Non-arteritic Anterior Ischemic Optic Neuropathy with Macular Star following COVID-19 Vaccination

Ocul Immunol Inflamm. 2022 Jul;30(5):1274-1277. doi: 10.1080/09273948.2022.2059522. Epub 2022 Apr 12.

Abstract

Purpose: To report a case of non-arteritic anterior ischemic optic neuropathy (NAAION) with macular star after receiving the second dose of SARS-CoV-2 vaccination.

Method: Case report.

Observation: A 51-year-old male presented with acute visual disturbances one day after the second dose of BNT162b2 mRNA SARS-CoV-2 vaccination. At presentation, best corrected visual acuity (BCVA) was 20/25 right eye (OD) and counting fingers at 3 feet left eye (OS). Anterior segment examination was normal in both eyes. Dilated fundoscopy was unremarkable OD, however, it disclosed optic nerve swelling and subretinal fluid OS. Patient was treated with a gradual tapering dose of oral prednisone over 1 month. At the five-week follow-up visit, optic disc swelling and subretinal fluid resolved with minimal improvement in BCVA to 20/400 OS.

Conclusion: It is unclear whether COVID-19 vaccination was the triggering agent to the NAAION or just a coincidence, yet ophthalmologists should be aware of such a possible association.

Keywords: Optic neuropathy-macular star- NAION-COVID-19- vaccine.

Publication types

  • Case Reports

MeSH terms

  • BNT162 Vaccine
  • COVID-19 Vaccines* / adverse effects
  • COVID-19* / prevention & control
  • Humans
  • Male
  • Middle Aged
  • Optic Neuropathy, Ischemic* / chemically induced
  • Optic Neuropathy, Ischemic* / complications
  • Papilledema* / chemically induced
  • Prednisone
  • SARS-CoV-2
  • Vaccination / adverse effects
  • Visual Acuity

Substances

  • BNT162 Vaccine
  • COVID-19 Vaccines
  • Prednisone