Uveitis and Other Ocular Complications Following COVID-19 Vaccination.

Elena Bolletta,Valentina Mastrofilippo,Alessandro Zerbini,Martina Bonacini,Luigi Fontana,Lucia Belloni,Luca Cimino,Chantal Adani,Carlo Salvarani,Stefania Croci,Luca De Simone,Danilo Iannetta,Fabrizio Gozzi

doi:10.3390/jcm10245960

Abstract

Coronavirus disease 2019 (COVID-19) vaccines can cause transient local and systemic post-vaccination reactions. The aim of this study was to report uveitis and other ocular complications following COVID-19 vaccination. The study included 42 eyes of 34 patients (20 females, 14 males), with a mean age of 49.8 years (range 18–83 years). The cases reported were three herpetic keratitis, two anterior scleritis, five anterior uveitis (AU), three toxoplasma retinochoroiditis, two Vogt-Koyanagi-Harada (VKH) disease reactivations, two pars planitis, two retinal vasculitis, one bilateral panuveitis in new-onset Behçet’s disease, three multiple evanescent white dot syndromes (MEWDS), one acute macular neuroretinopathy (AMN), five retinal vein occlusions (RVO), one non-arteritic ischemic optic neuropathy (NAION), three activations of quiescent choroidal neovascularization (CNV) secondary to myopia or uveitis, and one central serous chorioretinopathy (CSCR). Mean time between vaccination and ocular complication onset was 9.4 days (range 1–30 days). Twenty-three cases occurred after Pfizer-BioNTech vaccination (BNT162b2 mRNA), 7 after Oxford-AstraZeneca vaccine (ChAdOx1 nCoV-19), 3 after ModernaTX vaccination (mRNA-1273), and 1 after Janssen Johnson & Johnson vaccine (Ad26.COV2). Uveitis and other ocular complications may develop after the administration of COVID-19 vaccine.

Highlights

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the coronavirus disease 2019 (COVID-19), a multisystemic disorder with medical and socioeconomic consequences that have led to public health crises worldwide
Twenty-three cases occurred after Pfizer-BioNTech vaccination (BNT162b2 messenger ribonucleic acid (mRNA)), seven after Oxford-AstraZeneca vaccine (ChAdOx1 nCoV-19), three after ModernaTX vaccination, and one after Janssen Johnson & Johnson vaccine (Ad26.COV2)
In accordance with other studies, we reported anterior uveitis (AU) in patients with or without a history of previous uveitis and/or uveitis-related systemic disease [17,32]

Summary

Introduction

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causes the coronavirus disease 2019 (COVID-19), a multisystemic disorder with medical and socioeconomic consequences that have led to public health crises worldwide. In an effort to alleviate the morbidity and mortality associated with COVID-19 and arrest viral transmission, different types of vaccinations have been developed. Among these vaccines are the inactivated vaccines (PiCoVacc, Sinovac [1]; BBIBP-CorV, Sinopharm [2]), the viral vector vaccines (Ad26.COV2, Janssen Johnson & Johnson [3]; ChAdOx1 nCoV-19/AZD1222, OxfordAstraZeneca [4]), the messenger ribonucleic acid (mRNA)-based vaccines (BNT162b2, Pfizer-BioNTech [5]; mRNA-1273, ModernaTX [6]), and the protein subunit vaccine (NVXCoV2373, Novavax [7]). Different types of ocular complications have been reported after COVID-19 vaccination, including facial nerve palsy, abducens nerve palsy, new-onset Graves’ disease, episcleritis, anterior scleritis, anterior uveitis (AU), multifocal choroiditis, reactivation of Vogt-Koyanagi-Harada (VKH) disease, multiple evanescent white dot syndrome (MEWDS), acute macular neuroretinopathy (AMN), paracentral acute middle maculopathy (PAAM), thrombosis, and central serous retinopathy (CSR) [9]

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