Optic Neuritis Following the BNT162b2 mRNA COVID-19 Vaccine in a Patient with Systemic Lupus Erythematosus Uncovering the Diagnosis of Neuromyelitis Optica Spectrum Disorders

Shirah, Bader; Mulla, Israa; Aladdin, Yasser

doi:10.1080/09273948.2022.2089901

Cited by 14 publications

(8 citation statements)

References 16 publications

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“…Optic neuropathy is suspected as one of adverse events of the COVID-19 vaccine, which includes ON associated with or without demyelinating CNS diseases [ 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 ], NA-AION [ 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 ], and NMOSD [ 8 , 9 ]. Lotan et al reviewed 14 case reports and 2 case series by electronic searches of the published literature regarding neuro-ophthalmological complications of COVID-19 vaccines and reported that optic neuritis was the most common, occurring in 61 of 76 cases (80.3%) [ 25 ].…”

Section: Discussionmentioning

confidence: 99%

“…Multiple sclerosis (MS) or neuromyelitis optica spectrum disorders (NMOSD) after COVID-19 vaccination have been reported [ 1 , 2 , 3 , 4 , 5 , 6 ], while a complication of optic neuritis (ON) is also known [ 7 , 8 , 9 , 10 ]. Although idiopathic ON after COVID-19 vaccination is also reported [ 11 , 12 , 13 , 14 , 15 ], those visual prognoses are generally favorable.…”

Section: Introductionmentioning

confidence: 99%

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A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

2022

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Background: We report a case of atypical unilateral optic neuritis after receiving the BNT162b2 mRNA-based COVID-19 vaccine. Case Presentation: An 86-year-old man complained of blurred vision and decreased visual acuity in his right eye 8 days after receiving the second BNT162b2 mRNA-based COVID-19 vaccine and was referred to our hospital. He also had pain with eye movement. Best corrected visual acuity (BCVA) in the right eye was 20/200 and critical flicker frequency dropped to 16 Hz. Relative afferent pupillary defect was positive and central scotomas were observed on visual field analysis. Fundus examination and SD-OCT revealed optic disc swelling and apparent thickening of the retinal nerve fiber layer around the optic disc in the right eye. Although either an increase in CRP or ESR on laboratory tests, demyelinating lesion on MRI, or positive of anti-MOG antibodies or anti-AQP4 antibodies were not observed, fluorescein angiography presented only hyperfluorescence of the optic disc in the right eye, but there were no findings such as papillary deficiency and choroidal delay that would suggest ischemic optic neuropathy. We diagnosed atypical optic neuritis developed after the SARS-CoV-2 mRNA-based vaccination and initiated oral corticosteroid therapy. One month later, the optic disc swelling disappeared and BCVA improved to 20/100; however, the central scotoma remained and no further improvement in visual function OD was obtained. Conclusions: An atypical acute idiopathic optic neuritis can occur after receiving the second vaccination with BNT162b2, which may present a limited response to corticosteroid therapy.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

2022

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“…Similar cases have since been reported. [137][138][139][140][141][142] A series of seven patients experiencing CNS inflammatory syndrome within 1 to 21 days of inoculation included three patients with ON, all of whom returned to baseline with corticosteroid therapy. 143 Two of these heralded a new diagnosis of relapsing-remitting MS, while one had been diagnosed 9 years before.…”

Section: Afferent Complications Associated Temporally With Sars-cov-2...mentioning

confidence: 99%

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

Dinkin

Sathi

2023

Semin Neurol

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We set out to describe in detail the afferent neuro-ophthalmological complications that have been reported in association with coronavirus disease 2019 (COVID-19) infection. We describe and elaborate on mechanisms of disease, including para-infectious inflammation, hypercoagulability, endothelial damage, and direct neurotropic viral invasion. Despite global vaccination programs, new variants of COVID-19 continue to pose an international threat, and patients with rare neuro-ophthalmic complications are likely to continue to present for care.Afferent complications from COVID-19 include homonymous visual field loss, with or without higher cortical visual syndromes, resulting from stroke, intracerebral hemorrhage, or posterior reversible leukoencephalopathy. Optic neuritis has frequently been reported, sometimes along with acute disseminated encephalomyelopathy, often in association with either myelin oligodendrocyte glycoprotein antibodies (MOG-IgG) or less commonly aquaporin-4 seropositivity or in newly diagnosed multiple sclerosis. Ischemic optic neuropathy has rarely been reported. Papilledema, resulting either from venous sinus thrombosis or idiopathic intracranial hypertension in the setting of COVID-19, has also been described.Observed afferent neuro-ophthalmic associations need to be confirmed though larger comparative studies. Meanwhile, the range of possible complications should be recognized by neurologists and ophthalmologists alike, to facilitate faster diagnosis and treatment of both COVID-19 and its neuro-ophthalmic manifestations.

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“…A few cases of new-onset neuromyelitis optica spectrum disorder (NMOSD) occurring after coronavirus disease 2019 (COVID-19) vaccination in patients with systemic lupus erythematosus (SLE) have been reported [ 1 , 2 ]. However, no cases of myelin oligodendrocyte glycoprotein antibody-associated disease (MOGAD) have been reported in SLE patients after COVID-19 vaccination.…”

mentioning

confidence: 99%

“…The authors of the study suggested that preexisting autoimmune diseases may increase the risk of developing other immune-mediated diseases, such as multiple sclerosis, NMOSD, or acute disseminated encephalomyelitis after COVID-19 vaccination [ 4 ]. Furthermore, two cases of NMOSD presenting as optic neuritis or area postrema syndrome that developed after COVID-19 vaccination in SLE patients were recently reported, suggesting that the COVID-19 vaccine may trigger occult autoimmune diseases such as NMOSD in patients with SLE [ 1 , 2 ]. To the best of our knowledge, our case report is the first to describe the occurrence of MOGAD following COVID-19 vaccination in patients with SLE.…”

mentioning

confidence: 99%

Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis following third dose of BNT162b2 COVID-19 vaccine in a patient with systemic lupus erythematosus

et al. 2023

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Optic Neuritis Following the BNT162b2 mRNA COVID-19 Vaccine in a Patient with Systemic Lupus Erythematosus Uncovering the Diagnosis of Neuromyelitis Optica Spectrum Disorders

Cited by 14 publications

References 16 publications

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

A Case of Atypical Unilateral Optic Neuritis Following BNT162b2 mRNA COVID-19 Vaccination

Neuro-Ophthalmic Visual Impairment in the Setting of COVID-19

Myelin oligodendrocyte glycoprotein antibody-associated optic neuritis following third dose of BNT162b2 COVID-19 vaccine in a patient with systemic lupus erythematosus

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