ACUTE MACULAR NEURORETINOPATHY FOLLOWING MODERNA mRNA COVID-19 VACCINATION

Area of Science:

• Ophthalmology
• Vaccinology
• Immunology

Background:

• Acute macular neuroretinopathy (AMN) is a rare condition affecting the macula.
• mRNA COVID-19 vaccines have been widely administered globally.

Purpose of the Study:

• To report a case of acute macular neuroretinopathy (AMN) temporally associated with mRNA COVID-19 vaccination.

Main Methods:

• Case report detailing clinical presentation, diagnostic imaging (OCT, fundus photography, autofluorescence), and multimodal angiography (ICG, fluorescein).

Main Results:

• A 79-year-old man developed AMN after his second mRNA COVID-19 vaccine dose.
• Symptoms and imaging findings worsened after a third mRNA vaccine dose.
• Spontaneous improvement occurred 15 months post-initial presentation without specific therapy.

Conclusions:

• The temporal relationship and exacerbation after a booster suggest a possible causal link between mRNA COVID-19 vaccines and AMN.
• Clinicians may consider alternative vaccine vectors or foregoing boosters in patients experiencing AMN post-vaccination.
• This case highlights the importance of monitoring for rare ocular side effects following vaccination.