to a qualitative examination of the results, at least one breakup occurred in 47 (77%) of the post-COVID-19 participants' eyes, 50 (79.4%) of the vaccinated group's eyes, and 33 (57.9%) of the control group's eyes. In terms of this qualitative value, the post-COVID-19 and vaccinated groups had significantly higher breakup rates than the control group (p=0.018). CONCLUSIONS Destabilization in the tear film was more common in both the post covid group and the vaccinated group. In addition to individuals who have post-Covid, we think that post-vaccination individuals should be followed closely in terms of ocular surface diseases.
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Affiliation(s)
- Yaşar Dağ
- Department of Ophthalmology, Başakşehir çam ve sakura city hospital. Istanbul, Turkey, Mobile: +0905330188247.
| | - Yakup Acet
- Department of Ophthalmology, Mardin Training and Research Hospital. Mardin, Turkey, Mobile: +0905307849019.
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Acute macular neuroretinopathy after COVID-19 vaccine. J Fr Ophtalmol 2022; 45:e299-e302. [PMID: 35717218 PMCID: PMC9130638 DOI: 10.1016/j.jfo.2022.01.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2022] [Accepted: 01/28/2022] [Indexed: 11/23/2022]
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Lee C, Park KA, Ham DI, Seong M, Kim HJ, Lee GI, Oh SY. Neuroretinitis after the second injection of a SARS-CoV-2-vaccine: A case report. Am J Ophthalmol Case Rep 2022; 27:101592. [PMID: 35642221 PMCID: PMC9132495 DOI: 10.1016/j.ajoc.2022.101592] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Revised: 04/23/2022] [Accepted: 05/18/2022] [Indexed: 01/06/2023] Open
Affiliation(s)
- Chaeyeon Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Kyung-Ah Park
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Corresponding author. Department of Ophthalmology, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Don-Il Ham
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
- Corresponding author. Department of Ophthalmology, Samsung Medical Center, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, South Korea.
| | - Minjung Seong
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Hyung-Jin Kim
- Department of Radiology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Ga-In Lee
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Sei Yeul Oh
- Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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5
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Ophthalmic manifestation after SARS-CoV-2 vaccination: a case series. J Ophthalmic Inflamm Infect 2022; 12:20. [PMID: 35737133 PMCID: PMC9219386 DOI: 10.1186/s12348-022-00298-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Accepted: 06/08/2022] [Indexed: 12/23/2022] Open
Abstract
Background The aim of this report is to describe ocular side effects in patients who received one of the two COVID-19 vaccines – Astra Zeneca or Pfizer-Biontech and to contribute to the common understanding of the COVID-19 vaccination process. Results Three patients reactivated underlying herpetic disease and developed uveitis and keratitis. Two of them were vaccinated with Pfizer and one was with Astra Zeneca. Two patients were vaccinated with Pfizer-Biontech and had thrombosis on the 8th and 10th days following the day of vaccination. The man has diagnosed with nonarteritic anterior ischemic optic neuropathy and the woman had a subarachnoid haemorrhage, ptosis of upper eyelid and deviated eyeball. Conclusion There is a causal relationship between vaccines and the underlying disease. For more details, further large studies are necessary.
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Priluck AZ, Arevalo JF, Pandit RR. Ischemic retinal events after COVID-19 vaccination. Am J Ophthalmol Case Rep 2022; 26:101540. [PMID: 35465337 PMCID: PMC9014657 DOI: 10.1016/j.ajoc.2022.101540] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2021] [Revised: 04/08/2022] [Accepted: 04/11/2022] [Indexed: 12/01/2022] Open
Abstract
Purpose We report 2 cases of ischemic retinal events occurring soon after administration of the Moderna and Johnson & Johnson/Janssen COVID-19 vaccines. To our knowledge, these are the first reports of isolated ischemic retinal events occurring after COVID-19 vaccination. Observations A 57-year-old female had new onset floaters of the left eye within days of her second Moderna COVID-19 vaccination, which progressively worsened prompting her to present for evaluation. She was diagnosed with a branch retinal vein occlusion in the left eye. A 20-year-old female presented with persistent central scotomata in both eyes, which she first noticed two days after her Johnson & Johnson/Jannsen COVID-19 vaccination. She was diagnosed with acute macular neuroretinopathy of both eyes. Conclusions and Importance The potential side effects of COVID-19 vaccines are still being established; however, there has been concern over pro-thrombotic events with these vaccines, with most concerns directed toward the Johnson & Johnson vaccine. We observed likely transient pro-thrombotic retinal milieu in patients who received these vaccines though it remains unclear whether there is a shared mechanism between systemic response to the COVID-19 spike protein and the highly pro-thrombotic state seen in COVID-19 infections. In the case of our patients, we postulate their immunologic responses to the vaccines - and possibly a resultant pro-thrombotic state - may have precipitated their ischemic retinal events. We thus recommend that patients with ocular symptoms after COVID-19 vaccination undergo comprehensive ophthalmologic evaluation.
