key: cord-0947311-0qal5jvw
authors: Chen, Simon; Hodge, Chris
title: Comment on: ‘Acute macular neuroretinopathy following COVID-19 vaccination’
date: 2021-09-28
journal: Eye (Lond)
DOI: 10.1038/s41433-021-01781-x
sha: 19d5d7972c1a3e144f61e1250bfa00f2c491572d
doc_id: 947311
cord_uid: 0qal5jvw

nan

barely visible oval parafoveal lesions with slight hyperfluorescence on imaging (Optos, MA, USA). Infrared reflectance imaging (Cirrus, Zeiss, Germany) confirmed two parafoveal oval hypo-reflective lesions. Findings were consistent with left AMN (Figs. 1-2).

Paracentral scotomas have been described in almost threequarters of AMN cases (73%), remaining symptomatic at final follow-up in over half of these patients [5] . Decreased acuity remains less common (12-16%) [5] . Exact pathophysiology is unknown but a potential mechanism is ischemia in the deep retinal capillary plexus or choriocapillaris [5] . Dominant associated factors are recent infection, febrile illness and use of oral contraceptives [1] .

All reported cases of AMN following Vaxzevria COVID-19 vaccination have noteworthy similarities to our case [1] [2] [3] [4] . All cases involved females aged 21 to 28 years taking oral contraceptives. Acute paracentral scotomas developed 2 or 3 days following the initial vaccination. In all but one case, ocular symptoms were coexistent with systemic flu-like symptoms. Our case represents the first following BNT162b2 (Pfizer-BioNTech) injection.

The occurrence of AMN following COVID-19 vaccination is rare; however, with minimal impact on acuity and often subtle retinal 

Acute macular neuroretinopathy following COVID-19 vaccination

Acute macular neuroretinopathy following coronavirus disease 2019 vaccination

Bilateral acute macular neuroretinopathy after vaccination against SARS-CoV-2

Acute macular neuroretinopathy after COVID-19 vaccine

Acute macular neuroretinopathy: a comprehensive review of the literature

SC was responsible for the patient consultation and analysis. SC and CH were responsible for writing the report, extracting and preparation of the images and final review of the correspondence.

The authors declare no competing interests.

Correspondence and requests for materials should be addressed to Simon Chen.Reprints and permission information is available at http://www.nature.com/ reprintsPublisher's note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.