Leber hereditary optic neuropathy triggered by the AstraZeneca coronavirus disease 2019 vaccination

Abstract Leber hereditary optic neuropathy (LHON) is a rare mitochondrial disorder primarily affecting young males, characterized by progressive vision loss due to retinal ganglion cell degeneration. LHON is typically associated with specific mitochondrial mutations with potential triggers such as environmental factors and, more recently, postvaccination complications. We present a case of a 35-year-old male who experienced LHON onset 3 weeks following administration of the AstraZeneca Coronavirus disease 2019 vaccine. Despite lacking traditional risk factors, genetic testing confirmed the presence of the mitochondrial genome coding for the NADH-ubiquinone oxidoreductase chain four (MT-ND4) m.11778G >A mutation. The patient’s presentation contributed to a delay in diagnosing LHON as demyelinating disease optic neuritis, and after excluding all the possible causes, the diagnosis of postvaccination LHON was considered. Continued vigilance and awareness among healthcare providers are essential for prompt identification and management of LHON in postvaccination contexts.