Bilateral Persistent Placoid Maculopathy Following COVID-19 Vaccines: Real or Coincidence?

Area of Science:

• Ophthalmology
• Immunology
• Vaccinology

Background:

• Reports of inflammatory uveitis following COVID-19 vaccination exist.
• Persistent Placoid Maculopathy (PPM) is an inflammatory eye condition affecting the macula.

Observation:

• A 58-year-old man developed bilateral vision decrease two weeks post-AstraZeneca COVID-19 vaccination.
• Fundus examination revealed bilateral, well-delineated, whitish, plaque-like macular lesions involving the fovea.

Findings:

• Clinical and multimodal imaging were consistent with PPM.
• Infective and autoimmune screens were negative, except for elevated MPO-ANCA.
• Systemic autoimmune and infectious diseases were excluded.

Implications:

• This case suggests a potential localized autoimmune inflammatory response to COVID-19 vaccines affecting the choriocapillaris.
• Further research is necessary to understand the association between COVID-19 vaccines and inflammatory placoid retinal lesions.
• The patient's vision improved with corticosteroids and immunosuppression, indicating a treatable inflammatory process.