Título

CENTRAL SEROUS CHORIORETINOPATHY AFTER YELLOW FEVER VACCINATION

Objetivo

We report a case of Central serous chorioretinopathy two weeks after Yellow Fever Vaccination

Relato do Caso

Central Serous Choroidopathy (CSC) is an idiopathic disease characterized by serous macular retinal pigment epithelium (EPR) detachment due to a leakage in the choriocapilarries. Generally, this condition affects men between 25 and 55 years of age and women are affected 8 times less than men, generally in an older age. CSC risk factors include, chronical corticosteroids use, stress and pregnancy. Yellow fever is an arbovirusis endemic in tropical countries and has a high mortality rate. Recently an epidemic occurred near heavily populated regions in Brazil. Vaccination campaign in 2017 is planned to immunize 38.2 million people. The main source of vaccines are made in a single public source, Fiocruz,in their Bio-Manguinhos laboratory. We report a case of an 19 year old woman, with a history of dyschromatopsia and micropsia in her left eye two weeks after yellow fever vaccination. The patient denied use of medications, illicit drugs, being pregnant and any stress factor. She had a vision of 20/20 in both eyes, with a normal anterior segment exam. Fundus examination was normal in her right eye, with altered left fovea reflex. Left macular OCT showed a serous fovea detachment and angioflureceinography revealed a leakage point in the macula region. After a 2 weeks follow-up, the patient had vision improvement, with the OCT showing a reduction in the serous detachment.

Conclusão

Vaccines account for 0,2% drugs adverse reaction in the eye. Currently there are only four other cases of adverse reactions against yellow fever vaccination, all of them happened with a combination of yellow fever and other vaccines. Our report was first temporal adverse event of CSC after a single yellow fever vaccine. Due to the recent vaccination campaign in Brazil, ophthalmologists should be aware of possible adverse effects and report them to the Departamento de Vigilância Epidemiológica.