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2019年冠状病毒病灭活疫苗会导致双侧神经营养性角膜病变吗?

Can Inactivated Coronavirus Disease 2019 Vaccine Cause Bilateral Neurotrophic Keratopathy?

作者信息

Belviranli Selman, Oltulu Refik, Mirza Enver, Adam Mehmet, Gundogan Ali Osman

机构信息

Department of Ophthalmology, Meram Faculty of Medicine, Necmettin Erbakan University, Konya, Turkey.

出版信息

J Curr Ophthalmol. 2024 Oct 16;36(1):99-102. doi: 10.4103/joco.joco_224_23. eCollection 2024 Jan-Mar.

Abstract

PURPOSE

To present a case of bilateral neurotrophic keratopathy (NK) following an inactivated coronavirus disease 2019 (COVID-19) vaccine administration.

METHODS

Case report.

RESULTS

A 46-year-old female patient was referred to our cornea department with unhealing corneal epithelial defects in both eyes. The patient's complaints, including ocular redness, sensitivity to light and blurred vision, started 1 week after the second dose of CoronaVac vaccine and continued to increase for 2 months. Ophthalmological examination revealed mild ocular redness, epithelial defects in the central cornea, and decreased corneal sensitivity in both eyes. No pathology that could cause NK was detected in the patient's anamnesis and tests. Treatment including bandage contact lens application, autologous serum eye drops, preservative-free artificial tears, and oral doxycycline resulted in closure of the epithelial defect on the 10 day, and on the 2-month follow-up visit, it was observed that corneal sensitivity had increased.

CONCLUSIONS

In the presented case, it is thought that bilateral NK may be associated with the vaccine due to the chronological relationship between the vaccine administration and the lack of any other explanatory etiology. A cure was achieved in a short time with appropriate treatment, and the increase in corneal sensitivity over time indicates that the corneal neuropathy was reversible. Nowadays, with the worldwide administration of COVID-19 vaccines, ophthalmologists should keep in mind that, although rare, NK manifestation may still be encountered after vaccination.

摘要

目的

报告1例接种2019年冠状病毒病(COVID-19)灭活疫苗后发生双侧神经营养性角膜病变(NK)的病例。

方法

病例报告。

结果

一名46岁女性患者因双眼角膜上皮缺损不愈合被转诊至我院角膜科。患者在接种第二剂科兴疫苗1周后开始出现眼红、畏光和视力模糊等症状,并持续加重2个月。眼科检查发现双眼轻度眼红、中央角膜上皮缺损和角膜敏感性下降。在患者的病史和检查中未发现可导致NK的病变。包括应用绷带角膜接触镜、自体血清滴眼液、不含防腐剂的人工泪液和口服多西环素在内的治疗使上皮缺损在第10天闭合,在2个月的随访中,观察到角膜敏感性有所提高。

结论

在本病例中,由于疫苗接种与缺乏任何其他解释性病因之间的时间关系,认为双侧NK可能与疫苗有关。通过适当治疗在短时间内实现了治愈,且随着时间推移角膜敏感性增加表明角膜神经病变是可逆的。如今,随着COVID-19疫苗在全球范围内的接种,眼科医生应牢记,尽管罕见,但接种疫苗后仍可能出现NK表现。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a8cc/11567604/5a1997f6ff70/JCO-36-99-g001.jpg

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