Acute Multifocal Placoid Pigment Epitheliopathy-like Presentation following the First Dose of BNT162B2 COVID-19 Vaccination.

PURPOSE: To report a case with acute posterior multifocal placoid pigment epitheliopathy (APMPPE)-like presentation following the first dose of BNT162b2 COVID-19 vaccination.

CASE REPORT: An otherwise healthy 45-year-old woman presented with a headache and blurred vision in her right eye 7 days after the administration of first dose of mRNA (BNT162b2) COVID-19 vaccine. Fundus examination of the right eye revealed multiple discrete yellow-white placoid lesions at the level of deep retinal layers throughout the posterior pole, while left fundus was unremarkable at that time. Swept source-optical coherence tomography (SS-OCT) showed subretinal fluid together with an appearance of bacillary layer detachment at the right macula. A detailed systemic evaluation was carried out without any positive finding. Two weeks after the initial eye examination, similar multiple placoid lesions were observed in her left eye. Fundus lesions almost totally resolved without any treatment bilaterally 5 weeks after the onset of initial symptoms.

CONCLUSION: To the best of our knowledge, this is the first report of APMPPE-like presentation described after the BNT162b2 COVID-19 vaccination. Previous COVID-19 vaccination should be kept in mind in the differential diagnosis of APMPPE disease spectrum.