Optic Neuritis After COVID-19 Vaccination: A Case Series and a Review of Literature

J Neuroophthalmol. 2024 Sep 1;44(3):330-336. doi: 10.1097/WNO.0000000000002161. Epub 2024 Jun 3.

Abstract

Background: The coronavirus disease (COVID-19) pandemic broke out in March 2020, causing tremendous damage to public health and more than 6 million deaths. After authorization for the emergency use of COVID-19 vaccines, various adverse events have been reported, including optic neuritis. COVID-19 vaccination was implemented in Taiwan in March 2021.

Methods: We report patients who developed optic neuritis after COVID-19 vaccination at one university-affiliated tertiary hospital, between March 2021 and December 2022. We also provided a literature review of optic neuritis cases after COVID-19 vaccination.

Results: Five patients who developed optic neuritis after COVID-19 vaccination have been identified. Four brands of vaccine used were as follows: Moderna, Pfizer-BioNTech, Medigen, and Oxford AstraZeneca. Optic neuritis developed after the first dose of vaccination in 4 patients, whereas in 1 patient, it developed after the second shot. In the 3 patients with poor initial visual acuity, intravenous methylprednisolone pulse therapy achieved substantial improvement.

Conclusions: Optic neuritis is a rare but potentially vision-threatening adverse effect of COVID-19 vaccination. We suggest early diagnosis and treatment to maximize visual outcomes.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Aged
  • COVID-19 Vaccines* / adverse effects
  • COVID-19* / complications
  • COVID-19* / prevention & control
  • Female
  • Glucocorticoids / therapeutic use
  • Humans
  • Male
  • Methylprednisolone / therapeutic use
  • Middle Aged
  • Optic Neuritis* / diagnosis
  • Optic Neuritis* / etiology
  • SARS-CoV-2*
  • Vaccination / adverse effects
  • Visual Acuity / physiology

Substances

  • COVID-19 Vaccines
  • Methylprednisolone
  • Glucocorticoids