Rapid Progression of Polypoidal Choroidal Vasculopathy following Third BNT162b2 mRNA Vaccination

Hirofumi Sasajima1, Masahiro Zako2, Rio Maeda1

  • 1Department of Ophthalmology, Shinseikai Toyama Hospital, Imizu, Japan.

Insights

A rare case of rapid polypoidal choroidal vasculopathy (PCV) progression occurred after the third Pfizer-BioNTech mRNA vaccine dose. This case highlights a potential, though infrequent, association between mRNA COVID-19 vaccines and PCV worsening.

Area of Science:

  • Ophthalmology
  • Vaccinology

Background:

  • Polypoidal choroidal vasculopathy (PCV) is a subtype of neovascular age-related macular degeneration.
  • The Pfizer-BioNTech (BNT162b2) mRNA vaccine is widely used for COVID-19 prevention.

Observation:

  • A 79-year-old male experienced blurred vision 16 hours after his third BNT162b2 mRNA vaccine dose.
  • Clinical examination revealed massive submacular hemorrhage (SMH) and subretinal fluid (SRF) due to PCV in the left eye.
  • The patient had a history of diabetes, cataracts, nonproliferative diabetic retinopathy, glaucoma, and previous treatment for diabetic macular edema.

Findings:

  • The patient underwent intravitreal bevacizumab injection, vitrectomy, and subretinal tissue plasminogen activator injection.
  • Post-surgery, the SMH and SRF showed significant reduction within 13 days.
  • This case suggests a possible, albeit rare, link between mRNA COVID-19 vaccination and PCV exacerbation.

Implications:

  • Healthcare providers should be aware of potential rare ocular complications following mRNA vaccinations.
  • Further research is needed to investigate the potential association between COVID-19 vaccines and PCV progression.
  • Prompt diagnosis and management are crucial for patients presenting with vision changes post-vaccination.