Optic neuritis associated COVID-19 vaccine: a systematic review for clinical characteristics of an uncommon side effect

Marlon R. Dionisio, Laboratorio de Neurofarmacología Molecular y Nanotecnología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City; Facultad de Medicina, Universidad Lamar, Guadalajara, Jalisco; Mexico
Juan C. Martínez-Lazcano, Laboratorio de Neurofarmacología Molecular y Nanotecnología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico
Graciela Cárdenas, Departamento de Neurología, Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suárez, Mexico City, Mexico

To characterize the clinical presentation of optic neuritis (ON) associated with COVID-19 vaccination. Following the Preferred Reporting Items for Systematic reviews and Meta-Analyses statement, a search was performed in PUBMED, Google Scholar, and SciELO database using the keywords “COVID-19 vaccination” AND “optic neuritis.” Only articles written in English were included. A total of 126 articles were retrieved, of which 33 corresponded to cases of ON. Because 15 (13 patients) of the 33 articles had comorbidities, these were excluded. The mean age of the included patients was 42 years, the incidence was 79% in women versus 29% in men, and 27 of the cases were unilateral versus 17 bilateral. Treatment consisted of steroids in 37 of the cases, steroids plus plasmapheresis in 7 cases. Vaccines associated with ON were vector type in 18 of the cases, genetic type in 22 cases, and inactivated type in 4 cases; no association with ON was reported for viral and protein attenuated vaccine types. As in the case reported by our group, evidence in the literature indicates that bilateral ON is rare but requires prompt plasmapheresis as an adjunct to intravenous methylprednisolone to reduce neurological sequels.

Keywords: COVID-19. Vaccine. Optic neuritis.