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Parmar UPS, Surico PL, Singh RB, Musa M, Scarabosio A, Surico G, Maniaci A, Lavalle S, D’Esposito F, Longo A, Russo A, Gagliano C, Zeppieri M. Ocular Implications of COVID-19 Infection and Vaccine-Related Adverse Events. J Pers Med 2024; 14:780. [PMID: 39201972 PMCID: PMC11355216 DOI: 10.3390/jpm14080780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 09/03/2024] Open
Abstract
The COVID-19 pandemic, caused by SARS-CoV-2, has significantly impacted various organ systems, including the eyes. Initially considered a primarily respiratory disease, it is now evident that COVID-19 can induce a range of ocular symptoms. Recognizing these ocular manifestations is crucial for eye care practitioners as they can serve as early indicators of the disease. This review consolidates current evidence on the ocular effects of COVID-19, identifying manifestations such as conjunctivitis, scleritis, uveitis, and retinopathy. The increasing prevalence of these symptoms highlights the importance of thorough eye examinations and detailed patient histories in COVID-19 cases. Potential routes of viral entry into ocular tissues and the underlying mechanisms, including direct infection, immune responses, and vascular involvement, are explored. