ABSTRACT
A 49?year?old Indian male presented with rapidly progressive vision loss 1 day after receiving the second dose of BNT162b2 mRNA coronavirus disease 2019 (COVID?19) vaccine (Pfizer?BioNTech, NY, USA). The eye had secondary angle closure glaucoma, bullous retinal detachment, and massive intraocular hemorrhage. Ultrasound showed an ill?defined subretinal mass with moderate internal reflectivity. Magnetic resonance imaging (MRI) confirmed an enhancing heterogeneous subretinal mass. Histopathology showed a necrotic melanocytic lesion arising from the posterior edge of the ciliary body and choroid. Necrotic uveal melanoma was confirmed after expert histopathology opinion. Uveal melanomas can rarely present with tumor necrosis following mRNA COVID?19 vaccination.
ABSTRACT
PURPOSE: Cytomegalovirus retinitis (CMV) is the most common ocular opportunistic infection in transplant recipients. This retrospective study attempts to report the differences in occurrence of cytomegalovirus retinetis in transplant recipients from those reported in patients with acquired immunodeficiency syndrome (AIDS). METHODS: 25 eyes of 15 transplant recipients (14 renal and one cardiac) with cytomegalovirus retinitis were retrospectively reviewed. Immunological profile included CD4+ and CD8+ T lymphocyte counts, CD4+/CD8+ cell ratio (5 cases) and serology for the viral antibodies (8 cases). RESULTS: A predominantly bilateral presentation (60%) was noted. Active cytomegalovirus retinitis (72%) in zone 2 (92%) of the inferotemporal quadrant (68%) was noted. The average cell counts were within normal limits (mean CD4 cell count-711/microliter), unlike in late stages of AIDS with cytomegalovirus retinitis (CD4 count < 50/microliter). Serology revealed an IgM positivity of 53%. Retinal detachment (52%) was the most common complication occurring after an average of 5.4 months. CONCLUSION: CMV retinitis in organ transplant recipients appears to differ from that in AIDS patients. CMV retinitis presents early and has different immunological profile, probably owing to differences in pathogenesis.