Retinal artery vasculitis secondary to administration of influenza vaccine

Abstract

There are many differential diagnoses in investigating patients who present with retinal vasculitis, and the laboratory investigations used to investigate this have low-to-moderate sensitivity and/or specificity. Diagnoses include conditions such as tuberculosis or sarcoidosis, which may require long courses of antibiotics or immunosuppression. Influenza vaccination has been recognised as a cause of vasculitis for decades, although a purely ocular presentation is rare. We present a case of a 78-year-old Caucasian woman presenting with a single vessel arterial vasculitis of the right eye 8 weeks following influenza vaccination at her local general practitioner practice. We encourage ophthalmologists, rheumatologists and uveitis specialists to consider influenza vaccine as a cause of ocular vasculitis if the vaccine has been recently administered.

Figure 1

Colour fundus photograph of the right eye demonstrating retinal arterial vasculitis affecting an inferonasal branch retinal artery.

Figure 2

Fundus fluorescein angiogram of the right eye demonstrating three foci of hyperfluorescence in a single branch retinal artery indicative of vasculitis.