一例急性视网膜坏死与 COVID-19 疫苗接种后水痘带状疱疹病毒再激活相关。
A Case of Acute Retinal Necrosis Associated with Reactivation of Varicella Zoster Virus after COVID-19 Vaccination.
机构信息
Department of Ophthalmology, National Defense Medical College, Tokorozawa, Japan.
出版信息
Ocul Immunol Inflamm. 2023 Jan;31(1):233-235. doi: 10.1080/09273948.2021.2001541. Epub 2021 Nov 22.
PURPOSE
To report a case of acute retinal necrosis (ARN) after receiving COVID-19 vaccination.
METHODS
A case report.
RESULTS
A 78-year-old man complained of blurred vision and floaters in the right eye 2 days after receiving BNT162b2 mRNA-based COVID-19 vaccine and was referred to our hospital with worsening visual acuity after 7 days. He had no systemic symptoms and no history of systemic diseases. Ophthalmic examination revealed white-yellowish placoid lesions spreading to the entire circumference of the retina, and temporal and upper lesions extending to the posterior pole, although anterior inflammation and vitreous opacity were mild. Diagnostic and therapeutic vitrectomy was performed, and VZV-DNA was detected by comprehensive PCR using a vitreous fluid sample. The ocular inflammation subsided by systemic administration of antivirals and corticosteroids. However, total retinal detachment requiring repeat vitrectomy using silicone oil occurred after the second vaccination.
CONCLUSION
ARN associated with VZV reactivation may develop after SARS-CoV-2 mRNA vaccination.
目的
报告 1 例接种 COVID-19 疫苗后发生急性视网膜坏死（ARN）的病例。
方法
病例报告。
结果
1 名 78 岁男性在接种 BNT162b2 mRNA 新冠疫苗后 2 天出现右眼视力模糊和漂浮物，7 天后视力进一步下降，遂来我院就诊。患者无全身症状，无全身疾病史。眼部检查显示灰白色盘状病变向整个视网膜扩散，颞侧和上侧病变延伸至后极，尽管前炎症和玻璃体混浊较轻。进行了诊断和治疗性玻璃体切除术，并通过使用玻璃体样本的综合 PCR 检测到 VZV-DNA。通过全身应用抗病毒药物和皮质类固醇治疗，眼部炎症得到缓解。然而，第二次接种后，由于需要再次使用硅油进行玻璃体切除术，患者出现了全视网膜脱离。
结论
SARS-CoV-2 mRNA 疫苗接种后可能会发生与 VZV 再激活相关的 ARN。
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