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Case Reports
. 2023 Feb 21;16(1):157-160.
doi: 10.4103/ojo.ojo_31_22. eCollection 2023 Jan-Apr.

A rare case of bilateral optic neuritis post-Covishield (ChAdOx1-S [recombinant]) vaccination

Tanie Natung  1 , Thangjam Amit Singh  1 , Oinam Somapika Devi  1 , Ishita Pandey  1
Affiliations
Case Reports

A rare case of bilateral optic neuritis post-Covishield (ChAdOx1-S [recombinant]) vaccination

Tanie Natung et al. Oman J Ophthalmol. .

Abstract

Multiple adverse effects have been reported in people receiving the COVID-19 vaccinations including few reports of optic neuritis. However, there is no report till date, of bilateral optic neuritis post-ChAdOx1-S (recombinant) vaccination. We report here, for the first time, such a case in a previously healthy woman. Although a direct causal relationship cannot be proven, there was a temporal association between the vaccination and the onset of optic neuritis. Some vaccine adjuvants inciting disproportionate systemic inflammation, molecular mimicry, and the hypercoagulable state seen after COVID-19 vaccination could be the possible causes for the development of optic neuritis. Clinicians should be aware of this adverse effect apart from various other adverse effects of COVID-19 vaccination.

Keywords: Bilateral optic neuritis; COVID-19 vaccination; ChAdOx1-S (recombinant); Covishield vaccine.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1:
Figure 1:
(a) Fundus picture of the right eye showing the optic disc which is reddish in color, cup-disc ratio is obliterated but margins are sharp and vessels are normal, suggestive of mild disc edema. (b) Fundus picture of left eye showing the optic disc which is elevated and reddish in color, cup-disc ratio is obliterated and margins are blurred, indicating optic disc edema. Vessels are tortuous and dilated
Figure 2:
Figure 2:
(a) VEP at presentation showing prolonged P-100 latencies in both the eyes. (b) Contrast enhanced MRI of brain WNL and orbits showing optic disc swelling in left eye. (c) Fundus fluorescein angiography of left eye showing leakage of dye from the optic disc in the late phase. (d) VEP at 1-month follow-up showing improvement in the P-100 latencies in both the eyes. VEP: Visual evoked potential, MRI: Magnetic resonance imaging, WNL: Within normal limit
Figure 3:
Figure 3:
(a) HFA 30-2 of both the eyes at presentation, showing enlarged blind spot in the left eye and depressed peripheral fields in both the eyes. (b) HFA 30-2 at 1-month follow-up showing improvement of visual field defects in both the eyes, left improving more than the right. HFA: Humphrey visual field analysis
See this image and copyright information in PMC

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