Kraemer Laura S, Montgomery Jay R, Baker Katherine M, Colyer Marcus H
Uniformed Services University of the Health Sciences, F. Edward Hébert School of Medicine, Bethesda, Maryland.
Defense Health Agency Immunization Healthcare Branch, Walter Reed National Military Medical Center, Bethesda, Maryland; and.
Retin Cases Brief Rep. 2022 Jan 1;16(1):16-19. doi: 10.1097/ICB.0000000000000959.
To report a case of acute posterior multifocal placoid pigment epitheliopathy occurring in temporal association with multiple immunizations in a previously healthy 25-year-old woman.
Acute posterior multifocal placoid pigment epitheliopathy was diagnosed based on ophthalmological findings of bilateral placoid subretinal lesions complicated by a serous retinal detachment in the left eye.
Through HLA typing, the patient was found to possess the HLA-B40 and HLA-DB115 alleles. She was treated with topical prednisolone acetate 1% and monitored for several months. The serous retinal detachment resolved, and visual acuity returned to normal.
This case report adds to the body of knowledge regarding possible atypical interplay between vaccines and specific T-cell receptors of the host immune system and adds Polio and Tetanus to the growing list of vaccines potentially triggering acute posterior multifocal placoid pigment epitheliopathy. Increased awareness of the presentation of acute posterior multifocal placoid pigment epitheliopathy and that it may arise after immunization may also improve evaluation of acute changes in visual acuity.
报告一例急性后极部多灶性扁平色素上皮病变，该病例发生在一名既往健康的25岁女性身上，与多次免疫接种存在时间关联。
根据双眼扁平状视网膜下病变并伴有左眼浆液性视网膜脱离的眼科检查结果，诊断为急性后极部多灶性扁平色素上皮病变。
通过HLA分型，发现该患者拥有HLA - B40和HLA - DB115等位基因。她接受了1%醋酸泼尼松龙局部治疗，并进行了数月的监测。浆液性视网膜脱离得到缓解，视力恢复正常。
本病例报告增加了关于疫苗与宿主免疫系统特定T细胞受体之间可能存在的非典型相互作用的知识体系，并将脊髓灰质炎疫苗和破伤风疫苗添加到可能引发急性后极部多灶性扁平色素上皮病变的疫苗清单中。提高对急性后极部多灶性扁平色素上皮病变表现的认识以及其可能在免疫接种后出现的认识，也可能改善对视力急性变化的评估。
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