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Purpose <p>To report a case of intraocular inflammation following adjuvanted recombinant Varicella-Zoster subunit vaccine (RZV) in a patient with previously resolved VZV-related acute retinal necrosis (ARN).</p> Methods <p>Single case report. Multimodal imaging, including true-color fundus photography, spectral-domain (SD-OCT) and dye-based angiography, was used to evaluate the retinal alterations.</p> Results <p>A 73-year-old male, with past history of VZV-related acute retinal necrosis (ARN) developed unilateral cystoid macular edema and diffuse blood-retinal barrier (BRB) breakdown in the affected eye after receiving the second dose of RZV vaccine. A complete resolution of this complication was observed after a short course of systemic corticosteroids.</p> Conclusion <p>Our case suggests a possible pathogen-specific intraocular inflammatory reaction, resembling immune reconstitution uveitis (IRU), following RZV administration in a patient with previously resolved VZV-related ARN. While RZV remains safe, intraocular inflammation should be considered as a possible side effect in patients with previously resolved VZV uveitis.</p>

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Unilateral uveitis following adjuvanted Varicella-Zoster subunit vaccine in a patient with previously resolved Varicella Zoster acute retinal necrosis

  • 期刊论文

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  • 发表日期：

    2025年8月2日

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  • A. Trinco,
  • F. Zicarelli,
  • F. Romano,
  • M. Oldani,
  • A. Riva,
  • A. Invernizzi

摘要

Purpose

To report a case of intraocular inflammation following adjuvanted recombinant Varicella-Zoster subunit vaccine (RZV) in a patient with previously resolved VZV-related acute retinal necrosis (ARN).

Methods

Single case report. Multimodal imaging, including true-color fundus photography, spectral-domain (SD-OCT) and dye-based angiography, was used to evaluate the retinal alterations.

Results

A 73-year-old male, with past history of VZV-related acute retinal necrosis (ARN) developed unilateral cystoid macular edema and diffuse blood-retinal barrier (BRB) breakdown in the affected eye after receiving the second dose of RZV vaccine. A complete resolution of this complication was observed after a short course of systemic corticosteroids.

Conclusion

Our case suggests a possible pathogen-specific intraocular inflammatory reaction, resembling immune reconstitution uveitis (IRU), following RZV administration in a patient with previously resolved VZV-related ARN. While RZV remains safe, intraocular inflammation should be considered as a possible side effect in patients with previously resolved VZV uveitis.