{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,21]],"date-time":"2026-02-21T04:49:30Z","timestamp":1771649370660,"version":"3.50.1"},"reference-count":42,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T00:00:00Z","timestamp":1667952000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>Background: Neuro-ophthalmic manifestations after vaccines are rare, with optic neuritis (ON) being the most common presentation. Patients with vaccine-related ON are similar to those with idiopathic ON. The temporal relationship between vaccination against and the occurrence of ON is vital. Here, we report a case of bilateral ON after the administration of the ChAdOx1-S nCoV-19 SARS-CoV-2 vaccine. Case: A 49-year-old healthy Asian female presented with sudden onset of bilateral blurred vision within 2 days. She complained of photophobia and extraocular pain upon movement over 3 days. Upon examination, her best corrected visual acuity (BCVA) was 20\/30 in the right eye and 20\/200 in the left eye. Anterior segment findings were unremarkable, with normal intraocular pressure. Fundoscopic examination revealed bilateral disc edema with vessel engorgement. Visual field examination revealed profound visual field defect in both eyes. She denied any trauma, use of new medication or medical history. She had received the ChAdOx1 nCoV-19 SARS-CoV-2 vaccine 14 days prior. Under suspicion of vaccine-related optic neuritis, she was given intravenous methylprednisolone 1 gm\/day for 3 days, shifting to oral prednisolone under gradual tapering for 2 weeks. Conclusions: Typically presenting with sudden-onset visual decline and extraocular pain during movement, acute ON is generally idiopathic. Bilateral ON is rare, but quick identification is important because it can potentially lead to permanent loss of vision if left untreated. Vaccination-induced ON is even rarer but not difficult to treat. However, such patients require further evaluation and long-term follow-up because they may be prone to other neurological disorders in the future.<\/jats:p>","DOI":"10.3390\/vaccines10111889","type":"journal-article","created":{"date-parts":[[2022,11,9]],"date-time":"2022-11-09T02:44:32Z","timestamp":1667961872000},"page":"1889","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Bilateral Optic Neuritis after COVID-19 Vaccination: A Case Report"],"prefix":"10.3390","volume":"10","author":[{"given":"Ching-Chih","family":"Liu","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Chi Mei Medical Center, Tainan 71004, Taiwan"},{"name":"Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung 80708, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9972-8899","authenticated-orcid":false,"given":"Wan-Ju Annabelle","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Chi Mei Medical Center, Tainan 71004, Taiwan"},{"name":"School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan 70101, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,11,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"122","DOI":"10.1016\/j.spen.2017.04.004","article-title":"Pediatric Optic Neuritis","volume":"24","author":"Chang","year":"2017","journal-title":"Semin. Pediatr. Neurol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1097\/WCO.0000000000000414","article-title":"Optic neuritis: The eye as a window to the brain","volume":"30","author":"Jenkins","year":"2017","journal-title":"Curr. Opin. Neurol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1080\/01658107.2017.1335333","article-title":"Atypical Optic Neuritis After Inactivated Influenza Vaccination","volume":"42","author":"Jun","year":"2018","journal-title":"Neuro-Ophthalmology"},{"key":"ref_4","first-page":"e3352","article-title":"Simultaneous Bilateral Optic Neuritis Following Human Papillomavirus Vaccination in a Young Child","volume":"10","author":"Michael","year":"2018","journal-title":"Cureus"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1016\/j.phrs.2018.04.007","article-title":"Human papillomavirus vaccine and demyelinating diseases-A systematic review and meta-analysis","volume":"132","author":"Mouchet","year":"2018","journal-title":"Pharmacol. Res."},{"key":"ref_6","first-page":"85","article-title":"Optic neuritis following anti-rabies vaccine","volume":"50","author":"Agarwal","year":"2020","journal-title":"Trop. Dr."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e300","DOI":"10.1097\/WNO.0000000000001077","article-title":"Bilateral Optic Neuritis After Vero Cell-Derived Antirabies Vaccination","volume":"41","author":"Wang","year":"2020","journal-title":"J. Neuro-Ophthalmol."},{"key":"ref_8","doi-asserted-by":"crossref","unstructured":"Elnahry, A.G., Asal, Z.B., Shaikh, N., Dennett, K., Abd Elmohsen, M.N., Elnahry, G.A., Shehab, A., Vytopil, M., Ghaffari, L., and Athappilly, G.K. (2021). Optic neuropathy after COVID-19 vaccination: A report of two cases. Int. J. Neurosci., 1\u20137.","DOI":"10.1080\/00207454.2021.2015348"},{"key":"ref_9","first-page":"72","article-title":"Optic neuritis after COVID-19 vaccine application","volume":"13","author":"Alban","year":"2021","journal-title":"Clin. Exp. Neuroimmunol."