Título / Title

ACUTE RETINAL PIGMENT EPITHELIITIS AFTER VACCINATION FOR COVID-19: CASE REPORT.

Introdução / Purpose

Acute retinal pigment epitheliitis (ARPE) is a rare, idiopathic, and self-limiting inflammatory retinal disorder. Its physiopathology is unknown, but it is postulated to be caused by an immune reaction targeting retinal pigment epithelium or neurosensory retina, and it could be associated with viral infections. Patients generally suffer from blurred vision, central scotoma, and metamorphopsia. OCT findings have revealed that the primary inflammation area is in the outer retinal layers, especially in the interdigitation zone, ellipsoid zone, and external limiting membrane, rather than the RPE . The coronavirus disease 2019, caused by severe acute respiratory syndrome coronavirus 2, resulted in an unprecedented pandemic worldwide. In literature, we can see some cases of acute macular neuroretinopathy, which is related to vascular events .

Material e Método / Methods

A 60-year-old woman presented with a decreased visual acuity and metamorphopsia in right eye (RE); she reported vaccination for SARS-CoV-2 in the previous week and there were no other relevant medical data.

Resultados / Results

Fundoscopy revealed a subtle gray spot surrounded by a yellowish halo over the macula in RE. Spectral domain OCT revealed a defect in the RPE and the ellipsoid bands in the right eye. Metamorphopsia disappeared after four months. OCT findings showed decrease in ellipsoid discontinuity área in follow-up.

Discussão e Conclusões / Conclusion

It is unclear why this case appeared after vaccination. We hypothesize that after a vaccination, a viral antigen causes a crossed immune reaction toward tissue in the neurosensory retina, RPE or choriocapillaris and produces focal inflammation. Although most theories postulate that photoreceptors and the RPE could be the main involved tissue in the pathogenesis of ARPE, in some studies, we see alterations in the choriocapillaris. And, as we said before, some cases in literature is related to acute macular neuroretinopathy, which is associate to vascular events.

Palavras Chave

Acute retinal pigment epitheliitis ; Krill disease; SARS-CoV-2; COVID-19;

Area

CLINICAL RETINA