ABSTRACT
We report on a case of multiple evanescent white dot syndrome (MEWDS) following the simultaneous administration of the human papillomavirus and meningococcal (conjugate) vaccines and two recurrences of MEWDS following the administration of the second dose of the human papillomavirus (HPV) vaccine and the COVID-19 vaccine and COVID-19 viral infection. A 17-year-old Hispanic female presented with a one-week history of photopsia and blurred vision in her left eye following the simultaneous administration of the human papillomavirus and meningococcal (conjugate) vaccines. Upon a comprehensive examination, her best-corrected visual acuity was 20/20 in the right eye and 20/100 in the left eye. A left fundus examination revealed multiple white dots in the macula and nasal periphery, consistent with a diagnosis of MEWDS. Ancillary testing, including fundus autofluorescence, fluorescein angiography, indocyanine green angiography, and optical coherence tomography, supported the diagnosis. One month following her initial diagnosis, the patient's symptoms had resolved without any therapy, and a fundus examination revealed multiple relatively ill-defined brown-colored subretinal lesions in the nasal midperiphery, corresponding to the location of the previous MEWDS lesions. Subsequently, she received the second dose of the HPV vaccine and then developed a mild COVID-19 infection. Four months after the initial presentation, she received the first dose of the BNT162b2 COVID-19 vaccine, followed by the second dose a month later. Eight months following her initial presentation, she presented with photopsia in the right eye. Her visual acuity remained 20/20 in the right eye and improved to 20/20 in the left eye, and white dots were identified nasal to the disk and surrounding the peripapillary region; the contralateral MEWDS diagnosis was confirmed by the previously mentioned ancillary tests. At her one-month follow-up, she presented new onset photopsia of the right eye. Her visual acuity remained 20/20 in both eyes, and a fundus examination revealed white lesions suggestive of active MEWDS temporal to the macula and brown-colored spots nasal to the disk, suggestive of recovering MEWDS, nasally. The aforementioned testing confirmed the coexistence of new and resolving lesions; nonetheless, the patient's symptoms resolved without any therapy, and she received the third dose of the BNT162b2 COVID-19 vaccine 11 months after her initial presentation. Our case suggests that vaccines may serve as immunological triggers of MEWDS. Recurrent MEWDS may occur when an individual is exposed to a powerful immune challenge, such as receiving a wide array of vaccinations in a short period of time. We believe this case constitutes a previously undescribed finding of multiple relatively ill-defined brown-colored subretinal lesions present in late MEWDS.
ABSTRACT
The COVID-19 pandemic resulted in unprecedented stressors for college students, and minority stress faced by LGBTQ + college students has been exacerbated by the pandemic. Associations between stress and sexual desire are complex, but research suggests that stress may be associated with higher solitary sexual desire and lower dyadic sexual desire. The current study examined associations between sexual desire and a multidimensional measure of pandemic stress among LGBTQ + and cisgender, heterosexual (cis-het) college students. Participants (N = 377, 57% LGBTQ+) completed an online survey during the Spring 2021 semester that included the Sexual Desire Inventory and a multidimensional COVID Stress Measure. LGBTQ + students reported higher stress in multiple domains-isolation, academics, living situation, concerns about racism and prejudice, and health care access-relative to cis-het students. For LGBTQ + and cis-het students, higher overall COVID stress, as well as higher stress related specifically to isolation and to the virus itself, were associated with higher solitary and dyadic sexual desire. Greater concern about racism and prejudice during the pandemic was associated with higher solitary sexual desire, especially for LGBTQ+ students. Our findings underscore the importance of sexuality as a means of seeking connection during an event that disrupted college students' lives in many ways. We highlight implications for university professionals, particularly the need to support LGBTQ +-affirming organizations, mental health resources, and sexual health resources as students return to college campuses. (PsycInfo Database Record (c) 2022 APA, all rights reserved) Impact Statement This study indicates that LGBTQ + college students experienced higher stress than their cisgender, heterosexual counterparts during the COVID-19 pandemic, and that higher stress was associated with higher sexual desire among LGBTQ + and cisgender, heterosexual college students. Results point to the importance of providing LGBTQ +-affirming mental and sexual health resources as students return to college campuses in the aftermath of the pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved)