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BMC Ophthalmol . Acute zonal occult outer retinopathy (AZOOR) complex associated with torpedo retinopathy following COVID-19 recombinant mRNA vacci

tetano

Editor, Senior Moderator
BMC Ophthalmol


. 2025 Jan 17;25(1):25.
doi: 10.1186/s12886-025-03844-z. Acute zonal occult outer retinopathy (AZOOR) complex associated with torpedo retinopathy following COVID-19 recombinant mRNA vaccination: a case report of a rare clinical presentation

Nai-Wen Chang[SUP] 1 [/SUP], Chia-Hao Kuo[SUP] 2 [/SUP], Hung-Da Chou[SUP] 3 4 [/SUP], Yi-Hsing Chen[SUP] 5 6 [/SUP]



Affiliations
Abstract

Background: While vaccination remains crucial in mitigating the impact of the COVID-19 pandemic, several ocular adverse events has been reported, including Acute Zonal Occult Outer Retinopathy (AZOOR) complex.
Case presentation: A 31-year-old female presented declined best corrected visual acuity (BCVA) and flashes in both eyes three days following second recombinant mRNA COVID-19 vaccine (Moderna). Fundus autofluorescence (FAF) illustrated speckled hyper-AF lesions surrounding right eye torpedo maculopathy site and hyper-AF lesions in the left macula. The spectral-domain optical coherence tomography delineated inner and outer segment (IS/OS) line disruption; hyperreflective deposits in the outer nuclear layer (ONL); and undetectable interdigitation zone (IDZ). Her BCVA further declined after 3-month observation, thus she received 8-month oral prednisolone and mycophenolate mofetil treatment. Her BCVA recovered; the hype-AF lesions resolved; and the IS/OS line and ONL resumed.
Conclusions: We present a rare case of AZOOR complex following COVID-19 vaccination inciting from torpedo retinopathy where outer-retinal barrier breaks down.

Keywords: Acute zonal occult outer retinopathy (AZOOR); Recombinant mRNA vaccine; Torpedo retinopathy.

 
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