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Momenaei B, Cheraqpour K, Soleimani M, Tabatabaei SA, Shahriari M, Etesali H, Hussein A, Vaseghi Y, Ramezani B, Djalilian AR. Ophthalmic side effects of COVID-19 vaccines. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2066523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bita Momenaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Seyed Ali Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoor Shahriari
- Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Etesali
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmed Hussein
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Vaseghi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Ramezani
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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Capuano V, Forte P, Sacconi R, Miere A, Mehanna CJ, Barone C, Bandello F, Souied EH, Querques G. Acute macular neuroretinopathy as the first stage of SARS-CoV-2 infection. Eur J Ophthalmol 2022; 33:NP105-NP111. [PMID: 35360952 PMCID: PMC8980851 DOI: 10.1177/11206721221090697] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Introduction To report two cases of Acute Macular Neuroretinopathy (AMN) presented as the
first stage of SARS-CoV-2 infection in two European countries during the
third wave of pandemic viral infection in the early months of 2021. Observations A unilateral case of type 1 AMN in a man and a bilateral case of type 2 AMN
in an otherwise heathy patients were reported. Sudden onset of paracentral
scotoma characterized the cases with no systemic symptoms. Structural
optical coherence tomography (OCT) shows multifocal middle and inner retinal
hyperreflective infarctions. OCT-Angiography showed the presence of
hypoperfusion of the deep capillary plexus (DCP) corresponding to the
hyperreflective lesions visible on structural OCT, confirming the
diagnosis. Conclusions and importance Type 1 and type 2 AMN may be the first stage of SARS-CoV-2 infection. We
suggest testing all patients with AMN for SARS-CoV-2. In our cases, the
natural history of AMN associated with SARS-CoV-2 infection was similar to
already described cases of AMN.
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Affiliation(s)
- Vittorio Capuano
- Department of Ophthalmology, 26949Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Paolo Forte
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy
| | - Riccardo Sacconi
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy
| | - Alexandra Miere
- Department of Ophthalmology, 26949Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Carl-Joe Mehanna
- Department of Ophthalmology, 26949Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | | | - Francesco Bandello
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy
| | - Eric H Souied
- Department of Ophthalmology, 26949Centre Hospitalier Intercommunal de Créteil, Créteil, France
| | - Giuseppe Querques
- Department of Ophthalmology, IRCCS Ospedale San Raffaele, Vita-Salute University, Milan, Italy
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Ocular Complications Following Vaccination for COVID-19: A One-Year Retrospective. Vaccines (Basel) 2022; 10:vaccines10020342. [PMID: 35214800 PMCID: PMC8875181 DOI: 10.3390/vaccines10020342] [Citation(s) in RCA: 44] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 02/16/2022] [Accepted: 02/18/2022] [Indexed: 12/24/2022] Open
Abstract
Vaccination efforts as a mitigation strategy in the corona virus disease 2019 (COVID-19) pandemic are fully underway. A vital component of understanding the optimal clinical use of these vaccines is a thorough investigation of adverse events following vaccination. To date, some limited reports and reviews have discussed ocular adverse events following COVID-19 vaccination, but a systematic review detailing these reports with manifestations and clinical courses as well as proposed mechanisms has yet to be published. This comprehensive review one-year into vaccination efforts against COVID-19 is meant to furnish sound understanding for ophthalmologists and primary care physicians based on the existing body of clinical data. We discuss manifestations categorized into one of the following: eyelid, orbit, uveitis, retina, vascular, neuro-ophthalmology, ocular motility disorders, and other.
