Acute bilateral optic/chiasm neuritis with longitudinal extensive transverse myelitis in longstanding stable multiple sclerosis following vector-based vaccination against the SARS-CoV-2

A systematic review of cases of CNS demyelination following COVID-19 vaccination

“… IVMP 1 g/day for 5 days Improvement. 30- Helmchen et al ( Helmchen et al, 2021 ) 40/F RRMS (for 21 years, on natalizumab) Negative nasopharyngeal swab for SARS-CoV-2-RT-PCR. Astra Zeneca, COVID19 Vaccine®; Vaxzevria®) Viral vector 1st 14 days NMOSD-like relapse (ON/LETM) Paraplegia, loss of sensory function below T5, and incontinence , rapidly progressing binocular blindness, back pain, and inability to walk.…”

COVID-19 Vaccination and The Eye

“…Two cases of COVID-19 vaccine-associated optic neuritis have been reported in the peer-reviewed literature to date (Table 1). 51,52 The first case occurred in a patient with longstanding relapsing-remittent multiple sclerosis (MS), who developed severe bilateral optic neuritis with chiasmal involvement and longitudinal extensive transverse myelitis, resembling neuromyelitis optica spectrum disorder (NMOSD), two weeks following receiving the first dose of the adenovirus vector ChAdOx1 nCoV-19 (AstraZeneca) vaccine. 51 The patient had previously been treated with natalizumab for 10 years, with the last dose received 8 days before immunisation.…”

“…51,52 The first case occurred in a patient with longstanding relapsing-remittent multiple sclerosis (MS), who developed severe bilateral optic neuritis with chiasmal involvement and longitudinal extensive transverse myelitis, resembling neuromyelitis optica spectrum disorder (NMOSD), two weeks following receiving the first dose of the adenovirus vector ChAdOx1 nCoV-19 (AstraZeneca) vaccine. 51 The patient had previously been treated with natalizumab for 10 years, with the last dose received 8 days before immunisation. Prior to receiving the vaccination, the patient had not previously demonstrated clinical or radiological evidence of NMOSD or optic neuritis.…”

Ocular Manifestations after Receiving COVID-19 Vaccine: A Systematic Review

“…Spinal MRI revealed myelitis at Th7-10, while aquaporin-4 (AQP4) was negative in serum and cerebrospinal fluid. Optic neuritis with AQP4-antibody negative neuromyelitis optica spectrum disorders-like syndrome was diagnosed [29].…”

“…Finally, the dysimmunological process may be triggered by the adenoviral vector-targeted B cell immune response. The immune reaction can induce the reactivation of optic neuritis with longitudinal extensive transverse myelitis in longstanding stable MS [29]. The relationship between adenoviral vector vaccines and all of the ocular symptoms mentioned should be further investigated.…”