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Case Reports
. 2022 Jun;45(6):597-602.
doi: 10.1016/j.jfo.2022.01.006. Epub 2022 May 13.

Central serous chorioretinopathy following the BNT162b2 mRNA vaccine

J Hanhart  1 , E Roditi  2 , L M Wasser  2 , W Barhoum  3 , D Zadok  2 , K Brosh  2
Affiliations
Case Reports

Central serous chorioretinopathy following the BNT162b2 mRNA vaccine

J Hanhart et al. J Fr Ophtalmol. 2022 Jun.

Abstract
in English, French

Background and purpose: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has accelerated vaccine development. The BNT162b2 messenger RNA (mRNA) vaccine is being administered worldwide. The purpose of this case series is to report a possible association between the BNT162b2 mRNA vaccine and Central serous chorioretinopathy (CSC). Although rare, CSC has been reported following the administration of anthrax, influenza and smallpox vaccines.

Methods: Four individuals who developed CSC following the BNT162b2 mRNA vaccine were examined in our institution using multimodal imaging of the retina, and their demographic data were analyzed and compared to all the similar cases published to date.

Results: Four patients (3 males, 1 female) between the ages of 35 and 65 presented with acute CSC (n=3) and relapsed CSC (n=1) within the first week following the administration of the BNT162b2 mRNA vaccine. Three individuals demonstrated hyper-reflective foci in the outer segments of the retina.

Conclusions: The timing of the BNT162b2 mRNA vaccine administration relative to the development of CSC suggests a possible causal relationship. Further research is necessary to explore this possible association.

Objectif: La pandémie de COVID-19 a stimulé le développement de vaccins dirigés contre son agent étiologique, le coronavirus 2 du syndrome respiratoire aigu sévère (SARS-CoV-2). Actuellement, le vaccin à ARN messager BNT162b2 est largement utilisé. Nous présentons, ici, une série de cas de choriorétinopathie séreuse centrale potentiellement associée à l’administration dudit vaccin. Quoique relativement rare, la choriorétinopathie séreuse centrale avait préalablement été décrite dans les suites de vaccins contre l’anthrax, la grippe ou encore la variole.

Méthodes: Analyse des données démographiques, cliniques, ainsi que de l’imagerie multimodale de quatre patients ayant présenté une choriorétinopathie séreuse centrale dans les suites immédiates du vaccin à ARN messager BNT162b2 et mise en parallèle avec tous les cas similaires publiés à ce jour.

Résultats: Quatre patients (trois hommes, une femme) âgés de 35 à 65 ans ont été reçus dans notre service avec un tableau de choriorétinopathie séreuse centrale aiguë (3 cas) ou récidivante (1 cas), alors que, la même semaine, ils avaient reçu leur première injection du vaccin à ARN messager BNT162b2. Chez trois de ces sujets, des foyers hyper-réflectifs pouvaient être observés dans les couches externes de la rétine.

Conclusions: La proximité temporelle entre la vaccination au BNT162b2 et l’apparition d’une choriorétinopathie séreuse centrale pourrait indiquer une relation causale. Ce lien, possible, demande à être confirmé par de plus larges études.

Keywords: BNT162b2 mRNA vaccine; COVID-19; Central serous chorioretinopathy; Choriorétinopathie séreuse centrale; Coronavirus 2 du syndrome respiratoire aigu sévère; Décollement séreux de la rétine; Pachychoroid; Pachychoroïde; SARS-CoV-2; Serous retinal detachment; Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2); Vaccin BNT162b2 à RNA messager; Vaccination.

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Figures

Figure 1
Figure 1
Enhanced Depth Imaging Optic Coherence Tomography (EDI-OCT) for patient 1. A. On presentation, right eye demonstrated SFCT of 452 μm, SRF under the fovea and nasal macula (B) worsening of the SRF. C. Horizontal scan superior to fovea demonstrating multiple hyper-reflective foci at the photoreceptor layers (arrowheads). D. Left eye on presentation which demonstrated SFCT of 507 μm with an attached flat retina.
Figure 2
Figure 2
Optic Coherence Tomography (OCT) of patient 2. A. On presentation, the right eye demonstrated a focal pigment epithelium detachment with adjacent subretinal fluid inferior to the fovea. C. EDI-OCT of the right eye one month after presentation demonstrated worsening of the subretinal fluid and a thickened choroid measuring 517 μm. B. Left eye OCT demonstrated a para-foveal bleb with SRF on presentation (D) EDI-OCT of the left eye at follow-up demonstrated a thickened choroid of 487 μm.
Figure 3
Figure 3
Multimodal imaging of patient 3. A. Right eye EDI-OCT on presentation demonstrated a SFCT of 440 μm, SRF, hyper-reflective foci at the outer retina and drusen. B. Left eye on presentation demonstrated SFCT of 435 μm and drusen. C. Late-stage FA demonstrated focal leakage superotemporal to the fovea. D. Worsening of SRF thickness inferior to fovea two months after presentation. E. En-face OCT of the outer nuclear layer demonstrated numerous hyper-reflective foci.
Figure 4
Figure 4
OCT of patient 4. A. Right eye OCT on presentation demonstrated SRF and hyper-reflective foci at the outer retina. B. Improvement of SRF one month following presentation.
See this image and copyright information in PMC

References

    1. Arbel R., Moore C.M., Sergienko R., Pliskin J. How many lives do COVID vaccines save? Evidence from Israel. Am J Infect Control. 2022;50:258–261. doi: 10.1016/j.ajic.2021.12.019. OPT: Epub 2021 Dec 29. - DOI - PMC - PubMed
    1. Bar-On Y.M., Goldberg Y., Mandel M., Bodenheimer O., Freedman L., Kalkstein N., et al. Protection of BNT162b2 vaccine booster against COVID-19 in Israel. N Engl J Med. 2021;385:1393–1400. - PMC - PubMed
    1. Barda N., Dagan N., Cohen C., Hernán M.A., Lipsitch M., Kohane I.S., et al. Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study. Lancet. 2021;398:2093–2100. - PMC - PubMed
    1. Gurwitz D. COVID-19 vaccine hesitancy: lessons from Israel. Vaccine. 2021;39:3785–3786. - PMC - PubMed
    1. van Rijssen T.J., van Dijk E.H.C., Yzer S., Ohno-Matsui K., Keunen J.E.E., Schlingemann R.O., et al. Central serous chorioretinopathy: towards an evidence-based treatment guideline. Prog Retin Eye Res. 2019;73:100770. - PubMed

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