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Case Reports
. 2022 Feb 25;10(3):363.
doi: 10.3390/vaccines10030363.

Susac Syndrome Following COVID-19 Vaccination: A Case Report

Po-Jui Chen  1 , Yi-Sheng Chang  1   2 , Chen-Chee Lim  3 , Yu-Kuei Lee  1
Affiliations
Case Reports

Susac Syndrome Following COVID-19 Vaccination: A Case Report

Po-Jui Chen et al. Vaccines (Basel). .

Abstract

Due to the COVID-19 pandemic, numerous vaccines have been developed for the disease. However, with large-scale vaccination has come the gradual emergence of immunological phenomena caused by these new vaccines. Herein, we report a 48-year-old female with a sudden onset of inferior visual field defects in the left eye following her first dose of the ChAdOx1 vaccine. Dilated fundus examination combined with optical coherence tomography and fluorescein angiography confirmed the diagnosis of branch retinal artery occlusion. Within 4 weeks following vaccination, symptoms associated with hearing impairment developed, and magnetic resonance imaging revealed leptomeningeal enhancement. The diagnosis of Susac syndrome (SS) was confirmed. The development of SS may be caused by endotheliopathy resulting from the molecular mimicry of the ChAdOx1 vaccine. Clinicians should be aware of the symptoms of SS, which may develop after COVID-19 vaccination. Further experimental surveillance and case-control studies are required to confirm this relationship.

Keywords: COVID-19 vaccine; Susac syndrome; adenoviral vector vaccine; case report.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
(A) Color fundus imaging of the left eye revealed a pale retinal patch around the superior arcade. (B) Fluorescein angiography of the left eye showed delayed superior branch retinal artery filling. (C) Fluorescein angiography of the left eye in the late phase showed disc leakage and fluffy vessels. (D) Optical coherence tomography imaging of the left eye revealed retinal edema at the superior area of the macula (red arrows). Scale bar equals 250 μm. (E) Visual field testing of the left eye revealed inferior arcade scotoma and peripheral visual field defect.
Figure 2
Figure 2
Magnetic resonance imaging (T1 series) showed continuous leptomeningeal enhancement (yellow arrows). Scale bar equals 10 cm.
See this image and copyright information in PMC

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