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A Case of Bilateral Frosted Branch Angiitis after mRNA COVID-19 Vaccination

Mai Kitaoka1, Takako Ohnishi1, Satoshi Sugaya1

  • 1Division of Ophthalmology, Department of Visual Sciences/Nihon University School of Medicine/Itabashi, Tokyo, Japan.

Case Reports in Ophthalmology
|July 19, 2023
PubMed

Insights

Frosted branch angiitis, a severe retinal vasculitis, can occur after messenger RNA (mRNA) COVID-19 vaccination. Prompt treatment with steroids and antivirals improved vision in a case linked to the mRNA-1273 vaccine.

Area of Science:

  • Ophthalmology
  • Infectious Diseases
  • Vaccinology

Background:

  • The mRNA-1273 COVID-19 vaccine (Moderna) is widely used globally.
  • Retinal vasculitis encompasses inflammatory conditions affecting retinal blood vessels.
  • Frosted branch angiitis (FBA) is a rare, severe form of retinal vasculitis.

Observation:

  • A 79-year-old male developed bilateral FBA with blurred vision after his third mRNA-1273 COVID-19 vaccine dose.
  • Fundoscopy revealed severe retinal vasculitis and macular edema.
  • Epstein-Barr virus (EBV) was detected in the aqueous humor.

Findings:

  • The patient experienced worsening vision and macular edema in both eyes.
  • Treatment with pulse steroid therapy and intravenous acyclovir led to resolution of macular edema and improvement in retinal vessel sheathing.
  • Visual acuity improved significantly at 5 months post-vaccination.

Implications:

  • This case highlights a potential, albeit rare, association between mRNA COVID-19 vaccination and severe uveitis like FBA.
  • Early diagnosis and treatment are crucial for managing post-vaccination ocular inflammatory conditions.
  • Further research is warranted to understand the immunopathogenesis of vaccine-associated uveitis.
Keywords:
Epstein-Barr virusFrosted branch angiitisUveitismRNA COVID-19 vaccination

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