Presumed Unilateral Acute Idiopathic Maculopathy following H1N1 Vaccination

Abstract

Purpose: To report a case of unilateral acute idiopathic maculopathy (UAIM) following vaccination for type A influenza virus (H1N1).Methods: Clinical, fundus autofluorescence (FAF), fluorescein angiography (FA) and optical coherence tomography (OCT) findings are presented.Results: A 25-year old white male presented with an acute decrease of vision in his left eye eight days after immunization with influenza A vaccine. Clinical evaluation revealed a deep yellowish-white lesion at the macula, early hyperfluorescence at the level of retinal pigment epithelium (RPE), and leakage and staining during the late phase of FA. OCT demonstrated disruption of the photoreceptor ellipsoid zone, as well as heterogeneous reflectivity changes and thickening at the level of the outer retina-RPE. Three months after presentation, fundus examination showed resolution of the yellowish foveal lesion, with persistence of mild RPE atrophic changes.Conclusion: This is the first reported case of UAIM following H1N1 vaccination to date.

Keywords: Maculopathy; fluorescein angiography; optical coherence tomography; uveitis; vaccination.