Bilateral Multifocal Central Serous Retinopathy Follows COVID-19 Vaccine, Resolves

A woman experienced bilateral multifocal central serous chorioretinopathy (CSCR) following a COVID-19 vaccine, according to a case study published in the Journal Français d’Ophtalmologie.

A healthy 32-year-old White woman presented to investigators with progressive painless loss of vision beginning 3 days following her first dose of a COVID-19 vaccine. She reported no past medical or ocular history and denied taking any medications. She reported pain at the vaccine injection site on her arm and fatigue that lasted for 24 hours after the injection. 

Her best corrected visual acuity (BCVA) was 20/60 in both eyes at baseline and accommodative response was normal. Slit lamp evaluation did not detect any significant findings and intraocular pressure was 12 mm Hg in both eyes. Fundus examination revealed bilateral multifocal serous retinal elevations. No hemorrhages or vascular abnormalities were noted.

Fluorescein angiography demonstrated multifocal single point leakage bilaterally and a macular optical coherence tomography (OCT) scan confirmed the bilateral serous detachments in the posterior pole with a temporal pigment epithelial detachment with subretinal fluid in the left eye.

The researchers observed improvements in BCVA at 2 follow-up visits conducted 1 month and 6 weeks following the initial visit (OD 20/30, OS 20/20 and OD 20/25, OS 20/20, respectively) and further reductions in subretinal fluid on OCT.

The patient did not develop any ocular or systemic side effects following the second administration of the COVID-19 vaccine. Her BCVA improved in both eyes (20/20 OU) and her OCT was dry centrally with a small pigment epithelial detachment remaining temporally in the left eye.

Investigators acknowledge that the incidence of this adverse reaction may be underreported, but caution, “post-COVID19 vaccination occurrence of CSCR is not a sufficient reason to withhold the second dose of the vaccine.”

Reference

Mechleb N, Khoueir Z, Assi A. Bilateral multifocal central serous retinopathy following the COVID-19 mRNA vaccine. Journal Français d’Ophtalmologie. 2022;45(6):603-607. doi:10.1016/j.jfo.2022.02.001