Title

VACCINE ASSOCIATED UVEITIS

Summary

We here present a case of BCG vaccine-associated posterior uveitis with serous retinal detachment. A previously healthy 65 years old woman presented with progressive blurred vision and floaters for the past 3 days in left eye (OS). Recently vaccinated with BCG for prophylaxis as her son and husband were treating for leprosy, also presented with swelling and hyperemia in the site of injection for the past 3 days. In the initial examination, the visual acuity presented was 20/20 in the right eye and 20/80 in the left eye. She had high yellowish lesions in the macular and nasal region, near the optic nerve in OS. The optic coherence tomography (OCT) revealed subretinian fluid. Performed fluorescein angiography of left eye that showed areas of hyperfluorescence in optic nerve, staining and pinpoint leakage in posterior pole in OS. In OR leakage in periphery could also be noted. Investigation for infectious diseases was negative. Diagnosed with autoimmune/inflammatory syndrome induced by adjuvants (ASIA), patient was treated with 80mg per day oral prednisone with good improvement of VA and subretinal fluid in first week already. Vaccine associated uveitis is a rare condition, presented mostly in women around 30 years old. Anterior uveitis is more common than posterior and both have good response to oral steroids. The precise pathogenesis remains unclear with proposed mechanisms have included both molecular mimicry and antigen-specific cell and antibody mediated hypersensitivity reactions.

Area

CLINICAL CASE

Authors

Talitha Borges Aguiar, Francynne Veiga Reis Cyrino, Lauro José Franco Melo, João Marcello Fortes Furtado, Rodrigo Jorge