Case Report: Acute Posterior Multifocal Placoid Pigment Epitheliopathy after SARS-CoV-2 Vaccination

Acute posterior multifocal placoid pigment epitheliopathy is an uncommon inflammatory chorioretinopathy that has been reported after vaccination. This is the first reported case, to our knowledge, after vaccination for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in a healthy adolescent boy.

This report aimed to inform the eye care community about a possible ocular sequela of SARS-CoV-2 vaccination.

A 17-year-old boy presented to a clinic for a second opinion after sudden-onset blind spots in his right eye. His medical history was remarkable for receiving the first dose of the Pfizer-BioNTech SARS-CoV-2 vaccine 2 weeks before symptom onset. He had no history of ocular inflammation, autoimmune disease, or systemic infection. A diagnosis of unilateral acute posterior multifocal placoid pigment epitheliopathy was made based on the presence of typical fundus lesions and noninvasive imaging with fundus autofluorescence, retinal optical coherence tomography, and optical coherence tomography angiography. The diagnosis was further confirmed with fluorescein angiography. The patient developed an anterior vitritis in the right eye 42 days after initial symptom onset. His unilateral intraocular inflammation resolved after a 5-week course of prednisone.

Acute posterior multifocal placoid pigment epitheliopathy is a self-limited inflammatory condition of the outer retina that usually affects young adults and often does not require treatment. It has been reported to occur after vaccination for influenza, polio, hepatitis B, meningococcus C, and varicella zoster virus. This is the first known case to occur after SARS-CoV-2 vaccination in a healthy adolescent boy.