},{"key":"ref_10","first-page":"n1114","article-title":"Arterial events, venous thromboembolism, thrombocytopenia, and bleeding after vaccination with Oxford-AstraZeneca ChAdOx1-S in Denmark and Norway: Population based cohort study","volume":"373","author":"Lund","year":"2021","journal-title":"BMJ"},{"key":"ref_11","first-page":"e17961","article-title":"Neuromyelitis Optica in a Healthy Female After Severe Acute Respiratory Syndrome Coronavirus 2 mRNA-1273 Vaccine","volume":"13","author":"Fujikawa","year":"2021","journal-title":"Cureus"},{"key":"ref_12","first-page":"1200","article-title":"Acute Thyroiditis and Bilateral Optic Neuritis following SARS-CoV-2 Vaccination with CoronaVac: A Case Report","volume":"29","author":"Leber","year":"2021","journal-title":"Neurol. Sci."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"3537","DOI":"10.1007\/s10072-021-05427-4","article-title":"Watch out for neuromyelitis optica spectrum disorder after inactivated virus vaccination for COVID-19","volume":"42","author":"Chen","year":"2021","journal-title":"Neurol. Sci."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"679","DOI":"10.4103\/ijo.IJO_2374_21","article-title":"Optic neuritis following COVID-19 vaccination: Coincidence or side-effect?\u2014A case series","volume":"70","author":"Roy","year":"2022","journal-title":"Indian J. Ophthalmol."},{"key":"ref_15","doi-asserted-by":"crossref","unstructured":"Shirah, B., Mulla, I., and Aladdin, Y. (2022). Optic Neuritis Following the BNT162b2 mRNA COVID-19 Vaccine in a Patient with Systemic Lupus Erythematosus Uncovering the Diagnosis of Neuromyelitis Optica Spectrum Disorders. Ocul. Immunol. Inflamm., 1\u20133.","DOI":"10.1080\/09273948.2022.2089901"},{"key":"ref_16","first-page":"82","article-title":"Optic neuritis: A review","volume":"16","author":"Shams","year":"2009","journal-title":"Int. MS J."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"250","DOI":"10.1159\/000112858","article-title":"Optic neuritis among National Health Insurance enrollees in Taiwan, 2000\u20132004","volume":"29","author":"Woung","year":"2007","journal-title":"Neuroepidemiology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"417","DOI":"10.1016\/j.ophtha.2019.09.032","article-title":"Population-based Incidence of Pediatric and Adult Optic Neuritis and the Risk of Multiple Sclerosis","volume":"127","author":"Lee","year":"2020","journal-title":"Ophthalmology"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e17446","DOI":"10.2196\/17446","article-title":"Active Surveillance of Adverse Events Following Human Papillomavirus Vaccination: Feasibility Pilot Study Based on the Regional Health Care Information Platform in the City of Ningbo, China","volume":"22","author":"Liu","year":"2020","journal-title":"J. Med. Internet Res."},{"key":"ref_20","doi-asserted-by":"crossref","unstructured":"Nagaratnam, S.A., Ferdi, A.C., Leaney, J., Lee, R.L.K., Hwang, Y.T., and Heard, R. (2022). Acute disseminated encephalomyelitis with bilateral optic neuritis following ChAdOx1 COVID-19 vaccination. BMC Neurol., 22.","DOI":"10.1186\/s12883-022-02575-8"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"137","DOI":"10.2147\/NDT.S343438","article-title":"Post COVID-19 Vaccination-Associated Neurological Complications","volume":"18","author":"Assiri","year":"2022","journal-title":"Neuropsychiatr. Dis. Treat."},{"key":"ref_22","first-page":"253","article-title":"Optic neuritis in paediatric patients: Experience over 27 years and a management protocol","volume":"36","year":"2021","journal-title":"Neurologia (Engl. Ed.)"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1016\/S1473-3099(21)00224-3","article-title":"Vaccine side-effects and SARS-CoV-2 infection after vaccination in users of the COVID Symptom Study app in the UK: A prospective observational study","volume":"21","author":"Menni","year":"2021","journal-title":"Lancet Infect. Dis."},{"key":"ref_24","first-page":"49","article-title":"Acute bilateral optic\/chiasm neuritis with longitudinal extensive transverse myelitis in longstanding stable multiple sclerosis following vector-based vaccination against the SARS-CoV-2","volume":"269","author":"Helmchen","year":"2021","journal-title":"J. Korean Med. Sci."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1093\/qjmed\/hcac208","article-title":"COVID-19 Vaccine associated Optic Neuritis","volume":"115","author":"Lee","year":"2022","journal-title":"QJM Mon. J. Assoc. Physicians"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"770","DOI":"10.1016\/j.survophthal.2019.06.001","article-title":"Critical review: Typical and atypical optic neuritis","volume":"64","author":"Abel","year":"2019","journal-title":"Surv. Ophthalmol."