Abstract
Purpose :
COVID-19 vaccination has been accompanied by reports of inflammatory events. We aim to report the first case of bilateral persistent placoid maculopathy (PPM) following COVID-19 vaccination.
Methods :
Case report
Results :
A 58-year-old man presented with bilateral sudden painless decrease in vision approximately two weeks after the second dose of AstraZenaca® COVID-19 vaccine. Visual acuity (VA) at presentation was 1.00 LogMAR in the right eye (RE) and hand movement in the left eye (LE). He had no known medical or ophthalmic history, up until after his first AstraZenaca® COVID-19 vaccine dose, he was diagnosed with palmoplantar pustular psoriasis and was started on 60mg of oral Prednisolone. Fundus examination revealed bilateral well-delineated whitish plaque-like macular lesions involving the fovea, sparing the peripapillary region in the RE (Figure 1a & e). Multimodal imaging including fluorescein angiography, indocyanine-green angiography, fundus autofluorescence and optical coherence tomography were consistent with PPM (Figure 1 & 2). Infective and auto-immune screen were all negative apart from a positive MPO-ANCA, prompting a rheumatology review which subsequently excluded any systemic vasculitis. Patient was monitored closely and his VA improved and stabilised with tapering regime of oral Prednisolone. To prevent relapse of PPM, patient was commenced on Mycophenolate Mofetil as a long-term steroid sparing immunosuppression.
Conclusions :
Our case demonstrated a likely inflammatory or autoimmune response affecting choriocapillaris driven by the COVID-19 vaccine and there may be a correlation between the two. The patient in our case portrayed features classical of PPM, which is a selective autoimmune vasculitis causing microinfarcts on choriocapillaris, resulting in focal choroidal hypoperfusion after the COVID-19 vaccine.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.