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10
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Franchi A, Rauchegger T, Palme C, Frede K, Haas G, Blatsios G, Kralinger M, Zehetner C. Two Cases of Acute Macular Neuroretinopathy Associated with the Adenovirus-based COVID-19 Vaccine Vaxzevria (Astrazeneca). Ocul Immunol Inflamm 2022; 30:1234-1239. [PMID: 35050829 DOI: 10.1080/09273948.2022.2027463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE To report two cases of acute macular neuroretinopathy (AMN) in young female patients following the administration of the adenovirus-based coronavirus disease 2019 (COVID-19) vaccine Vaxzevria (AstraZeneca). METHODS Spectral-domain optical coherence tomography and infrared imaging were used to confirm the diagnosis of AMN. RESULTS Both patients showed a parafoveal hyperreflective band in the outer nuclear layer, disruption of the ellipsoid and interdigitation zones of the photoreceptor layers, and correlating hyporeflective areas on the near-infrared images. Both patients presented with flu-like fever and sudden onset of fortifications within 48 hours of vaccination. One patient showed altered flow in the deep capillary plexus and highly elevated thrombotic parameters. CONCLUSION We report a possible association between immune-mediated AMN and the administration of adenovirus-based COVID-19 vaccine Vaxzevria.
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Affiliation(s)
- Alexander Franchi
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Teresa Rauchegger
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Christoph Palme
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Katharina Frede
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Gertrud Haas
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Georgios Blatsios
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Martina Kralinger
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
| | - Claus Zehetner
- Department of Ophthalmology and Optometry, Medical University Innsbruck, Innsbruck, Austria
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Abstract
PURPOSE To present the rare case of a patient who developed acute macular neuroretinopathy (AMN) after administration of a single-dose adenovector coronavirus vaccine. METHODS Retrospective chart review. RESULTS A 26-year-old woman presented with paracentral scotomas in both eyes that acutely developed 2 days after administration of a single-dose adenovector SARS-CoV-2 vaccine (Johnson & Johnson, New Brunswick, NJ). She had previously received the seasonal influenza immunization without any symptoms and denied having any recent history of viral illnesses. On examination, optical coherence tomography showed parafoveal hyperreflective bands in the outer retina of both eyes without retinal thickening and near-infrared reflectance showed wedge-shaped parafoveal lesions pointing to the fovea, both classic findings in acute macular neuroretinopathy. DISCUSSION This report highlights the development of acute macular neuroretinopathy after a SARS-CoV-2 vaccination in an otherwise healthy female patient. A single case cannot establish cause and effect, and millions of COVID-19 vaccines have been administered safely at the time of writing. However, this may be a rare association, and clinicians can consider inquiring about recent vaccination history in patients presenting with acute macular neuroretinopathy.
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Affiliation(s)
- Samir N Patel
- Wills Eye Hospital, Mid Atlantic Retina, Thomas Jefferson University, Philadelphia, Pennsylvania
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Abstract
PURPOSE To report a case of acute macular neuroretinopathy after the vaccination for coronavirus disease 2019. METHODS A 22-year-old White woman presented with symptoms of paracentral scotomas within a week of receiving coronavirus disease 2019 vaccination. Complete evaluation was performing using multimodal imaging techniques. RESULTS Spectral domain optical coherence tomography and near-infrared imaging showed characteristic features of acute macular neuroretinopathy. CONCLUSION/DISCUSSION To the best of our knowledge this is the first reported case of acute macular neuroretinopathy after coronavirus disease 2019 vaccination. Optical coherence tomography angiography did not reveal any signal attenuation, and multifocal electroretinogram and central visual fields were normal indicating that near-infrared imaging and spectral domain optical coherence tomography remain the gold standard in diagnosing this condition especially in smaller lesions.
