Bilateral Persistent Placoid Maculopathy Following COVID-19 Vaccines: Real or Coincidence?

ABSTRACT

COVID-19 vaccinations have been accompanied by reports of inflammatory uveitis. Herein, we report the first case of bilateral persistent placoid maculopathy (PPM) following COVID-19 vaccinations in a previously healthy 58-year-old man who presented with bilateral decrease in vision approximately 2 weeks after the second dose of AstraZenaca® ChAdOx1-S/nCoV-19 vaccine. Fundus examination revealed bilateral well-delineated whitish plaque-like macular lesions involving the fovea. Clinical and multimodal imaging findings were suggestive of PPM. Infective and autoimmune screen were all negative except for a raised MPO-ANCA. Medical review excluded systemic autoimmune and infectious diseases. Patient was monitored closely and his visual acuity improved and stabilised after a tapering regime of oral prednisolone. Mycophenolate mofetil was given as long-term steroid sparing immunosuppression. Our case demonstrated a likely localised autoimmune inflammatory response to the COVID-19 vaccine affecting choriocapillaris. Further research is needed to clarify the association between COVID-19 vaccines and inflammatory placoid lesions of the retina.

KEYWORDS:

• COVID-19
• persistent placoid maculopathy
• vaccine

Disclosure statement

No potential conflict of interest was reported by the author(s).

Author contributions

P Kumar supervised the work. CS Chean and E Ali led the writing of the case report. CS Chean, E Ali, P Kulkarni, B Kapoor and P Kumar were involved in the diagnostic work-up and management of the patient. CS Chean, E Ali, P Kulkarni, B Kapoor and P Kumar contributed to manuscript and image preparation, reviewing the draft and approving the final version.

Institutional review board statement

Institutional Review Board (IRB) or Ethics Committee of University Hospitals of Leicester NHS Trust has ruled that approval was exempted for this case report.

Informed consent statement

Written informed consent was taken from the patient for publication of this report.

Data availability statement

No new data were created or analysed in this study. Data sharing is not applicable to this article.

Additional information

Funding

The author(s) reported that there is no funding associated with the work featured in this article.