Acute idiopathic blind spot enlargement syndrome following influenza vaccination

Abstract

Purpose To report a case of acute idiopathic blind spot enlargement syndrome (AIBSES) following influenza vaccination. Observations A 57-year old woman presented with a one-month history of photopsia, temporal visual field disturbance on the right eye, 11 days following the administration of the influenza virus vaccine. Visual acuity was 20/30, and color vision remained normal. Examination revealed mild venular dilation at the edge of the right optic disk and was otherwise unremarkable. Visual field testing revealed enlargement of the right physiological blind spot. Medical workup, including brain CT scan, brain MRI, RPR, Treponema pallidum antibodies, Chest X-Ray, ANA, and PPD testing, was found within normal limits. Ancillary testing was compatible with an assessment of AIBSES secondary to influenza virus vaccination. Conclusions and Importance Although direct causation may not be absolutely established by a single report, our case suggests that the influenza virus vaccine may serve as an immunological trigger for some cases of AIBSES. Thoughtful vaccination history is of the utmost importance when evaluating patients with AIBSES, as it may help elucidate the underlying precipitating factor. To our knowledge, this is the first reported case of AIBSES following influenza virus vaccination.

Transient visual field loss after COVID-19 vaccination: Experienced by ophthalmologist, case report

“…AIBSES is a rare condition, and currently believed to be in a spectrum of primary inflammatory choriocapillaropathy (PICCP). 25 This condition has been reported following influenza vaccination. The patient could present with acute monocular scotoma, with otherwise normal fundus.…”

Acute Idiopathic Blind Spot Enlargement Syndrome (AIBSES) – Nutzen der OCT: Übersichtsarbeit

“…In 6 der 27 von Volpe et al beschriebenen Fälle trat ein Rezidiv zwischen 1 und 15 Jahren nach dem ersten Auftreten auf. In 2 Fällen war auch das kontralaterale Auge betroffen [7].…”

“…Über den Einsatz von systemischen Steroiden wurde in Einzelfallbeschreibungen berichtet [3,4,6,7,10,17,21]. Zwölf der eingeschlossenen behandelten Patienten erhielten eine systemische Therapie mit Prednison in einer initialen Dosierung zwischen 30 mg und 100 mg, in der Folge ausschleichend über mehrere Wochen [3,4,6,7,10,15,24,26,31,35]. Der Zeitraum zwischen Symptomauftreten und Therapiebeginn lag dabei zwischen 1 und 4 Wochen.…”

“…The etiology of AIBSES remains unclear. In particular, previous viral infections and vaccinations against Influenza, Covid-19, and mumps, measles, and rubella are discussed as possible triggers [7,8,10,17,18]. Genetic and hormonal factors are also considered, as females are clearly predominantly affected.…”

“…Therapeutic options are not described either in the earliest description of AIBSES or in the largest case series of 27 patients [9,19]. The use of systemic steroids has been re-ported in individual case descriptions [3,4,6,7,10,17,21]. Out of the treated patients included in this review, 12 received systemic treatment with prednisone at an initial dose of 30 to 100 mg, subsequently tapered over several weeks [3,4,6,7,10,15,24,26,31,35].…”