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Affiliation(s)
- Naima Zaheer
- Birmingham and Midland Eye Centre, Sandwell & West Birmingham Hospitals NHS Trust, Birmingham, United Kingdom
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Azar G, Bonnin S, Vasseur V, Faure C, Salviat F, Clermont CV, Titah C, Farès S, Boulanger E, Derrien S, Couturier A, Duvilliers A, Manassero A, Hage R, Tadayoni R, Behar-Cohen F, Mauget-Faÿsse M. Did the COVID-19 Pandemic Increase the Incidence of Acute Macular Neuroretinopathy? J Clin Med 2021; 10:jcm10215038. [PMID: 34768555 PMCID: PMC8585041 DOI: 10.3390/jcm10215038] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/23/2021] [Accepted: 10/27/2021] [Indexed: 12/31/2022] Open
Abstract
Background: Acute macular neuroretinopathy (AMN) is an increasingly diagnosed disorder associated with several diseases. The aim of this study was to report the incidence of AMN cases diagnosed during the 2020 coronavirus disease 2019 (COVID-19) pandemic year in a French hospital, and to describe their different forms. Methods: All patients diagnosed between 2019 and 2020, in Paris Rothschild Foundation Hospital, with AMN, paracentral acute middle maculopathy (PAMM) and multiple evanescent white dot syndrome (MEWDS) were retrospectively collected using the software Ophtalmoquery® (Corilus, V1.86.0018, 9050 Gand, Belgium). Systemic and ophthalmological data from AMN patients were analyzed. Results: Eleven patients were diagnosed with AMN in 2020 vs. only one patient reported in 2019. The incidence of AMN significantly increased from 0.66/100,000 visits in 2019 to 8.97/100,000 visits in 2020 (p = 0.001), whereas the incidence of PAMM and MEWDS remained unchanged. Four (36%) of these AMN patients were tested for COVID-19 and received positive polymerase chain reaction (PCR) tests. Conclusions: The incidence of AMN cases increased significantly in our institution in 2020, which was the year of the COVID-19 pandemic. All AMN-tested patients received a positive COVID PCR test, suggesting a possible causative link. According to the different clinical presentations, AMN may reflect different severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) pathogenic mechanisms.
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Affiliation(s)
- Georges Azar
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Anterior Segment Department, Adolphe de Rothschild Foundation, 75019 Paris, France
- Correspondence:
| | - Sophie Bonnin
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Vivien Vasseur
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Céline Faure
- Ramsay Générale de Santé, Private Hospital Saint Martin, 14000 Caen, France;
| | - Flore Salviat
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Catherine Vignal Clermont
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Cherif Titah
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Anterior Segment Department, Adolphe de Rothschild Foundation, 75019 Paris, France
| | - Selim Farès
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Anterior Segment Department, Adolphe de Rothschild Foundation, 75019 Paris, France
| | - Elise Boulanger
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Sabine Derrien
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Aude Couturier
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Ophthalmology Department, Lariboisière Hospital—Assistance Publique-Hôpitaux de Paris, AP-HP, 75010 Paris, France
| | - Amélie Duvilliers
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Anthony Manassero
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Rabih Hage
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
| | - Ramin Tadayoni
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
- Ophthalmology Department, Lariboisière Hospital—Assistance Publique-Hôpitaux de Paris, AP-HP, 75010 Paris, France
| | - Francine Behar-Cohen
- Ophthalmology Department, OphtalmoPôle, Hôpital Cochin, Assistance Publique-Hôpitaux de Paris, AP-HP, Université de Paris, 75014 Paris, France;
- Centre de Recherche des Cordeliers, Team 17, INSERM U1138, Université de Paris, 75006 Paris, France
| | - Martine Mauget-Faÿsse
- Clinical Investigative Platform Department, Adolphe de Rothschild Foundation, 75019 Paris, France; (S.B.); (V.V.); (F.S.); (C.V.C.); (C.T.); (S.F.); (E.B.); (S.D.); (A.C.); (A.D.); (A.M.); (R.H.); (R.T.); (M.M.-F.)
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14
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Drüke D, Pleyer U, Hoerauf H, Feltgen N, Bemme S. Acute macular neuroretinopathy (AMN) following COVID-19 vaccination. Am J Ophthalmol Case Rep 2021; 24:101207. [PMID: 34580648 PMCID: PMC8457905 DOI: 10.1016/j.ajoc.2021.101207] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/14/2021] [Accepted: 09/20/2021] [Indexed: 11/06/2022] Open
Abstract
Purpose To describe a case of acute macular neuroretinopathy (AMN) in a 23-year-old Caucasian female after a COVID-19 vaccination (Vaxzevira). Observations Our patient perceived visual symptoms in both eyes one day after COVID-19 vaccination. Hyporeflective petalloid shaped perifoveal lesions appeared in infrared reflectance (IR) imaging, and Spectral domain-optical coherence tomography (SD-OCT) revealed structural alterations of outer retinal layers that resulted in persistent disruption of the ellipsoid zone (EZ) and the interdigitation zone (IZ). Conclusions and importance We report a novel association between AMN and COVID-19 vaccination. In addition to a febrile infection and oral contraception, previous vaccination should also be considered a potential risk factor for AMN.
