De novo Vogt-Koyanagi-Harada disease after vaccination for COVID-19, successfully treated with systemic steroid therapy and monitored with laser speckle flowgraphy

Chiaki Yamaguchi; Hiroshi Kunikata; Kazuki Hashimoto; Masaaki Yoshida; Takahiro Ninomiya; Takehiro Hariya; Toshiaki Abe; Toru Nakazawa

doi:10.1016/j.ajoc.2022.101616

De novo Vogt-Koyanagi-Harada disease after vaccination for COVID-19, successfully treated with systemic steroid therapy and monitored with laser speckle flowgraphy

Am J Ophthalmol Case Rep. 2022 Jun 11:27:101616. doi: 10.1016/j.ajoc.2022.101616. eCollection 2022 Sep.

Authors

Chiaki Yamaguchi¹, Hiroshi Kunikata^{1

2}, Kazuki Hashimoto¹, Masaaki Yoshida¹, Takahiro Ninomiya¹, Takehiro Hariya¹, Toshiaki Abe³, Toru Nakazawa^{1

2

4

5}

Affiliations

¹ Department of Ophthalmology, Tohoku University Graduate School of Medicine, Sendai, Japan.
² Department of Retinal Disease Control, Tohoku University Graduate School of Medicine, Sendai, Japan.
³ Division of Clinical Cell Therapy, United Centers for Advanced Research and Translational Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
⁴ Department of Advanced Ophthalmic Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
⁵ Department of Ophthalmic Imaging and Information Analytics, Tohoku University Graduate School of Medicine, Sendai, Japan.

Abstract

Purpose: Vogt-Koyanagi-Harada (VKH) disease after vaccination for coronavirus disease 2019 (COVID-19) is rare, and the prognosis for this condition and its effect on ocular blood flow remains unclear. The purpose of this paper is to present the first case of de novo VKH disease after the second vaccination for COVID-19 with an mRNA vaccine that was successfully treated with systemic steroid therapy and monitored with laser speckle flowgraphy (LSFG).

Observations: A 30s-year-old Japanese woman reported bilateral decreased visual function 2 weeks after receiving a second dose of the BNT162b2 mRNA vaccine. Best-corrected visual acuity was 20/50 OD and 20/70 OS. Optical coherence tomography revealed bilateral serous retinal detachment over the swollen choroidal layer. LFSG showed decreased blood flow in the peripapillary region of both eyes. This case was diagnosed as complete VKH syndrome, and the patient underwent systemic steroid therapy. After treatment, the retinal detachment disappeared, choroidal thickness decreased, and ocular blood flow increased. Three months later, visual acuity recovered to 20/20 in both eyes.

Conclusions: Caution should be exercised in cases with visual symptoms after COVID-19 vaccination, even after more than one dose and more than one week after vaccination. LSFG may be a useful way to measure the ocular blood flow response to treatment and determine the prognosis for VKH disease after COVID-19 vaccination.

Keywords: COVID-19; Laser speckle flowgraphy; Mean blur rate; Vaccination; Vogt-Koyanagi-Harada disease; mRNA vaccine.

Publication types

Case Reports