COVID-19 백신 접종 후 발생한 소실성다발흰점증후군 2예
Multiple Evanescent White Dot Syndrome following COVID-19 Vaccination: Two Case Reports
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목적: COVID-19 백신 접종 후 발생한 소실성다발흰점증후군(multiple evanescent white dot syndrome, MEWDS) 2예를 보고하고자 한다. 증례요약: 첫 번째 증례는 14세 남환으로 2차 BNT162b2 (Pfizer-BioNTech, Kronach, Germany) 접종 후 좌안 이측의 시력저하를 호소하였다. 두 번째 증례는 38세 여환으로 1차 BNT162b2 접종 후 우안의 시력저하를 호소하였다. 특히, 두 증례의 환자 모두 기저 질환은 없었고 COVID-19 백신 접종 후 상기도 감염 증상도 호소하지 않았다. 안저검사에서 두 증례 모두 다수의 흰 반점이 관찰되었다. 6주 후 이전 시야검사상 나타났던 확대된 암점과 망막의 흰 반점들은 소실되었으며, 7개월 후 시력 및 안저검사상 정상 소견을 보였다. 결론: 최근 COVID-19의 대유행으로 전 세계적으로 백신 접종 수치가 유례없는 수준으로 높아졌다. 특히, MEWDS의 경우 이전에 인플루엔자 및 간염을 포함한 백신 접종과 상당한 연관성을 보여주었으며, 이번 증례들 또한 BNT162b2 백신 접종과 MEWDS 사이의 잠재적 연관성을 보여준다.
Abstract
Purpose: We present two cases of multiple evanescent white dot syndrome (MEWDS) following COVID-19 vaccination. Case summary: We present two cases of visual field defects following BNT162b2 (Pfizer-BioNTech, Kronach, Germany) COVID-19 vaccination. A 14-year-old male experienced reduced visual acuity in the temporal field of his left eye after his second dose. Similarly, a 38-year-old woman experienced decreased visual acuity in her right eye after her first dose. Notably, neither patient had pre-existing medical conditions or exhibited COVID-19 symptoms following vaccination. Funduscopic examination revealed multifocal peripapillary hyperreflective lesions in both cases. Visual field defects and hyperreflective lesions spontaneously resolved within 6 weeks, with normal visual acuity and fundus findings at the 7-month follow-up. Conclusions: The recent COVID-19 pandemic has led to a significant increase in vaccination rates. Notably, MEWDS demonstrated a significant association with previous vaccines, including influenza and hepatitis, and the cases describe herein also suggest a potential association between BNT162b2 vaccination and MEWDS.
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