Te Whatu Ora Health New Zealand Te Toka Tumai Auckland, Department of Ophthalmology, Greenlane Clinical Centre, Auckland, New Zealand.
University of Auckland, Faculty of Medical and Health Sciences, Department of Ophthalmology, Auckland, New Zealand.
Eur J Ophthalmol. 2024 Sep;34(5):NP78-NP82. doi: 10.1177/11206721241257969. Epub 2024 May 24.
To report a recurrence of punctate inner choroidopathy (PIC) with an inflammatory choroidal neovascular membrane (iCNVM) after the Pfizer-BioNTech COVID-19 vaccine.
Case report.
A 38-year-old female with a history of myopia and previous episodes of PIC and iCNVM presented with distorted vision in her right eye, seven days after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. The patient exhibited active PIC lesions with iCNVM confirmed on multimodal imaging. Treatment with a combination of oral corticosteroids and intravitreal anti-VEGF injection led to disease resolution. Subsequent COVID-19 vaccinations, administered while the patient was immunosuppressed, did not lead to disease relapse. However, relapse occurred following the fourth COVID-19 vaccine, when the patient was not immune suppressed.
This case highlights the potential risk of PIC disease relapse following COVID-19 vaccination. Further research is needed to investigate the relationship between COVID-19 vaccination and PIC exacerbation, as well as to determine optimal management strategies in this population, including close observation and consideration of prophylactic immune suppression at the time of COVID-19 vaccine for high-risk individuals.
报告一例在接种辉瑞-生物科技公司的 COVID-19 疫苗后，出现点状内层脉络膜病变（PIC）伴炎症性脉络膜新生血管膜（iCNVM）复发的病例。
病例报告。
一位 38 岁的女性，有近视史和先前的 PIC 和 iCNVM 发作史，在接种辉瑞-生物科技公司的 COVID-19 疫苗第一剂后 7 天出现右眼视力扭曲。患者表现出活跃的 PIC 病变，多模态成像证实存在 iCNVM。口服皮质类固醇和玻璃体内抗 VEGF 注射联合治疗导致疾病缓解。在患者免疫抑制期间接种随后的 COVID-19 疫苗并未导致疾病复发。然而，在第四次 COVID-19 疫苗接种后，当患者未免疫抑制时，疾病复发。
本病例强调了 COVID-19 疫苗接种后 PIC 疾病复发的潜在风险。需要进一步研究 COVID-19 疫苗接种与 PIC 加重之间的关系，并确定在这一人群中的最佳管理策略，包括对高危人群在接种 COVID-19 疫苗时进行密切观察和考虑预防性免疫抑制。
