Case report of 2 cases who developed bilateral Acute Exudative Polymorphous Vitelliform Maculopathy (AEPVM) after COVID-19 vaccine. It is a rare and unique disorder of the RPE. The diagnosis was confirmed by typical findings by multimodal imaging and electrophysiological studies.
Methods
Two young healthy adults presented to our clinic with typical clinical picture of AEVPM within days after the first shot of AZD1222 vaccine against COVID-19 in October 2021 . The diagnosis was confirmed by multimodal imaging. Electrooculogram showed reduced Arden ratio confirming RPE dysfunction. Corrected visual acuity dropped to 20/30-20/25 range. The lesions progressed within days and remained stationary despite systemic corticosteroids in 1 patient. Systemic work up did not show any underlying inflammation. The presence of neoplasia was ruled out by oncology. Patients were advised against the second dose of the vaccine. Their visual complaints slowly regressed.
Results
We postulate a relationship between the AZD1222 vaccine and the developing RPE pathology that led to AEPVM,
possibly via autoantibodies against the Sars-CoV-2 virus structural surface glycoprotein antigens that cross react with the normal RPE cells.
Conclusion
AEPVM is a presumed RPE pathology that has been reported in patients with neoplasms and under certain classes of drugs. The pathophysiology remains unclear despite the typical clinical features. We report 2 cases who developed AEVPM after the first dose of AZD1222 vaccine
Conflict of interest
No
Authors 1
Last name
BADDAR
Initials of first name(s)
D
Department
Watany Eye Hospital
City
Cairo
Country
Egypt
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