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Review
. 2023 Jan;46(1):72-82.
doi: 10.1016/j.jfo.2022.09.008. Epub 2022 Nov 24.

Acute macular neuroretinopathy and COVID-19 vaccination: Case report and literature review

S Fekri  1 , M Khorshidifar  1 , M S Dehghani  1 , H Nouri  2 , S-H Abtahi  3
Affiliations
Review

Acute macular neuroretinopathy and COVID-19 vaccination: Case report and literature review

S Fekri et al. J Fr Ophtalmol. 2023 Jan.

Abstract
in English, French

Objective: To review cases of acute macular neuroretinopathy (AMN) after COVID-19 vaccination and add a similar case to the literature.

Methods: A thorough PubMed search was conducted, and data from studies describing AMN after COVID-19 vaccination were extracted, tabulated, pooled, and reviewed.

Results: We present a case of AMN in a young woman 5 days after immunization with the BBIBP-CorV (Sinopharm) COVID-19 vaccine. Data from 21 cases were pooled and reviewed. The most frequent vaccines among the cases were recombinant ones (13/21), followed by mRNA-based (6/21) and inactivated vaccines (2/21). Only one patient (5%) was male. Seventeen over twenty-one (81%) were young women, ages 18-33. Most cases (14/21; 67%) reported recent/concurrent use of contraceptive medication. In 90% of cases (19/21), symptoms appeared within 8 days of vaccination. A confined wedge-/oval-shaped lesion morphology was more frequent than a diffuse, semilunar one. Resolution of symptoms took 4 to over 15 weeks.

Conclusion: Attention should be paid to the history of vaccination and contraceptive use in patients with sudden-onset visual symptoms. Optical coherence tomography is integral to the detection of AMN-related abnormalities.

Objectif: Examiner les cas de neurorétinopathie maculaire aiguë (AMN) après la vaccination contre la COVID-19 et ajouter un cas similaire à la littérature.

Méthodes: Une recherche approfondie sur PubMed a été menée et les données des études décrivant l’AMN après la vaccination contre la COVID-19 ont été extraites, regroupées et examinées.

Résultats: Nous présentons un cas d’AMN chez une jeune femme 5 jours après l’immunisation avec le vaccin BBIBP-CorV (Sinopharm) COVID-19. Les données de 21 cas ont été regroupées et examinées. Les vaccins les plus fréquents parmi les cas étaient les vaccins recombinants (13/21), suivis des vaccins à base d’ARNm (6/21) et des vaccins inactivés (2/21). Un seul patient (5 %) était de sexe masculin. 17/21 (81 %) étaient de jeunes femmes âgées de 18 à 33 ans. La plupart des cas (14/21 ; 67 %) avaient utilisé récemment ou simultanément des médicaments contraceptifs. Dans 90 % des cas (19/21), les symptômes sont apparus dans les 8 jours suivant la vaccination. Une morphologie lésionnelle confinée cunéiforme/ovale était plus fréquente qu’une morphologie semi-lunaire diffuse. La résolution des symptômes peut prendre de 4 à plus de 15 semaines.

Conclusions: Une attention particulière doit être portée aux antécédents de vaccination et d’utilisation de contraceptifs chez les patients présentant des symptômes visuels d’apparition soudaine. La tomographie par cohérence optique fait partie intégrante de la détection des anomalies liées à l’AMN.

Keywords: Acute macular neuroretinopathy; COVID-19; Contraceptifs oraux; Neurorétinopathie maculaire aiguë; Oral contraceptives; SARS-CoV-2; Vaccination.

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Figures

Figure 1
Figure 1
Baseline color fundus photographs (a and b) showing perifoveal areas of hypopigmentation, corresponding to hyporeflective lesions seen on infrared reflectance images (c and d).
Figure 2
Figure 2
Cross-sectional optical coherence tomography scans at baseline (b and e; OD and OS), showing areas of outer plexiform layer thickening, outer nuclear layer thinning, and disruption of ellipsoid zone, and upon 2-week follow-up visit (c and f; OD and OS), showing partial improvement of abnormalities (c and f; OD and OS), corresponding to the section shown on en face scans (a and d; OD and OS, respectively).
See this image and copyright information in PMC

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