Multiple attacks of transient monocular visual loss in a previously healthy man: a possible complication after COVID-19 vaccination?

International Journal of Retina and Vitreous

Ângelo Atalla¹  Leonardo Provetti Cunha²  Mário Luiz Ribeiro Monteiro³  Leandro Cabral Zacharias³  Rony Carlos Preti³  José de Melo Costa-Neto⁴  Luciana Virgínia Ferreira Costa-Cunha⁴ 

[1]Department of Hematology, Federal University of Juiz de Fora Medical School

[2]Department of Ophthalmology, Federal University of Juiz de Fora Medical School

[3]Department of Ophthalmology, University of São Paulo Medical School

[4]Juiz de Fora Eye Hospital

关键词: Retinal vasospasm;    Amaurosis fugax;    Transient monocular visual loss;    COVID-19 vaccine;    Pfizer-BioNTech;    Optical coherence tomography angiography;   

DOI  :  10.1186/s40942-022-00393-1

来源: DOAJ

【 摘 要 】

Abstract Background The present case aims to describe a previously healthy man who presented multiple attacks of transient monocular visual loss after Pfizer-BioNTech COVID-19 vaccination and to discuss the possible mechanisms related to occurrence of this condition. Case presentation We report a case of multiple attacks of transient monocular visual loss in a previously healthy middle-aged man two weeks after Pfizer-BioNTech COVID-19 vaccination. TVL attacks were described as sudden and painless complete visual loss, lasting about one minute, followed by a full recovery. He presented several non-simultaneous attacks in both eyes, 16 in the right eye, and 2 in the left eye on the same day, fifteen days after receiving the second dose of the Pfizer-BioNTech COVID-19 vaccine. The brain’s magnetic resonance angiography, echocardiogram, and doppler ultrasound imaging of the carotid and vertebral arteries were non-revealing. The complete blood exam revealed a slightly elevated C-reactive protein test. We assessed fundus examination during the transient visual loss attack and revealed diffuse vascular narrowing for both arterial and venous branches, notably in the emergence of the optic disc in right eye. In addition, the circumpapillary optical coherence tomography angiography (OCTA) vessel density map was reduced. Oral verapamil hydrochloride 60 mg twice daily was initiated, and the attacks of transient visual loss improved after two days. Conclusions To date, and the best of our knowledge, this is the first case report of multiple transient monocular visual loss attacks due to retinal vasospasm in a previously healthy middle-aged man documented by fundus retinography and OCTA. We discuss in this article the possible association of retinal vasospasm and Pfizer-BioNTech COVID-19 vaccination, probably related to vaccine-induced inflammation.

【 授权许可】

Unknown