Bilateral Cystoid Macular Edema and Corneal Endothelial Graft Rejection following Influenza and Varicella-Zoster Vaccinations

ABSTRACT

Purpose

Multiple cases of corneal graft rejection after various vaccinations have been reported over the past decades. Here we described a case of bilateral cystoid macular edema (CME) and endothelial rejection in a DSAEK patient following influenza and varicella vaccines.

Case Report

A 72-year-old woman with bilateral Fuch’s endothelial dystrophy received bilateral DSAEK surgeries. She received an influenza vaccination and her left visual acuity (VA) decreased due to CME. Half a year later, the patient received a varicella-zoster virus vaccine. 11 days later, she was found to have signs of endothelial graft rejection in both eyes. Unfortunately, her vision further deteriorated despite intensive topical steroid treatment.

Conclusions

In view of the current worldwide efforts on mass vaccination against the COVID-19 pandemic, we suggest an increased use of topical corticosteroids both before and after vaccination may be helpful in reducing this risk.

KEYWORDS:

• Vaccine
• DSAEK
• corneal graft rejection
• influenza
• varicella-zoster virus

Acknowledgments

We would like to thank the medical photography team for their contribution in acquiring the above images.

Authorship statement

V.K. was responsible for the conceptualization of the study. D.H. and S.S. participated in collecting clinical data. D.H., S.S. and V.K. performed data analysis. D.H. and S.S. participated in drafting the article. D.H., S.S. and V.K. participated in critical revision and final approval of the manuscript.

Disclosure statement

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

Ethics statement

This case report was exempt from approval from an ethics’ board and patient has consented to its publication.

Additional information

Funding

We declare no relevant funding.