Acute Retro-Foveal Neovascularization After Recombinant Hepatitis B Vaccine

Abstract

Abstract: : Purpose: To report one case of retro-foveal neovascularization after vaccination with a recombinant hepatitis B virus vaccine. Methods: A thirty one year old woman with no ophthalmological pathology history develops visual loss ten days after the administration of one shot of recombinant hepatitis B virus surface antigen (Engerix-B). There had been no adverse reactions after the first two injections. Results: Visual acuity was 20/200 OD and 20/20 OS. Right eye fundus examination shows one macular hemorrhage associated whith exudates and fluorescein angiograms show typical retro-foveal neovascularisation. The blood cell count reveals no abnormalities. There was no response to intraveinous corticotherapy. After surgical removal of the neovessel and complementary phodynamic therapy, visual acuity is finaly restored. Conclusion: Hepatitis B vaccine immunization may be a risk factor for acute retro foveal neovascularization. This case suggests that hepatitis B surface antigen may trigger an immune mediated response leading to neoangiogenesis even in the absence of blood cell count abnormalities. Even if a causal link has not been demonstrated and that the benefits of hepatitis B vaccine greatly outweigh its risk, immunization histories should be obtained in young patients presenting with acute retro-foveal neovascularization.

Keywords: 353 clinical (human) or epidemiologic studies: outcomes/complications • 566 retinal neovascularization • 568 retinitis