• Sayako Inagawa, Masahiro Onda, Taishi Miyase, Shiho Murase, Hiroki Murase, Kiyofumi Mochizuki, and Hirokazu Sakaguchi.
• Department of Ophthalmology, Gifu University Graduate School of Medicine, Gifu, Japan.
• Medicine (Baltimore). 2022 Jan 14; 101 (2): e28582e28582.

RationaleMultiple evanescent white dot syndrome (MEWDS) is an acute, usually unilateral, retinal disorder of unknown etiology that predominantly occurs in healthy young women. We report a case of bilateral asymmetric MEWDS that developed following the first vaccination for coronavirus-19 and worsened after a second vaccination.Patient ConcernsA 30-year-old Japanese woman was examined in an eye clinic for blurred vision in her left eye for 1 week duration. Thirteen days before her examination, she had received her first BNT162b2 mRNA SARS-CoV-2 vaccination. Her best-corrected visual acuity was 20/20 in both eyes. Fundus examination revealed multiple yellowish-white spots in the perifoveal area of both eyes. Visibility of the spots gradually decreased during the following week. She was then vaccinated with a second dose, and 3 days later, her vision worsened in her left eye. She was then referred to our hospital because of worsened vision and the appearance of white spots on other parts of the retina. Ophthalmological examination revealed a best-corrected visual acuity of 30/20 both eyes.DiagnosisThe flare value in the anterior chamber was elevated in both the eyes. Fundus examination showed multiple white spots in the perifoveal area of both eyes, but they were more prominent in the left eye. Fundus fluorescein angiography revealed early hyperfluorescent spots located circumferentially around the fovea in both eyes. We concluded that the patient had MEWDS, which was most likely due to mRNA COVID-19 immunization.InterventionsThe patient was treated with topical betamethasone sodium phosphate/fradiomycin sulfate 0.1% thrice daily for 2 months.OutcomesTwo months after treatment, her blurry vision resolved with the disappearance of the fundus lesions.LessonClinicians should be aware of potential adverse ocular events following similar vaccinations.Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

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