Optic neuritis after anthrax vaccination.

OBJECTIVE

To report the occurrence of optic neuritis after anthrax vaccination in two patients.

DESIGN

Observational case reports, review of literature.

METHODS

Description of clinical history, examination, neuroimaging, and further studies in two patients experiencing optic neuritis in temporal association with anthrax vaccination.

MAIN OUTCOME MEASURES: Visual acuity, visual fields.

RESULTS

Two patients, 39 and 23 years of age, were seen with acute optic neuritis 1 month and 2 weeks, respectively, after anthrax booster vaccination and successfully treated with intravenous methylprednisolone. The first patient had a typical presentation and course of unilateral retrobulbar optic neuritis with excellent visual recovery. The second patient had a bilateral anterior optic neuritis and has required chronic immunosuppression to maintain his vision. Retinal and optic nerve autoantibodies were present in the second patient. No cross-reactive epitopes between anthrax vaccine and retina/optic nerve were identified.

CONCLUSION

Optic neuritis is a potential adverse reaction of anthrax vaccination.