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Affiliation(s)
- Daniela Drüke
- University Medical Center Goettingen, Department of Ophthalmology, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Uwe Pleyer
- Charité - Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Department of Ophthalmology, Campus Virchow, Charité, 13353, Berlin, Germany
| | - Hans Hoerauf
- University Medical Center Goettingen, Department of Ophthalmology, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Nicolas Feltgen
- University Medical Center Goettingen, Department of Ophthalmology, Robert-Koch-Straße 40, 37075, Göttingen, Germany
| | - Sebastian Bemme
- University Medical Center Goettingen, Department of Ophthalmology, Robert-Koch-Straße 40, 37075, Göttingen, Germany
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15
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Neri P, Pichi F. SARS-CoV-2 and the Eye: The Pandora's Box of Ocular Immunology. J Ocul Pharmacol Ther 2021; 37:502-509. [PMID: 34515538 DOI: 10.1089/jop.2021.0058] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
The Pandora's box myth addresses the evilness in the world that undisputedly nowadays is identified in severe acute respiratory syndrome (SARS)-Coronavirus 2 (CoV-2), formerly known as Covid-19, which belongs to coronaviridae family, identified in Wuhan, Hubei district of the Republic of China in December 2019. Since then, SARS-CoV-2 has affected ∼180 million people and made almost 4 million victims, with a mortality rate of 6.1%, which is 6 times higher than influenza virus. However, coronaviruses are well known in the ophthalmology field because they were used in the so-called experimental coronavirus retinopathy model. That model certainly brings intriguing concepts for understanding coronavirus pathophysiology, which may have important implications on treatment strategies. Certainly, the recent availability of vaccines gives hope on the control of virus spreading; however, vaccines might create immune reactions involving the eye structure. In this study, we reviewed the literature and elaborated the available data to speculate on possible new interpretation of both pathophysiology and treatment of SARS-CoV-2.
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Affiliation(s)
- Piergiorgio Neri
- Uveitis Service of The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Cleveland Lerner College of Medicine, Case Western University, Cleveland, Ohio, USA.,Khalifa University Medical School, Abu Dhabi, United Arab Emirates
| | - Francesco Pichi
- Uveitis Service of The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates.,Cleveland Lerner College of Medicine, Case Western University, Cleveland, Ohio, USA
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16
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Acute macular neuroretinopathy following Pfizer-BioNTech COVID-19 vaccination. Am J Ophthalmol Case Rep 2021; 24:101200. [PMID: 34485760 PMCID: PMC8409052 DOI: 10.1016/j.ajoc.2021.101200] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 06/30/2021] [Accepted: 08/31/2021] [Indexed: 11/21/2022] Open
Abstract
Purpose To describe a case of acute macular neuroretinopathy (AMN) in a patient immediately following administration of the Pfizer-BioNTech COVID-19 vaccine. Observations The patient complained of paracentral scotoma supported by paracentral visual field loss on multiple Humphrey visual fields that corresponded to outer retinal pathology on optical coherence tomography. The patient's symptoms resolved without treatment. Conclusions and Importance We conclude that the clinical testing demonstrated findings consistent with AMN. AMN may be an exceedingly rare adverse ocular effect of a novel vaccine and likely only in the setting of multiple other risk factors. Despite this, we strongly recommend vaccination against COVID-19.
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17
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Ng XL, Betzler BK, Testi I, Ho SL, Tien M, Ngo WK, Zierhut M, Chee SP, Gupta V, Pavesio CE, de Smet MD, Agrawal R. Ocular Adverse Events After COVID-19 Vaccination. Ocul Immunol Inflamm 2021; 29:1216-1224. [PMID: 34559576 PMCID: PMC8477588 DOI: 10.1080/09273948.2021.1976221] [Citation(s) in RCA: 102] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Revised: 08/24/2021] [Accepted: 08/29/2021] [Indexed: 12/23/2022]
Abstract
PURPOSE The COVID-19 pandemic has galvanized the development of new vaccines at an unprecedented pace. Since the widespread implementation of vaccination campaigns, reports of ocular adverse effects after COVID-19 vaccinations have emerged. This review summarizes ocular adverse effects possibly associated with COVID-19 vaccination, and discusses their clinical characteristics and management. METHODS Narrative Literature Review. RESULTS Ocular adverse effects of COVID-19 vaccinations include facial nerve palsy, abducens nerve palsy, acute macular neuroretinopathy, central serous retinopathy, thrombosis, uveitis, multiple evanescent white dot syndrome, Vogt-Koyanagi-Harada disease reactivation, and new-onset Graves' Disease. Studies in current literature are primarily retrospective case series or isolated case reports - these are inherently weak in establishing association or causality. Nevertheless, the described presentations resemble the reported ocular manifestations of the COVID-19 disease itself. Hence, we hypothesize that the human body's immune response to COVID-19 vaccinations may be involved in the pathogenesis of the ocular adverse effects post-COVID-19 vaccination. CONCLUSION Ophthalmologists and generalists should be aware of the possible, albeit rare, ocular adverse effects after COVID-19 vaccination.
