Various case reports have shown possible associations
between optic neuritis and different vaccines. Some of the vaccines include
influenza, hepatitis B and anthrax
To present evidence for a causal relationship between optic
neuritis and Live Attenuated Influenza Vaccine (LAIV), administered as nasal
Case Report. In a 13-year-old male with bilateral optic
neuritis, detailed clinical history, neuro-ophthalmologic examination, magnetic
resonance imaging, stereo-disc photos, visual field testing, ocular coherence
tomography, blood tests and cerebral spinal fluid analysis were performed.
Exam findings on presentation: BCVA: 20/CF OD; 20/LP OS.
Positive relative afferent pupil defect OD. Unremarkable anterior segment and
posterior segment exam. No papillitis or papilledema. Global visual field
defect OU based on Humphrey 30-2. MRI: diffuse enlargement of Optic Chiasm with
inflammation of distal optic nerves bilateral. Blood cultures and CSF were
negative. Patient received 3 divided doses of methyl prednisone with mild
improvement of vision upon hospital discharge and marked improvement of vision
at 2 month follow up.
In this child, no infectious, vascular, granulomatous, viral
or immune-related cause of optic neuritis was identified. This case provides
compelling evidence that supports the nasal flu vaccination as a cause of optic