Author: Borja Errazquin
Co-authors: Isabel Sendino Tenorio, Carlos Plaza Laguardia, Amancia Mateos Hernandez, Mirlibeth Loreto Carrero
Abstract
Purpose:To describe an AstraZeneca COVID-19 vaccine side effect involving the eye.
Setting/Venue:
Hospital de León.
Methods:
Case report.
Results:
A 61 years old woman presented with sudden visual loss of her right eye. She had no remarkable medical history except for having received AstraZeneca COVID-19 vaccine the previous day.
The best corrected visual acuity was 20/200 in the right eye and 20/20 in the left one. The funduscopic examination of the right eye showed a serous retinal detachment of the posterior pole and speckled yellowish lesions. The optic nerve and the blood vessels showed no alterations. The optic coherence tomography (OCT) showed a serous retinal detachment with a bacillary layer detachment component and thickened choroid. The exploration showed no more remarkable findings.
All the ancillary examination for infection and autoimmunity tested negative. Oral prednisone 40mg daily and topic nepafenac 3mg/ml once a day was initiated.
5 days after, the serous retinal detachment had improved both in the OCT and in the funduscopic examination and BCVA in the right eye was 20/40. Prednisone tapering was initiated.
10 days after, the serous retinal detachment had resolved, there were no lesions in the funduscopic examination and the patient recovered BCVA of 20/20.
Conclusions:
Ocular side effects have been reported with different types of vaccines for many years. Optic neuropathy and uveitis have been the more commonly reported ones. Different mechanisms have been proposed, such as direct infection of the attenuated pathogen, hypersensitivity due to molecular mimicry or adjuvants-induced inflammation.
AstraZeneca COVID-19 vaccine has been associated to different inflammatory diseases, some of them involving the eye (acute macular neurorretinopathy, multifocal choroiditis…). We present a case of corticosteroid-responsive serous retinal detachment presenting the day after vaccination with AstraZeneca COVID-19 vaccine. The vaccine could have caused an immune hiper-activation leading to vascular hyperpermeability and choroidal fluid leakage.
This and other reported cases, and the increasing coverage rate of COVID-19 vaccination, must warn the ophthalmologists about possible eye inflammatory complications in vaccinated patients.
State Financial Disclosure:
None.