Sarcoidosis presenting as bilateral optic neuritis after ChAdOx1 nCoV-19 vaccination

Sarcoidosis is an idiopathic granulomatous disease and can vir-tually affect any organ system. Multiple factors, including tubercu-lar antigens organic and environmental exposures, have been impli-cated in its pathogenesis. In addition to drugs, sarcoid-like reactions have been reported following varicella and influenza vaccination. Few reports of erythema nodosum and Lofgren syndrome have been reported after the COVID-19 vaccination, though no histolog-ic diagnosis was pursued in these cases. We herein report a case of sarcoidosis presenting with bilateral acute onset vision loss with a temporal association with COVID-19 vaccination (ChadOx-1 n-COV, COVISHIELDTM). Symptoms started within two weeks of receiving the vaccine. Alternate causes for optic neuritis were excluded. Transbronchial lung biopsy showed the presence of non -caseating epithelioid cell granulomas. The patient received high -dose corticosteroids immediately after diagnosis, albeit with incom-plete clinical improvement in vision on a three-month follow-up. In conclusion, we report a novel case of sarcoidosis-related optic neu-ritis following COVID-19 vaccination.