Bilateral Panuveitis with Occlusive Vasculitis following Coronavirus Disease 2019 Vaccination

ABSTRACT

Purpose

To report a case of bilateral panuveitis and occlusive vasculitis following COVID-19 vaccination.

Study design

Case report.

Results

A 41-year-old otherwise healthy male presented with progressive vision loss and floaters starting 48 hours after a first dose of COVID-19 vaccine. Examination initially showed bilateral anterior uveitis, but this evolved into bilateral panuveitis with occlusive vasculitis despite topical corticosteroids over two weeks. The patient underwent extensive testing for other etiologies which were excluded. He was successfully treated with a gradual taper of topical and systemic corticosteroids leading to improvement of signs and symptoms. Follow-up is maintained for observation of avascular zones with possible neovascularization which could require laser as needed.

Conclusions

The temporal association between vaccine and presentation makes this a plausible etiology. This remains a rare adverse event, but clinicians should be aware of this possibility to include it in their differential diagnosis when confronted with idiosyncratic ocular presentations.

KEYWORDS:

• Coronavirus disease 2019
• vaccination
• mRNA vaccine
• SARS-CoV-2
• retinal vasculitis
• autoimmunity
• inflammation
• panuveitis

Disclosure statement

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

Ethics approval

The Institutional Review Board of the Centre hospitalier universitaire de Québec – Université Laval waived the need to review this study (2022-6213). The patient provided written consent for the publication of this case.

Additional information

Funding

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