Long-term recurrence interval of Vogt–Koyanagi–Harada disease post-COVID-19 vaccination: A case study (preprint)

Purpose This study aimed to report a case of Vogt–Koyanagi–Harada (VKH) disease that recurred 46 years after initial treatment; the recurrence occurred 2 months after the third dose of coronavirus disease 2019 vaccination.Case report: A 59-year-old female patient had bilateral blurring for 2 months; she received her third dose of coronavirus disease 2019 vaccine 4 months before the onset of blurring. The best-corrected visual acuity was 1.0 in the right eye and 0.15 he left eye at the initial visit. Iritis and synechia between lens and iris were observed bilaterally. Sunset glow fundus was found in both eyes with no serous retinal detachments or disk hyperemia. She had a history of VKH disease and was treated with whole-body corticosteroid administration at another hospital when she was 13 years old. She was diagnosed with VKH disease recurrence, and oral corticosteroid intake and corticosteroid eyedrop treatments were initiated. The treatment response was good, but left synechia remained between the lens and iris in the left eye. Recurrence was not observed for 10 months until this study, and her best-corrected visual acuity was 1.0 in both eyes.Conclusion To our knowledge, this case represents the longest recorded interval of VKH disease recurrence in the literature.

Development of Branch Retinal Vein Occlusion Following COVID-19 Vaccination and Subsequent SARS-CoV-2 Infection While Taking Oral Contraceptives (preprint)

Objectives: Oral contraceptive use, vaccination for coronavirus disease 2019 (COVID-19), and the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection are all risk factors for venous thromboembolism (VTE). Although, in general, branch retinal vein occlusion (BRVO) develops during the mid-60s in general, we present a case of BRVO caused by the abovementioned risk factors in a young woman. To the best of our knowledge, this is the first report about BRVO associated with oral contraceptives, COVID-19 vaccination, and SARS-CoV-2. Case presentation: A 21-year-old woman was referred to us after experiencing loss of visual acuity in her right eye from 10 days ago. She had been using oral contraceptives for 2 years for paramenia before noticing her ophthalmological symptoms. Despite having received two does of the mRNA COVID-19 vaccine, she had contracted COVID-19 with fever, sore throat, cough, low back pain, and general malaise about 40 days before the initial visit. However, only the cough persisted for a month. The right eye showed BRVO with macular edema (ME). She did not smoke or have diabetes mellitus or systemic hypertension. The result of blood test was normal, including the cardiolipin antibody IgG. She was treated with an intravitreal aflibercept injection immediately. The right fundus showed rapid improvement in the resolution of ME. Conclusions The combination of oral contraceptive use, COVID-19 vaccination, and subsequent SARS-CoV-2 infection could accelerate VTE, thereby leading to BRVO. Given that cases of COVID-19 have increased globally, patients with RVO who use oral contraceptives are likely to be encountered more frequently.