Sex: F
Vaccine: COVID19, COVID19
Symptoms: COVID-19, Drug ineffective, Fluorescence angiogram, Laboratory test, Magnetic resonance imaging
Clinical narrative: asymptomatic COVID-19 infection; asymptomatic COVID-19 infection; This is a literature report.  A 43-year-old female patient received BNT162b2 (BNT162B2), on 10Jan2021 as dose 2, single (Batch/Lot number: unknown) for covid-19 immunisation; coviD-19 vaccine (COVID-19 VACCINE), as dose 1, single (Batch/Lot number: unknown) for covid-19 immunisation. The patient's relevant medical history and concomitant medications were not reported. The following information was reported: COVID-19 (medically significant), DRUG INEFFECTIVE (medically significant) all with onset 19Jan2021, outcome "recovered" and all described as "asymptomatic COVID-19 infection". The patient underwent the following laboratory tests and procedures: Fluorescence angiogram: (unspecified date) mild peripheral vascular leakage; laboratory workup: (unspecified date) unremarkable; Magnetic resonance imaging: (unspecified date) normal; Optical coherence tomography: (unspecified date) showed mild vitreous debris, mild retinal, notes: and significant choroidal thickening; (23Feb2021) recurrence of mild choroidal thickening; SARS-CoV-2 test: (unspecified date) Negative, notes: no further tests were positive; (19Jan2021) positive, notes: had no symptoms and no other household contacts had symptoms or a positive test; Ultrasound scan: (unspecified date) showed choroidal thickening but no, notes: definite T-sign; Visual acuity tests: (unspecified date) 20/500, notes: in both eyes, 3-4+anterior chamber cell with 2-3+; (unspecified date) were unchanged and there were no neurological, notes: symptoms, intraocular inflammation had improved to trace cells bilaterally; (02Feb2021) had improved to 20/20 OU; (23Feb2021) remained 20/20, notes: she did have mild pain and new floaters, and OCT.  Clinical course: On 10Jan2021, a 43-year-old female emergency department registered nurse received her second dose of the COVID-19 Pfizer-Biontech mRNA vaccine. Apart from mild soreness at the injection site lasting around two days, she had no sideeffects from vaccination. On 13Jan2021 she experienced substantial vision loss, eye pain, eye redness, and sensitivity to light. She was examined on January 18 with a visual acuity of 20/500 in both eyes, 3-4+ anterior chamber cell with 2-3+ vitreous cell. Difluprednate drops four times daily and a cycloplegic drop were started. The following day, visual acuity (VA) and eye pain were unchanged and there were no neurological symptoms, intraocular inflammation had improved to trace cells bilaterally. Optical Coherence Tomography (OCT) imaging showed mild vitreous debris, mild retinal thickening and significant choroidal thickening. On fluorescein angiography, there was mild peripheral vascular leakage. B-scan ultrasound showed choroidal thickening but no definite T-sign. She was started on 50 mg/day of oral prednisone and her difluprednate was increased to every 2 hours. Magnetic Resonance Imaging scans of her brain and orbits with contrast was normal. The laboratory workup was unremarkable. She receives weekly nasopharyngeal swabs for asymptomatic COVID-19 infection screening; on 20Jan2021, she received notification that her 19Jan2021 test was positive. She had no symptoms and no other household contacts had symptoms or a positive test. This was her first ever positive COVID-19 PCR test and no further tests were positive. On 02Feb21, her pain had resolved, her VA had improved to 20/20 OU, there was no inflammation, and the choroidal thickening had completely resolved. Corticosteroids were tapered over 3 weeks, when she was seen again on 23Feb2021, her VA remained 20/ 20, however, she did have mild pain and new floaters, and OCT and B-scan showed recurrence of mild choroidal thickening. She was restarted on corticosteroids and is now planned for an extended taper.  No follow-up attempts are possible; information about lot/batch number cannot be obtained. No further information is expected.; Sender's Comments: Based on available information and temporal association the causal role of suspect product cannot be excluded for reported events Case will be reviewed on receipt of FU information.,Linked Report(s) : US-PFIZER INC-202101769619 Same article/ drug/ patient and different event;