Case Report

Multimodal Imaging in Diagnosing Multiple Evanescent White Dot Syndrome following Human Papillomavirus Vaccine Immunization

Table 1

Summary of all cases of MEWDS following vaccination.

StudyVaccine nameAgeGenderTime from vaccination (days)Vaccine typeComorbiditiesPresenting VA in affected eye (Snellen)Vision at last visit in the affected eyeInterventionTime until resolution (weeks)

Baglivo et al.[10]Hepatitis B booster 3rd dose23F1Recombinant vaccinesNone20/200Undisclosed-“recovery of vision”None12

Fine et al.[11]Hepatitis A33M13Inactivated vaccinesNone20/25-220/20None6

Stangos et al. [12]Hepatitis A and yellow fever50F10Inactivated vaccinesNone20/4020/20None6

Cohen [9]Human papilloma virus and meningococca17F30Recombinant vaccinesNone20/20020/20None8

Goyal et al. [13]Influenza53M10UndisclosedHepatitis B and C infection, polysubstance abuse20/25-220/20None4

Ogino et al. [8]Human papilloma virus (Cervarix®, Glaxo Smith Kline) 2nd dose16F14Recombinant vaccinesNone20/1620/16None initially, betamethasone and antihistamine later for peripheral vascular leakage and associated visual field constrictionRetinal lesions resolved at 2 months; worsening peripheral vision loss for 2 years

Abou-Samra et al. [14]Influenza27F14UndisclosedStevens-Johnson syndrome, Wolff-Parkinson-White, vesicourethral reflux, mild chronic kidneydisease, endometriosis, fibroadenomas, depression with anxiety20/25-2UndisclosedNone8

Yang et al. [15]Rabies 3rd dose33F14Embryonated-egg vaccineNone20/2020/20Retrobulbar triamcinolone acetonide 40 mgPartially resolved at 8 weeks

Ng et al. [2]Influenza (Flucelvax Quadrivalent® Seqirus)34M14Inactivated vaccinesNone20/20+220/16None4

Rabinovitch et al. [16]COVID-19 2nd dose39M5mRNA vaccinesNone20/3220/20None8
28F30mRNA vaccinesNone20/3220/20None8

Xu and Shen [17]COVID-19 1st dose49F2Inactivated vaccinesMEWDS20/10020/20Oral prednisone8

Inagawa et al. [18]COVID-19 1st dose30F6mRNA vaccinesNone20/2020/20Topical corticosteroid8

Yasuda et al. [19]COVID-19 2nd dose67F1mRNA vaccinesNone20/10020/25None2

Lin and Hsieh [20]COVID-19 1st dose36F2Recombinant vaccinesNone20/2520/20None4

Tomishige et al. [21]COVID-19 1st dose38F7Inactivated vaccinesNone20/40020/20Oral prednisone4

Smith et al. [22]COVID-19 2nd dose15M14mRNA vaccinesNone20/10020/20Oral prednisone2
21F21mRNA vaccinesNone20/6020/20Oral prednisone2

Bolletta et al. [23]COVID-19 2nd dose53M28mRNA vaccinesNone20/2520/20NoneUndisclosed time but complete resolution
COVID-19 1st dose18F4mRNA vaccinesNone20/6620/20NoneUndisclosed time but complete resolution
COVID-19 1st dose48M7mRNA vaccinesNone20/40020/20NoneUndisclosed time but complete resolution

Alhabshan and Scales [24]COVID-19 3rd dose71F3mRNA vaccinesRetinal tear was treated with laser barricade; hysterectomy, hypercholesterolemia20/30UndisclosedNone6

Gargouri et al.[25]COVID-19 1st dose23F10mRNA vaccinesSARS-CoV-2 infection20/2020/20None6
40M7mRNA vaccinesNone20/25UndisclosedNone6

41.7% developed after receiving the second or the third dose vaccinationMean:35.9
Median: 33.5
Range:15–71
66.7% femaleMean:11.1
Median: 8.5
Range: 1–30
91.7% of vaccines are inactive79.2% noneMean: 20/34
Median: 20/30
Range: 20/400–20/16
Mean: 20/20
Median: 20/20
Range: 20/25–20/16
70.8% noneMean: 5.9
Median: 6
Range: 2–12