ABSTRACT

Purpose

To report a case of acute retinal necrosis (ARN) due to varicella zoster virus (VZV) after COVID-19 vaccine administration.

Design/methods

Observational case report.

Result

A 62-year-old immunocompetent African American male presented with left eye redness, decreased vision, and floaters after receiving a COVID-19 vaccine seven days prior. Slit-lamp examination revealed diffuse fine endothelial keratic precipitates. Funduscopic examination was notable for vitreous cells, occlusive retinal vasculitis, large retinal hemorrhages, and three quadrants of peripheral areas of retinal whitening. Quantitative polymerase chain reaction testing was positive for varicella zoster virus in the vitreous humor. Treatment with intravitreal and intravenous antiviral therapy resulted in symptomatic improvement.

Conclusion

COVID-19 mRNA vaccination may cause an immunomodulatory response that leads to reactivation of dormant VZV. Early recognition and treatment can improve visual outcomes.

中文翻译：

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BNT162b2 mRNA COVID-19 疫苗接种后水痘带状疱疹病毒再激活引起的急性视网膜坏死

摘要

目的

报告一例在接种 COVID-19 疫苗后由水痘带状疱疹病毒 (VZV) 引起的急性视网膜坏死 (ARN) 病例。

设计/方法

观察病例报告。

结果

一名免疫功能正常的 62 岁非裔美国男性在 7 天前接种 COVID-19 疫苗后出现左眼发红、视力下降和飞蚊症。裂隙灯检查显示弥漫性细小内皮角质沉淀物。眼底检查可见玻璃体细胞、闭塞性视网膜血管炎、大面积视网膜出血和三个象限周边区域的视网膜变白。玻璃体液中水痘带状疱疹病毒定量聚合酶链反应检测呈阳性。玻璃体内和静脉内抗病毒治疗导致症状改善。

结论

COVID-19 mRNA 疫苗接种可能会引起免疫调节反应，从而导致休眠 VZV 重新激活。早期识别和治疗可以改善视觉效果。