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Affiliation(s)
- Xin Le Ng
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | | | - Ilaria Testi
- Moorfields Eye Hospital, NHS Foundation Trust, London, UK
| | - Su Ling Ho
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Melissa Tien
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Wei Kiong Ngo
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Manfred Zierhut
- Centre of Ophthalmology, University of Tuebingen, Tuebingen, Germany
| | - Soon Phaik Chee
- Department of Ocular Inflammation and Immunology, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, The Academia, Singapore
- Department of Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
| | - Vishali Gupta
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Carlos E Pavesio
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Marc D. de Smet
- MicroInvasive Ocular Surgery Clinic, Lausanne, Switzerland
- Department of Ophthalmology, University of Leiden, Leiden, The Netherlands
| | - Rupesh Agrawal
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Department of Ocular Inflammation and Immunology, Singapore National Eye Centre, Singapore
- Singapore Eye Research Institute, The Academia, Singapore
- Department of Ophthalmology & Visual Sciences Academic Clinical Program, Duke-NUS Medical School, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
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18
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Mambretti M, Huemer J, Torregrossa G, Ullrich M, Findl O, Casalino G. Acute Macular Neuroretinopathy following Coronavirus Disease 2019 Vaccination. Ocul Immunol Inflamm 2021; 29:730-733. [PMID: 34187278 DOI: 10.1080/09273948.2021.1946567] [Citation(s) in RCA: 45] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose: To report acute macular neuroretinopathy (AMN) in two young women two days after receiving Vaxzevria Coronavirus disease (COVID-19) vaccination.Methods: Observational case reports.Observation: The first patient was an Italian 22-year-old female with acute onset of paracentral scotoma two days post vaccination. The second patient was an Austrian 28-year-old female who presented with sudden onset paracentral scotoma two days after vaccination. Multimodal retinal imaging was consistent with AMN in both cases. Both patients were on long-term oral contraceptives, had no history of COVID-19 and experienced one-day duration fever the day after the vaccination.Conclusions: Vaccination may represent a possible risk factor for AMN onset in women on oral contraceptives. We encourage ophthalmologists to investigate recent vaccination status when dealing with new onset AMN. Further studies are needed to assess the link between vaccinations and AMN.
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Affiliation(s)
| | - Josef Huemer
- Vienna Institute for Research in Ocular Surgery, Vienna, Austria.,Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - Marlies Ullrich
- Vienna Institute for Research in Ocular Surgery, Vienna, Austria
| | - Oliver Findl
- Vienna Institute for Research in Ocular Surgery, Vienna, Austria
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19
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Fowler N, Mendez Martinez NR, Pallares BV, Maldonado RS. Acute-onset central serous retinopathy after immunization with COVID-19 mRNA vaccine. Am J Ophthalmol Case Rep 2021; 23:101136. [PMID: 34151047 PMCID: PMC8195685 DOI: 10.1016/j.ajoc.2021.101136] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Revised: 05/05/2021] [Accepted: 06/11/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose We report the case of a 33-year-old male who presented with unilateral central serous retinopathy three days after the injection of a COVID-19 vaccine. Observations A 33-year-old healthy Hispanic male referred to the ophthalmology service due to blurry vision and metamorphopsia in the right eye without any flashes, floaters, eye redness or pain. The patient reported that 69 hours prior to presentation he received the first dose of the Pfizer-BioNTech BNT162b2 mRNA COVID-19 vaccine. He denied any past ocular history or pertinent medical history. He does not take any medicines and denies stressful factors in his life. The clinical examination and imaging tests were consistent with central serous retinopathy that resolved in three months. Conclusions and importance This is the first report of an ocular complication potentially associated with a COVID-19 vaccination. Our case contributes information of a side effect potentially related to this new vaccine.