},{"key":"ref_27","first-page":"490","article-title":"COVID-19 Recombinant mRNA Vaccines and Serious Ocular Inflammatory Side Effects: Real or Coincidence?","volume":"16","author":"Maleki","year":"2021","journal-title":"J. Ophthalmic Vis. Res."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"356","DOI":"10.1186\/s13256-018-1903-9","article-title":"Optic neuritis following diphtheria, tetanus, pertussis, and inactivated poliovirus combined vaccination: A case report","volume":"12","author":"Wong","year":"2018","journal-title":"J. Med. Case Rep."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"E648","DOI":"10.1503\/cmaj.170871","article-title":"Quadrivalent human papillomavirus vaccination in girls and the risk of autoimmune disorders: The Ontario Grade 8 HPV Vaccine Cohort Study","volume":"190","author":"Liu","year":"2018","journal-title":"CMAJ Can. Med. Assoc. J."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"1705","DOI":"10.1080\/21645515.2017.1310788","article-title":"Evaluation of optic neuritis following human papillomavirus vaccination","volume":"13","author":"Sridhar","year":"2017","journal-title":"Hum. Vaccines Immunother."},{"key":"ref_31","first-page":"8740264","article-title":"Unilateral Optic Neuritis: A Rare Complication after Measles-Mumps-Rubella Vaccination in a 30-Year-Old Woman","volume":"2016","author":"Guaglione","year":"2016","journal-title":"Case Rep. Ophthalmol. Med."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1093\/cid\/ciw224","article-title":"Case-centered Analysis of Optic Neuritis After Vaccines","volume":"63","author":"Baxter","year":"2016","journal-title":"Clin. Infect. Dis."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"4881","DOI":"10.1016\/j.vaccine.2014.07.023","article-title":"Optic neuritis following Varicella zoster vaccination: Report of two cases","volume":"32","author":"Han","year":"2014","journal-title":"Vaccine"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"990","DOI":"10.1016\/j.autrev.2013.03.012","article-title":"A literature review on optic neuritis following vaccination against virus infections","volume":"12","year":"2013","journal-title":"Autoimmun. Rev."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"61","DOI":"10.3928\/01913913-20121108-01","article-title":"Retrobulbar optic neuritis and live attenuated influenza vaccine","volume":"50","author":"Crawford","year":"2013","journal-title":"J. Pediatr. Ophthalmol. Strabismus"},{"key":"ref_36","first-page":"690","article-title":"Vaccination-induced bilateral optic neuritis: Rare but existing","volume":"14","author":"Pillar","year":"2012","journal-title":"Isr. Med. Assoc. J. IMAJ"},{"key":"ref_37","first-page":"171","article-title":"Reversible blindness in bilateral optic neruritis associated with nasal flu vaccine","volume":"27","author":"Crawford","year":"2012","journal-title":"Binocul. Vis. Strabol. Q. Simms-Romano\u2019s"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"871","DOI":"10.1001\/archneur.63.6.871","article-title":"Anthrax vaccination and risk of optic neuritis in the United States military, 1998\u20132003","volume":"63","author":"Payne","year":"2006","journal-title":"Arch. Neurol."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"703","DOI":"10.1016\/S0002-9394(14)70918-3","article-title":"Optic neuritis after influenza vaccination","volume":"124","author":"Hull","year":"1997","journal-title":"Am. J. Ophthalmol."},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"195","DOI":"10.1038\/s41577-021-00526-x","article-title":"COVID-19 vaccines: Modes of immune activation and future challenges","volume":"21","author":"Teijaro","year":"2021","journal-title":"Nat. Rev. Immunol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/WCO.0000000000000766","article-title":"Clinical phenotype, radiological features, and treatment of myelin oligodendrocyte glycoprotein-immunoglobulin G (MOG-IgG) optic neuritis","volume":"33","author":"Chen","year":"2020","journal-title":"Curr. Opin. Neurol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"12","DOI":"10.1016\/j.survophthal.2019.08.001","article-title":"Optic neuritis in the era of biomarkers","volume":"65","author":"Chen","year":"2020","journal-title":"Surv. Ophthalmol."}],"container-title":["Vaccines"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-393X\/10\/11\/1889\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T01:12:56Z","timestamp":1760145176000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-393X\/10\/11\/1889"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,11,9]]},"references-count":42,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2022,11]]}},"alternative-id":["vaccines10111889"],"URL":"https:\/\/doi.org\/10.3390\/vaccines10111889","relation":{},"ISSN":["2076-393X"],"issn-type":[{"value":"2076-393X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,11,9]]}}}