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

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

Disclosure statement

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

Additional information

Funding

The authors report no relevant financial disclosure.