Sex: F
Vaccine: FLUX
Symptoms: Optical coherence tomography abnormal, Slit-lamp tests normal, Visual acuity tests normal, Visual field defect, Visual impairment
Clinical narrative: Initial information received from a literature article 08-Nov-2018. Abstract: This manuscript reports a rare association of the development of acute macular neuroretinopathy (AMN) after administration of an influenza vaccination. A 42-year-old female presented with a 2-week history of black spots and a paracentral scotoma in the right eye after receiving a seasonal influenza vaccination. Findings on multimodal imaging were classic for AMN, and these findings improved but did not fully resolve 4 weeks after initial presentation with observation alone. Although a febrile illness or the use of oral contraceptives is most commonly associated with the development of AMN, it is important for clinicians to also consider influenza vaccination as a possible etiology. This case involves a 42 years old female patient who experienced acute macular neuroretinopathy (AMN), black spots and a paracentral scotoma in the right eye, while she received vaccine INFLUENZA VACCINE. The patient's past medical history, medical treatment(s), vaccination(s) and family history were not provided. On an unknown date, the patient received a dose of suspect INFLUENZA VACCINE produced by unknown manufacturer lot number not reported via unknown route in unknown administration site. On an unknown date, patient developed a serious acute macular neuroretinopathy (AMN) (acute macular outer retinopathy). This event was assessed as medically significant. On an unknown date, patient developed black spots and a paracentral scotoma in the right eye and black spots and a paracentral scotoma in the right eye following the administration of INFLUENZA VACCINE. Lab data includes Snellen vision acuity (VA) in the right eye was 20/20 with an intraocular pressure (IOP) of 12 mmHg. The slitlamp examination was unremarkable. Funduscopic examination revealed a slight reddish-brown petaloid lesion superonasal to the fovea. Near-infrared (SLO) imaging of the right eye revealed a wedge-shaped dark lesion superonasal to the fovea. Spectral-domain optical coherence tomography (SD-OCT) demonstrated hyperreflectivity of the outer plexiform layer (OPL), with characteristic shadowing of the ellipsoid zone. A fluorescein angiography was performed, but the findings were unremarkable and did not show signs of any other inflammatory lesions. Final diagnosis was acute macular neuroretinopathy (AMN) and black spots and a paracentral scotoma in the right eye. It was not reported if the patient received a corrective treatment. Outcome of the event was recovering (AMN these findings improved but did not fully resolve). It was reported that, clinicians can also consider influenza vaccination as possible etiology. List of documents held by sender: none. Sender's Comments: Patient experienced Acute macular outer retinopathy after vaccination with Influenza Vaccine (unknown manufacturer). Time to onset is unknown. However, further information including patient's medical history, concomitant medications, previous vaccination and tolerance, laboratory investigations excluding other etiology would be needed to fully assess this case. Based on available information the role of vaccine cannot be assessed.