Abstract General Information


Concurrent Bilateral Optic Neuritis After Pfizer Vaccine Against COVID-19

Case Report

Case Presentation
A 51-year-old male patient presented with atypical optic neuritis, with symptoms starting with pulsating frontal headache and periorbital pain, worsening with eye movement and progressive decline in visual acuity. Two days after onset, the patient received pulse therapy with methylprednisolone for five days, which led to complete resolution of the condition. The patient reported being immunized with BNT162b2 eight days prior to the occurrence. On physical examination, the patient had bilateral scotomas, VA 20/20 in both eyes, and slightly reduced vibratory sensitivity in the lower limbs (EDSS 1.5). MRI showed hyperintense lesions in both optic nerves, and Humphrey's perimetry revealed decreased diffuse sensitivity and constriction of the fields bilaterally.

Several cases of adverse effects related to mRNA COVID-19 vaccines have been reported, including inflammatory diseases of the central nervous system (CNS). Epitope mimicry has been proposed as one of the mechanisms behind this immunological association. The case presented here adds to the growing body of evidence linking COVID-19 vaccination with optic neuritis. This condition is characterized by inflammation of the optic nerve and can lead to vision loss. In this patient, optic neuritis occurred after the third dose of the BNT162b2 vaccine, and although the condition resolved with pulse therapy, the patient continued to have some residual symptoms.

Final Comments
Health professionals should be aware of the potential adverse effects associated with COVID-19 vaccination and should monitor patients closely. More research is needed to determine the exact mechanism behind the association between COVID-19 vaccination and optic neuritis, but until then, patients should be informed of the potential risks and benefits of vaccination. The benefits of vaccination against COVID-19 outweigh the risks for most people, but for some individuals, like the patient presented here may have neurological complications.


Clinical findings


Felipe Baptista Brunheroto, Cleison Sanches Silva, Ana Cristina Cotta Queiroz, Beatriz Silva Lombardi, Clara Catharino Pinhati, Denison Pedrosa, Emerson Costa Oliveira, Gabriel Coelho, Grazielle Fialho de Souza, Hugo Brito, Juliana Monção, Larissa Ferrarez, Pedro L. B. dos Reis, Márcia Prates, Thales Ponsá, Juliana Santiago Amaral, Natália Cirino Talim, Paulo Pereira Christo, Marco Aurelio Lana-Peixoto