COVID-19 Vaccination and Bilateral Multifocal Choroiditis

Mungmunpuntipantip, Rujittika; Wiwanitkit, Viroj

doi:10.1080/09273948.2021.1968003

Cited by 5 publications

(2 citation statements)

References 4 publications

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“…A retrospective multicenter study collected 21 cases of unilateral or bilateral AU and 2 cases of MEWDS after the administration of the BNT162b2 mRNA vaccine [17]. Moreover, two case reports described bilateral multifocal choroiditis following COVID-19 vaccination [18,19]. Other cases of facial nerve palsy, abducens nerve palsy, new-onset Graves' disease, VKH disease reactivation, AMN, PAAM, and thrombosis have been described [9].…”

Section: Discussionmentioning

confidence: 99%

Uveitis and Other Ocular Complications Following COVID-19 Vaccination

Bolletta

Iannetta

Mastrofilippo

et al. 2021

JCM

109

105

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Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other ocular complications following COVID-19 vaccination. The study included 42 eyes of 34 patients (20 females, 14 males), with a mean age of 49.8 years (range 18–83 years). The cases reported were three herpetic keratitis, two anterior scleritis, five anterior uveitis (AU), three toxoplasma retinochoroiditis, two Vogt-Koyanagi-Harada (VKH) disease reactivations, two pars planitis, two retinal vasculitis, one bilateral panuveitis in new-onset Behçet’s disease, three multiple evanescent white dot syndromes (MEWDS), one acute macular neuroretinopathy (AMN), five retinal vein occlusions (RVO), one non-arteritic ischemic optic neuropathy (NAION), three activations of quiescent choroidal neovascularization (CNV) secondary to myopia or uveitis, and one central serous chorioretinopathy (CSCR). Mean time between vaccination and ocular complication onset was 9.4 days (range 1–30 days). Twenty-three cases occurred after Pfizer-BioNTech vaccination (BNT162b2 mRNA), 7 after Oxford-AstraZeneca vaccine (ChAdOx1 nCoV-19), 3 after ModernaTX vaccination (mRNA-1273), and 1 after Janssen Johnson & Johnson vaccine (Ad26.COV2). Uveitis and other ocular complications may develop after the administration of COVID-19 vaccine.

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Section: Discussionmentioning

confidence: 99%

Uveitis and Other Ocular Complications Following COVID-19 Vaccination

Bolletta

Iannetta

Mastrofilippo

et al. 2021

JCM

109

105

View full text Add to dashboard Cite

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“…This is very well shown by ICGA that characterises the process, identifying choriocapillaris non-perfusion in new developing lesions. Additional arguments for an immune mediated process are (1) several reports indicating that multifocal choroiditis developed after different types of vaccinations [ 41 – 43 ], and (2) the fact that the disease responds well to immunosuppression. Choriocapillaris non-perfusion is causing secondary ischaemia of the outer retina damaging photoreceptor outer segments well identified by spectral domain optical coherence tomography (SD-OCT) and by blue-light fundus autofluorescence (BL-FAF) showing hyperautofluorescence in the affected areas due to the loss of the photoreceptor screen to retinal pigment epithelium autofluorescence.…”

Section: Pathology and Clinicopathologymentioning

confidence: 99%

Idiopathic multifocal choroiditis (MFC): aggressive and prolonged therapy with multiple immunosuppressive agents is needed to halt the progression of active disease. An offbeat review and a case series

Papasavvas¹,

Neri

Mantovani

et al. 2022

J Ophthal Inflamm Infect

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Background and purpose Idiopathic multifocal choroiditis (MFC) is part of the group of choriocapillaritis entities. The clinical definition of the disease has evolved with time. The aim of this article was to undertake a review on MFC, on its present-day appraisal and nomenclature and we also report a series of patients with emphasis on the clinical presentation and the importance of vigorous immunosuppressive management. Methods A review of the literature and a retrospective case series study which was performed in the Centre for Ophthalmic Specialised care (COS), Lausanne, Switzerland. Patients diagnosed from 1994 to 2020 with idiopathic multifocal choroiditis (MFC) treated with multiple immunosuppressants were included. Exclusion criteria were insufficient follow up and cases not treated with vigorous immunosuppressive therapy. Imaging analysis included spectral domain optical coherence tomography (SD-OCT) / enhanced depth imaging OCT (EDI-OCT), OCT angiography (OCT-A). Fluorescein and Indocyanine angiography (FA, ICGA) before and after the instauration of treatment. Best corrected visual acuity (BCVA), intraocular pressure (IOP), routine ocular examination, laser flare photometry (LFP) were performed at presentation and follow-up. Immunosuppression comprised at minimum two among the following agents: prednisone, cyclosporine, azathioprine, mycophenolic acid or infliximab. Mean duration of therapy was calculated. Results 26 (52 eyes) of 2102 new patients (1.24%) were diagnosed with MFC. 25 (96%) patients were female and 1 (4%) was male. 43/52 (82%) eyes were myopic with a mean dioptre of − 5.87 ± 2.94, six (12%) eyes were hypermetropic with mean dioptres 2.0 ± 2.68 and three (6%) were emmetropic. 14/52 (27%) eyes had at least 1 anti-VEGF injection because of choroidal neovascularisation (CNVs), 1 eye had a phototherapy laser and 37/52 (71%) had no complication of CNVs during the follow-up. 5/26 (19%) fulfilled the inclusion criteria for our study. Mean age was 26.4 ± 9.3 years. Snellen best corrected visual acuity (BCVA) at presentation was 0.955+/-0.26. Mean follow up was 84+/-55 months. LFP at presentation was 6.34 ± 2.94 ph/ms. None of four patients with prolonged treatment and prolonged follow-up showed disease activity. One patient still under therapy after 4 months’ follow-up still showed an active neovascular membrane. Conclusion Treatment with multiple immunosuppressive agents was shown to stop the progression of the disease.

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