Department of Ophthalmology, Hôpital du Saint-Sacrement, Chu de Québec - Université Laval, Quebec City, Canada.
Ocul Immunol Inflamm. 2023 Apr;31(3):660-664. doi: 10.1080/09273948.2022.2042325. Epub 2022 Feb 28.
To report a case of bilateral panuveitis and occlusive vasculitis following COVID-19 vaccination.
Case report.
A 41-year-old otherwise healthy male presented with progressive vision loss and floaters starting 48 hours after a first dose of COVID-19 vaccine. Examination initially showed bilateral anterior uveitis, but this evolved into bilateral panuveitis with occlusive vasculitis despite topical corticosteroids over two weeks. The patient underwent extensive testing for other etiologies which were excluded. He was successfully treated with a gradual taper of topical and systemic corticosteroids leading to improvement of signs and symptoms. Follow-up is maintained for observation of avascular zones with possible neovascularization which could require laser as needed.
The temporal association between vaccine and presentation makes this a plausible etiology. This remains a rare adverse event, but clinicians should be aware of this possibility to include it in their differential diagnosis when confronted with idiosyncratic ocular presentations.
报告一例 COVID-19 疫苗接种后双侧全葡萄膜炎和闭塞性血管炎。
病例报告。
一名 41 岁健康男性，在接种第一剂 COVID-19 疫苗后 48 小时出现进行性视力下降和漂浮物。最初的检查显示双侧前葡萄膜炎，但尽管在两周内使用局部皮质类固醇治疗，病情仍进展为双侧全葡萄膜炎伴闭塞性血管炎。患者接受了广泛的其他病因检查，但均被排除。他成功地接受了逐渐减少局部和全身皮质类固醇的治疗，从而改善了体征和症状。需要时通过激光治疗以观察可能出现无血管区和新生血管化。
疫苗接种和发病之间的时间关联使这成为一个合理的病因。这仍然是一种罕见的不良事件，但临床医生应意识到这种可能性，以便在出现特发性眼部表现时纳入鉴别诊断。
