Department of Neurosurgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Alzahra Research Institute, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran; Ophthalmic Research Center, Research Institute for Ophthalmology, Vision Science, Shahid Beheshti University of Medical Sciences, Tehran, Iran; School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
J Fr Ophtalmol. 2024 Oct;47(8):104264. doi: 10.1016/j.jfo.2024.104264. Epub 2024 Aug 6.
To review cases of optic neuritis after COVID-19 vaccination and add similar cases to the literature.
Thorough PubMed and Scopus searches were conducted, and data from studies describing optic neuritis after COVID-19 vaccination were extracted, tabulated, pooled, and reviewed.
We present 6 cases of optic neuritis following COVID-19 vaccination. Our literature search yielded 48 similar cases. All 54 cases were divided into 3 groups with respect to their serostatus: (1) double-seronegative or unknown serostatus optic neuritis cases, (2) myelin oligodendrocyte glycoprotein (MOG)-associated optic neuritis cases, and (3) aquaporin-4-associated optic neuritis cases. Data from each group were separately pooled and reviewed. While the most frequent vaccine among the anti-AQP4+ subgroup was BNT162b2 (Pfizer-BioNTech) (2/3), recombinant vaccines, e.g., AZD122 and Ad26.Cov2.s were mostly injected in the other subgroups (23/51). No significant gender inclination was seen among different subgroups. The mean interval from vaccination to symptom onset was less than one month in all subgroups; symptom manifestations mainly occurred after the first dose (28/54). Almost all cases showed improvement after steroid therapy±plasma exchange (52/54).
Despite having rare side effects such as optic neuritis, vaccination remains our most helpful protection against SARS-CoV-2. Nevertheless, larger studies are needed to ascertain the pathophysiology of such adverse effects. Likewise, the association between COVID-19 vaccination and optic neuritis warrants further investigation.
回顾 COVID-19 疫苗接种后发生视神经炎的病例，并将类似病例添加到文献中。
彻底检索 PubMed 和 Scopus，并提取、列表、汇总和综述描述 COVID-19 疫苗接种后发生视神经炎的研究数据。
我们报告了 6 例 COVID-19 疫苗接种后发生的视神经炎。我们的文献检索得到了 48 例类似病例。根据血清学状态，将这 54 例病例分为 3 组：（1）双阴性或未知血清学状态的视神经炎病例，（2）髓鞘少突胶质细胞糖蛋白（MOG）相关的视神经炎病例，和（3）水通道蛋白-4（AQP4）相关的视神经炎病例。分别对每组数据进行汇总和综述。在抗 AQP4+亚组中，最常见的疫苗是 BNT162b2（辉瑞-生物科技）（2/3），而重组疫苗，如 AZD122 和 Ad26.Cov2.s，则主要在其他亚组中注射（23/51）。不同亚组中未观察到明显的性别倾向。所有亚组从接种到症状出现的平均间隔均不到 1 个月；症状主要发生在第一剂后（28/54）。几乎所有病例在接受类固醇治疗+血浆置换后均有改善（52/54）。
尽管 COVID-19 疫苗接种有罕见的副作用，如视神经炎，但它仍是我们预防 SARS-CoV-2 最有效的保护措施。然而，需要进行更大规模的研究以确定这些不良反应的病理生理学机制。同样，COVID-19 疫苗接种与视神经炎之间的关联需要进一步研究。
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