Unilateral optic neuritis after vaccination against the coronavirus disease: two case reports

Abstract

Background Due to the emergence of COVID-19, many countries have started mass immunization programs. To date, no cases of optic neuritis following COVID-19 vaccination have been reported in the literature. Case presentation Objective: Here, we report 2 cases of unilateral optic neuritis after vaccination against COVID-19 using the Sinopharm vaccine (Sinopharm Group Co. Ltd, China). Design The clinical history, examination, and test findings of two individuals with unilateral optic neuritis associated with the timing of COVID-19 vaccination were described and further analyzed. Setting Two patients developed optic neuritis after receiving the COVID-19 vaccine. One patient developed optic neuritis 6 weeks after the first dose and 3 weeks after the second dose. The other patient developed optic neuritis 3 weeks after the first dose. Participants: Two female patients, aged 21 and 39 years. Result The patients were successfully treated with intravenous methylprednisolone pulse therapy. Both patients had typical manifestations of optic neuritis and their visual acuity recovered fully after treatment. The second of these patients was positive for anti-myelin oligodendrocyte glycoprotein antibodies (MOG). Conclusion Optic neuritis is a potential adverse effect after vaccination against the coronavirus disease (COVID-19). Supplementary Information The online version contains supplementary material available at 10.1007/s10633-022-09880-0.

Neuro-Ophthalmologic Symptoms Associated With the Moderna mRNA COVID-19 Vaccine: A Case Report

“…Other studies have reported similar neuro-ophthalmologic complications following other COVID-19 vaccines Ad26.COV2.S vaccine (Janssen Pharmaceutical Companies) [6], Pfizer-BioNTech vaccine, AstraZeneca-Oxford vaccine [7], Covishield vaccine [8], and Sinopharm vaccine [9]. Similar neuroophthalmologic complications have been reported following the administration of the measles vaccine [10,11].…”

Ocular Adverse Events after Coronavirus Disease 2019 mRNA Vaccination

“…There have also been several case reports that suggest an increased risk of optic neuritis after COVID-19 vaccination 11 , 12 , 27 . A more recent database study indicated that the risk of optic neuritis following COVID-19 vaccination was low 28 .…”

“…However, previous studies have reported that COVID-19 vaccination may increase the risk of systemic adverse events such as myocarditis, lymphadenopathy, and appendicitis 4 , 5 . The vaccines may also increase the risk of ocular adverse events such as uveitis 2 , 4 , 6 , 7 , 8 , scleritis 9 , retinal vein occlusion (RVO) 10 and optic neuritis 11 , 12 . However, because nearly all of these were case reports or case series, the association between vaccination and ocular adverse events has not been established.…”

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

“…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 ].…”

“…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.…”