一名曾患水痘-带状疱疹急性视网膜坏死已治愈的患者，在接种佐剂水痘-带状疱疹亚单位疫苗后出现单侧葡萄膜炎。
Unilateral uveitis following adjuvanted Varicella-Zoster subunit vaccine in a patient with previously resolved Varicella Zoster acute retinal necrosis.
作者信息
Trinco A, Zicarelli F, Romano F, Oldani M, Riva A, Invernizzi A
机构信息
Department of Biomedical and Clinical Sciences, Ospedale Luigi Sacco, Eye Clinic, University of Milan, Via G.B. Grassi, 74, Milan, 20157, Italy.
Department of Biomedical and Clinical Sciences, Università degli Studi di Milano, Milan, Italy.
出版信息
J Ophthalmic Inflamm Infect. 2025 Aug 2;15(1):58. doi: 10.1186/s12348-025-00508-3.
PURPOSE
To report a case of intraocular inflammation following adjuvanted recombinant Varicella-Zoster subunit vaccine (RZV) in a patient with previously resolved VZV-related acute retinal necrosis (ARN).
METHODS
Single case report. Multimodal imaging, including true-color fundus photography, spectral-domain (SD-OCT) and dye-based angiography, was used to evaluate the retinal alterations.
RESULTS
A 73-year-old male, with past history of VZV-related acute retinal necrosis (ARN) developed unilateral cystoid macular edema and diffuse blood-retinal barrier (BRB) breakdown in the affected eye after receiving the second dose of RZV vaccine. A complete resolution of this complication was observed after a short course of systemic corticosteroids.
CONCLUSION
Our case suggests a possible pathogen-specific intraocular inflammatory reaction, resembling immune reconstitution uveitis (IRU), following RZV administration in a patient with previously resolved VZV-related ARN. While RZV remains safe, intraocular inflammation should be considered as a possible side effect in patients with previously resolved VZV uveitis.
目的
报告1例在接种含佐剂重组水痘-带状疱疹亚单位疫苗（RZV）后发生眼内炎症的病例，该患者既往有已痊愈的水痘-带状疱疹病毒（VZV）相关急性视网膜坏死（ARN）病史。
方法
单病例报告。采用多模态成像，包括真彩色眼底照相、光谱域光学相干断层扫描（SD-OCT）和染料血管造影，评估视网膜改变。
结果
一名73岁男性，既往有VZV相关急性视网膜坏死（ARN）病史，在接种第二剂RZV疫苗后，患眼出现单侧黄斑囊样水肿和弥漫性血视网膜屏障（BRB）破坏。在短期全身应用糖皮质激素后，该并发症完全消退。
结论
我们的病例提示，在既往有已痊愈的VZV相关ARN的患者中接种RZV后，可能会出现一种类似于免疫重建性葡萄膜炎（IRU）的病原体特异性眼内炎症反应。虽然RZV仍然安全，但对于既往有已痊愈的VZV葡萄膜炎的患者，应考虑眼内炎症为可能的副作用。
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