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. 2025 Feb 26;15(1):14.
doi: 10.1186/s12348-025-00455-z.

Sudden bilateral vision loss: a case report of frosted branch angiitis following pentavalent vaccination in a 2-year-old boy

Mohammed Falah Aljasir  1 , Dhoha Mohammed Alhamad  1 , Shahad Salah Alsubhi  2 , Assaf Mohammad Almalki  1
Affiliations

Sudden bilateral vision loss: a case report of frosted branch angiitis following pentavalent vaccination in a 2-year-old boy

Mohammed Falah Aljasir et al. J Ophthalmic Inflamm Infect. .

Abstract

Background: Frosted branch angiitis (FBA) is a rare form of retinal vasculitis that can lead to significant vision loss. This case report presents a unique case of idiopathic FBA in a 2-year-old boy following pentavalent vaccination.

Case presentation: A previously healthy 2-year-old Emirati boy presented with sudden painless bilateral vision loss for one day. His mother noted difficulty walking and a lack of interest in visual stimuli. A few days prior, the child had received a pentavalent vaccination and experienced upper respiratory tract symptoms. Ophthalmic examination revealed bilateral dilated pupils, anterior chamber inflammation, and extensive retinal vascular sheathing. Investigations were unremarkable. The patient was treated with oral Prednisolone and Acyclovir. Within two weeks, the vision improved significantly, with complete resolution of retinal vasculitis observed within one month. Over the course of one year, the patient showed no recurrence of symptoms, and only small, stable retinal scars were noted.

Conclusion: This case highlights the potential association between pentavalent vaccination and the onset of idiopathic FBA. The pathophysiology behind this association remains speculative, with potential mechanisms including immune dysregulation and molecular mimicry. Prompt recognition and treatment with systemic steroids can lead to favorable outcomes, emphasizing the importance of monitoring visual symptoms in pediatric patients following vaccination.

Keywords: Bilateral vision loss; Frosted branch angiitis; Pentavalent vaccination; Uveitis; Viral infection.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable (in out institution no need for IRB approval in case reports). Consent for publication: Informed written consent was obtained from the parents of the patient for publication of the case details and images. Competing interests: The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Fundus examination showing hyperemic discs, and extensive vascular sheathing in all quadrants of both eyes
Fig. 2
Fig. 2
Fundus fluorescein angiography displayed normal arterial, venous, and macular perfusion with optic disc leakage
Fig. 3
Fig. 3
Fundus fluorescein angiography displayed diffuse vascular leakage with peripheral capillary drop out
Fig. 4
Fig. 4
Bilateral small, diffuse, multifocal white scars in the periphery and outside the macula (arrows), with temporal peripheral retinal atrophy in both eyes
See this image and copyright information in PMC

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