PDF(Pubmed)
Abstract：
Various ocular manifestations associated with COVID-19 and vaccines, affecting both the anterior and posterior segments of the eye have been documented in the literature. In this report, we present the case of a 25-year-old male who complained of sudden-onset blurred vision and metamorphopsia in both eyes one day after receiving the second dose of the Sinopharm COVID-19 vaccine. The visual loss was painless, with no reported flashes or floaters. The patient had no significant medical or surgical history, no history of trauma, and no drug intake. Upon ocular examination, the best-corrected visual acuity was 6/60 (Snellen chart) in both eyes. The anterior segments appeared unremarkable, while fundoscopy revealed multiple yellowish-white subretinal lesions at the posterior pole of both eyes. Spectral domain optical coherence tomography (SD-OCT) confirmed the presence of subretinal fluid (SRF) with neurosensory detachment in each eye, along with bacillary layer detachment (BALAD). There were no signs of inflammation in the vitreous cavity. A diagnosis of acute posterior multifocal plaque pigment epitheliopathy (APMPPE) was established. The patient was prescribed nepafenac 0.1% drops to be instilled three times a day in both eyes and was advised to return for a follow-up examination in two weeks. At the follow-up visit, the patient\'s vision had improved to 6/9 in the right eye and 6/6 in the left eye, with most of the SRF absorbed. Unilateral APMPPE with BALAD has been mentioned in the literature following various COVID-19 vaccinations, but, to the best of our knowledge, this is the first case report where bilateral APMPPE with BALAD is reported. This case emphasizes the importance of a thorough eye examination for individuals experiencing ocular symptoms after receiving the COVID-19 vaccine.
摘要：
与COVID-19和疫苗相关的各种眼部表现，影响眼睛的前段和后段已在文献中记录。在这份报告中,我们介绍了一例25岁男性,他在接受第二剂国药COVID-19疫苗后一天,主诉双眼突然出现视力模糊和变形视错.视力丧失是无痛的，没有报告的闪光或漂浮物。患者无明显病史或手术史，没有外伤史,没有药物摄入。经眼部检查,双眼最佳矫正视力为6/60(Snellen图)。眼前段看起来不明显，而眼底镜检查显示双眼后极有多个黄白色视网膜下病变。谱域光学相干断层扫描（SD-OCT）证实了每只眼睛存在视网膜下液（SRF）与神经感觉脱离，随着菌层分离（BALAD）。玻璃体腔内没有炎症的迹象。建立了急性后部多灶性斑块色素上皮病（APMPPE）的诊断。给患者开了0.1％的奈帕芬胺滴剂，每天在双眼中滴注3次，并建议在两周内返回进行随访检查。在后续访问中，患者的视力改善到右眼6/9，左眼6/6，吸收了大部分SRF。在各种COVID-19疫苗接种后，文献中提到了BALAD的单侧APMPPE，但是,据我们所知,这是首例报道双侧APMPPE伴BALAD的病例报告.该病例强调了对接受COVID-19疫苗后出现眼部症状的个体进行彻底眼部检查的重要性。
