Abstract：
BACKGROUND: Many adverse occurrences in the eye have been reported after severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) vaccination. This is the first report of a patient with an unruptured retinal arterial macroaneurysm (RAM) who developed branch retinal artery occlusion (BRAO) one day after SARS-CoV-2 vaccination (BNT162b2 by Pfizer-BioNTech).
METHODS: A 75-year-old man with a pertinent history of type-2 diabetes mellitus visited the hospital complaining of sudden visual loss in his right eye 1 day after receiving the fourth dose of the SARS-CoV-2 mRNA vaccine; his best-corrected visual acuity (BCVA) decreased from 1.0 to 0.7 (Snellen decimal). The patient had previously been diagnosed with an unruptured RAM and superior paracentral acute middle maculopathy in the same eye. Fundus examination showed increased sheathing of blood vessels. Indocyanine green showed a hyperfluorescent area suggestive of RAM on the right eye disc. Fluorescein angiography and optical coherence tomography angiography revealed arterial obstruction findings in the upper retinal area.
METHODS: The patient was diagnosed with BRAO with RAM and was followed up without any additional treatment. Follow-up examination after 4 months did not show any improvement in BCVA value.
CONCLUSIONS: This case suggested that BRAO could develop after SARS-CoV-2 vaccination in patients with unruptured RAM; however, more research is required to investigate the causes.
METHODS: A 75-year-old man with a pertinent history of type-2 diabetes mellitus visited the hospital complaining of sudden visual loss in his right eye 1 day after receiving the fourth dose of the SARS-CoV-2 mRNA vaccine; his best-corrected visual acuity (BCVA) decreased from 1.0 to 0.7 (Snellen decimal). The patient had previously been diagnosed with an unruptured RAM and superior paracentral acute middle maculopathy in the same eye. Fundus examination showed increased sheathing of blood vessels. Indocyanine green showed a hyperfluorescent area suggestive of RAM on the right eye disc. Fluorescein angiography and optical coherence tomography angiography revealed arterial obstruction findings in the upper retinal area.
METHODS: The patient was diagnosed with BRAO with RAM and was followed up without any additional treatment. Follow-up examination after 4 months did not show any improvement in BCVA value.
CONCLUSIONS: This case suggested that BRAO could develop after SARS-CoV-2 vaccination in patients with unruptured RAM; however, more research is required to investigate the causes.
摘要：
背景：已经报道了严重急性呼吸道综合征冠状病毒2（SARS-CoV-2）疫苗接种后眼睛中的许多不良事件。这是首次报道未破裂的视网膜动脉大动脉瘤（RAM）患者在SARS-CoV-2疫苗接种（Pfizer-BioNTech的BNT162b2）后一天发生视网膜分支动脉阻塞（BRAO）。
方法：一名具有2型糖尿病相关病史的75岁男子在接受第四剂SARS-CoV-2mRNA疫苗后1天到医院就诊，抱怨右眼突然视力下降；他的最佳矫正视力（BCVA）从1.0降至0.7（Snellen十进制）。该患者先前在同一只眼睛中被诊断为未破裂的RAM和中央上旁急性中度黄斑病变。眼底检查显示血管鞘增加。吲哚菁绿在右眼盘上显示出高荧光区域，提示RAM。荧光素血管造影和光学相干断层扫描血管造影显示视网膜上区域的动脉阻塞。
方法：患者被诊断为BRAO伴RAM，并在没有任何额外治疗的情况下进行随访。4个月后的随访检查未显示BCVA值的任何改善。
结论：该病例提示BRAO可能在未破裂RAM的患者接种SARS-CoV-2疫苗后发展；然而，需要更多的研究来调查原因。
方法：一名具有2型糖尿病相关病史的75岁男子在接受第四剂SARS-CoV-2mRNA疫苗后1天到医院就诊，抱怨右眼突然视力下降；他的最佳矫正视力（BCVA）从1.0降至0.7（Snellen十进制）。该患者先前在同一只眼睛中被诊断为未破裂的RAM和中央上旁急性中度黄斑病变。眼底检查显示血管鞘增加。吲哚菁绿在右眼盘上显示出高荧光区域，提示RAM。荧光素血管造影和光学相干断层扫描血管造影显示视网膜上区域的动脉阻塞。
方法：患者被诊断为BRAO伴RAM，并在没有任何额外治疗的情况下进行随访。4个月后的随访检查未显示BCVA值的任何改善。
结论：该病例提示BRAO可能在未破裂RAM的患者接种SARS-CoV-2疫苗后发展；然而，需要更多的研究来调查原因。
