Acute Unilateral Vision Loss Following Recombinant Zoster (Shingrix) Vaccination: A Case of Presumptive Purtscher-Like Retinopathy

Abstract

Purpose: To report a case of Purtscher-like retinopathy associated with Shingrix vaccination. Methods: A single case was reviewed. Results: A 58-year-old man with no past medical or ocular history received the Shingrix vaccine and subsequently developed acute vision loss in his left eye. Examination revealed a visual acuity of 20/150 OS with peripapillary and macular cotton wool spots in a circumferential distribution. Macular optical coherence tomography demonstrated multifocal areas of inner retinal thickening and hyperreflectivity. A systemic laboratory workup was unremarkable. At the 3-month follow-up, fundus findings resolved, and visual acuity returned to baseline. Conclusions: A presumptive diagnosis of Purtscher-like retinopathy associated with Shingrix vaccination was made. Purtscher-like retinopathy may be related to the upregulation of the complement cascade and proinflammatory state after vaccination. Patients should be counseled to see an ophthalmologist if visual changes occur after vaccination.