Bilateral optic neuritis after COVID vaccination

Arnao, Valentina; Maimone, Mario Baronello; Perini, Valentina; Giudice, Gregorio Lo; Cottone, Salvatore

doi:10.1007/s10072-021-05832-9

Cited by 18 publications

(11 citation statements)

References 5 publications

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“…[ 3 ] However, neurological inflammatory side effects involving CNS after SARS-CoV-2 vaccination have been reported one after another. [ 4 , 5 ] Furthermore, isolated cranial neuropathies after several days of vaccination have been more frequently published [ [6] , [7] , [8] , [9] ] and they assumed the possibility of an immunogenic demyelinating or microvascular process triggered by the vaccine in susceptible individuals. [ 2 , 4 , 5 ]…”

Section: Discussionmentioning

confidence: 99%

Sequential orbital apex syndrome following the COVID-19 vaccination: A case report

Choi

et al. 2023

eNeurologicalSci

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Section: Discussionmentioning

confidence: 99%

Sequential orbital apex syndrome following the COVID-19 vaccination: A case report

Choi

et al. 2023

eNeurologicalSci

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“…Optic neuropathy is suspected as one of adverse events of the COVID-19 vaccine, which includes ON associated with or without demyelinating CNS diseases [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], NA-AION [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], and NMOSD [ 8 , 9 ]. Lotan et al reviewed 14 case reports and 2 case series by electronic searches of the published literature regarding neuro-ophthalmological complications of COVID-19 vaccines and reported that optic neuritis was the most common, occurring in 61 of 76 cases (80.3%) [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD) after COVID-19 vaccination have been reported [ 1 , 2 , 3 , 4 , 5 , 6 ], while a complication of optic neuritis (ON) is also known [ 7 , 8 , 9 , 10 ]. Although idiopathic ON after COVID-19 vaccination is also reported [ 11 , 12 , 13 , 14 , 15 ], those visual prognoses are generally favorable. We report a case of atypical unilateral ON after receiving the BNT162b2 mRNA-based COVID-19 vaccine, in which the recovery of visual functions was restricted despite corticosteroid therapy.…”

Section: Introductionmentioning

confidence: 99%

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

2022

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Background: We report a case of atypical unilateral optic neuritis after receiving the BNT162b2 mRNA-based COVID-19 vaccine. Case Presentation: An 86-year-old man complained of blurred vision and decreased visual acuity in his right eye 8 days after receiving the second BNT162b2 mRNA-based COVID-19 vaccine and was referred to our hospital. He also had pain with eye movement. Best corrected visual acuity (BCVA) in the right eye was 20/200 and critical flicker frequency dropped to 16 Hz. Relative afferent pupillary defect was positive and central scotomas were observed on visual field analysis. Fundus examination and SD-OCT revealed optic disc swelling and apparent thickening of the retinal nerve fiber layer around the optic disc in the right eye. Although either an increase in CRP or ESR on laboratory tests, demyelinating lesion on MRI, or positive of anti-MOG antibodies or anti-AQP4 antibodies were not observed, fluorescein angiography presented only hyperfluorescence of the optic disc in the right eye, but there were no findings such as papillary deficiency and choroidal delay that would suggest ischemic optic neuropathy. We diagnosed atypical optic neuritis developed after the SARS-CoV-2 mRNA-based vaccination and initiated oral corticosteroid therapy. One month later, the optic disc swelling disappeared and BCVA improved to 20/100; however, the central scotoma remained and no further improvement in visual function OD was obtained. Conclusions: An atypical acute idiopathic optic neuritis can occur after receiving the second vaccination with BNT162b2, which may present a limited response to corticosteroid therapy.

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“…There have been several case reports that have described bilateral disc edema after COVID-19 vaccination. [13][14][15] Roy et al [15] reported the case of a 40-year-old man who showed symptoms typical of acute bilateral optic neuritis 12 days after receiving a COVID-19 recombinant messenger RNA vaccine. He experienced vision loss and pain with eye movement, and orbital MRI demonstrated optic nerve enhancement.…”

Section: Discussionmentioning

confidence: 99%

Silent progressive bilateral papillitis after COVID-19 vaccination: A case report

2022

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Rationale: We report the case of a patient who developed asymptomatic bilateral papillitis after coronavirus disease 2019 (COVID-19) vaccination. Patient concerns: A 61-year-old man presented to our tertiary clinic with bilateral optic disc edema, which was incidentally detected during his visit to a primary ophthalmology clinic. He had received an adenovirus-vectored COVID-19 vaccine 2 weeks before the optic disc edema was detected and had experienced no ocular discomfort, except for a floater in his right eye. Although his visual acuity was normal and he had no color vision deficiencies or marked visual field defects, the optic disc edema worsened over several days. Orbital magnetic resonance imaging showed no optic tract enhancement, and lumbar puncture revealed normal cerebrospinal fluid pressure. The patient tested negative for aquaporin-4 and myelin oligodendrocyte glycoprotein antibodies and Leber hereditary optic neuropathy-associated gene mutations. Diagnosis: The patient was diagnosed with bilateral papillitis, possibly induced by the COVID-19 vaccination. Interventions: The patient received steroid pulse therapy with methylprednisolone (500 mg/day) for 3 days followed by an oral prednisolone taper for 3 weeks. Outcomes: The patient’s papillitis started to subside 3 weeks after he received systemic steroid therapy and completely resolved without any sequelae 2 months later. A year after the diagnosis, the fundus remained stable without disease recurrence or optic disc atrophy. Lessons: Healthy individuals receiving COVID-19 vaccines may present with various manifestations of optic neuritis. In the present case, the patient presented with asymptomatic progressive bilateral optic disc edema and had a favorable long-term course after receiving steroid therapy.

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Bilateral optic neuritis after COVID vaccination

Cited by 18 publications

References 5 publications

Sequential orbital apex syndrome following the COVID-19 vaccination: A case report

Sequential orbital apex syndrome following the COVID-19 vaccination: A case report

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

Silent progressive bilateral papillitis after COVID-19 vaccination: A case report

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