Kawasaki A, Purvin V A, Tang R
Midwest Eye Institute, Indianapolis, IN 46280, USA.
J Neuroophthalmol. 1998 Mar;18(1):56-9.
Optic neuritis is an occasional complication of vaccination. Visual loss can be unilateral or bilateral, and most patients recover substantially without treatment. The presumptive mechanism is an immune-mediated demyelinating injury of the optic nerve. We report two patients who had permanent visual loss following influenza vaccination. Their pattern of visual loss, segmental optic disc changes, and failure of visual recovery were atypical for demyelinating optic neuritis and reminiscent of a primary ischemic injury to the optic nerve. We speculate that an immune complex-mediated vasculopathy following vaccination can cause anterior ischemic optic neuropathy. Clinicians should be aware of this entity because of the less favorable prognosis for visual recovery in these cases.
视神经炎是疫苗接种的一种偶发并发症。视力丧失可为单侧或双侧，大多数患者未经治疗可基本恢复。推测其机制是视神经的免疫介导性脱髓鞘损伤。我们报告了两名在接种流感疫苗后出现永久性视力丧失的患者。他们的视力丧失模式、节段性视盘改变以及视力未恢复的情况对于脱髓鞘性视神经炎来说并不典型，让人联想到视神经的原发性缺血性损伤。我们推测接种疫苗后免疫复合物介导的血管病变可导致前部缺血性视神经病变。由于这些病例视力恢复的预后较差，临床医生应了解这一情况。