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Affiliation(s)
- Nicholas Fowler
- Department of Ophthalmology, University of Kentucky, 110 Conn Terrace, Suite 550, Lexington, KY, USA
| | - Noe R Mendez Martinez
- Hospital "La Raza" IMSS, Mexico City, Mexico.,Escuela Superior de Medicina - Instituto Politecnico Nacional, Mexico City, Mexico
| | | | - Ramiro S Maldonado
- Department of Ophthalmology, University of Kentucky, 110 Conn Terrace, Suite 550, Lexington, KY, USA
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20
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Cheng JY, Margo CE. Ocular adverse events following vaccination: overview and update. Surv Ophthalmol 2021; 67:293-306. [PMID: 33865883 DOI: 10.1016/j.survophthal.2021.04.001] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Revised: 04/05/2021] [Accepted: 04/08/2021] [Indexed: 01/30/2023]
Abstract
The Food and Drug Administration has licensed, approved, and expanded guidelines for dozens of vaccines since 2010. Although advancements in biotechnology have made vaccines more effective and safer, none are completely free from adverse effects. Many vaccines have been implicated in causing ocular adverse events based on the temporal association of exposure and putative complication. Determination of causality is difficult. We provide an overview of vaccine side effects and also examine the English literature and the Vaccine Adverse Events Reporting System (VAERS) from 2010 through 2020 for vaccine-implicated ocular adverse events. While reactions of eyelids and conjunctiva are commonly reported, the most frequently implicated serious adverse events are optic neuritis and various patterns of intraocular inflammation. Live attenuated vaccines have the potential to cause ocular infection from vaccine-strain organisms, particularly in those immunosuppressed. While postmarketing registries for suspect vaccination adverse events, such as VAERS, are unable to determine causal associations, they are a mainstay in signaling suspected trends that require investigation. The majority of probable and possible serious ocular adverse effects are distinctly uncommon.
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Affiliation(s)
- John Yu Cheng
- Morsani College of Medicine, University of South Florida, Tampa, FL, USA
| | - Curtis E Margo
- Departments of Ophthalmology, Pathology and Molecular Biology, Morsani College of Medicine, University of South Florida, Tampa, FL, USA.
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21
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Zamani G, Ataei Azimi S, Aminizadeh A, Shams Abadi E, Kamandi M, Mortazi H, Shariat S, Abrishami M. Acute macular neuroretinopathy in a patient with acute myeloid leukemia and deceased by COVID-19: a case report. J Ophthalmic Inflamm Infect 2021; 10:39. [PMID: 33415590 PMCID: PMC7790518 DOI: 10.1186/s12348-020-00231-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 12/09/2020] [Indexed: 11/13/2022] Open
Abstract
PURPOSE Acute macular neuroretinopathy (AMN) is a visual-deteriorating rare clinical entity with an uncertain etiology. We aimed to report a case of AMN and underlying disease of acute myeloid leukemia (AML). CASE PRESENTATION A thirty-five-year-old female patient with bone marrow biopsy confirmed AML, and bicytopenia, under chemotherapy, complained of sudden paracentral visual field defect in her right eye was referred. Visual acuity was 20/20 in both eyes. Posterior segment evaluation revealed multiple Roth's spots. Optical coherence tomography (OCT) demonstrated hyper-reflectivity band, in the outer nuclear layer and outer plexiform layer, nasal to the fovea of the right eye, and hyperreflective patch in outer retina segmentation en-face OCT, suggestive of the diagnosis of AMN. Nine days after AMN diagnosis, dyspnea, malaise, and cough was initiated. Ground glass opacities in lung CT scan, beside reverse transcription polymerase chain reaction of severe acute respiratory syndrome coronavirus-2, was conclusive of coronavirus disease 2019 (COVID-19). The patient deceased after 6 days. CONCLUSION We report a rare case of AMN following AML. Our findings support the role of ischemia in the outer retina, of which AML may contributed to the pathophysiological process. The patient has deceased less than 2 weeks from AMN initiation.
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Affiliation(s)
- Ghodsieh Zamani
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Sajjad Ataei Azimi
- Department of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Ali Aminizadeh
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Elham Shams Abadi
- Department of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mostafa Kamandi
- Department of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Hasan Mortazi
- Department of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Somayeh Shariat
- Department of Hematology-Oncology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mojtaba Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.
- Eye Research Center, Khatam-al-Anbia Eye Hospital, Qarani Blvd, Mashhad, 9195965919, Iran.
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