Department of Internal Medicine, Faculty of Medicine, Cairo University, Giza, Egypt.
Optom Vis Sci. 2023 Feb 1;100(2):170-173. doi: 10.1097/OPX.0000000000001988. Epub 2023 Jan 13.
Brown syndrome, or superior oblique tendon sheath syndrome, is characterized by limitation of elevation on adduction. The disorder is thought to involve the trochlea/superior oblique tendon complex through traumatic, surgical, and inflammatory mechanisms. It could be an indication of multiple underlying immunological or rheumatological disorders.
This study aimed to report an unusual strabismus after receiving the first dose of a live attenuated coronavirus disease 2019 (COVID-19) vaccine.
A 31-year-old female patient presented with painful vertical diplopia and tenderness of the left trochlear area 3 days after the first dose of COVID-19 vaccination. She had a compensatory chin elevation and face turn to the right, as well as a left 10-prism-diopter hypotropia in the primary position, which increased to 15 prism diopters in the right gaze and disappeared in the left gaze. Ocular motility revealed the limitation of elevation on adduction. The patient denied any history of ocular trauma and was consequently investigated for dysthyroid disease and various immunological and rheumatological disorders, which were excluded. A Hess chart was obtained to document the motility disorder.
We report a case of acquired Brown syndrome in a 31-year-old otherwise healthy woman shortly after COVID-19 vaccination. It is possible that the patient may have developed trochleitis and/or superior oblique tenosynovitis brought on by cross-reacting antibodies generated by the immune response to the vaccine. In the age of the widest vaccination campaign in human history, it is highly likely that we will continue to observe many unexpected potential adverse effects of these vaccines in our clinical practice.
Brown 综合征，或上斜肌腱鞘综合征，表现为内收时上抬受限。该疾病被认为涉及滑车/上斜肌腱复合体，通过创伤、手术和炎症机制。它可能是多种潜在免疫或风湿性疾病的指征。
本研究旨在报告首例接受活减毒 2019 年冠状病毒病（COVID-19）疫苗后出现的一种不寻常斜视。
一名 31 岁女性患者在 COVID-19 疫苗第一剂后 3 天出现疼痛性垂直复视和左侧滑车区压痛。她有代偿性颏部抬高和面向右侧的面部转动，以及左眼在主位时有 10 棱镜度的下斜视，在右注视时增加到 15 棱镜度，在左注视时消失。眼球运动显示内收时上抬受限。患者否认有任何眼部外伤史，因此排除了甲状腺疾病和各种免疫及风湿性疾病的可能性。进行 Hess 图表检查以记录眼球运动障碍。
我们报告了一例 31 岁健康女性在 COVID-19 疫苗接种后不久发生获得性 Brown 综合征。患者可能因疫苗免疫反应产生的交叉反应抗体而发生滑车炎和/或上斜肌腱鞘炎。在人类历史上最广泛的疫苗接种运动时代，我们很可能会继续在临床实践中观察到这些疫苗的许多意想不到的潜在不良反应。
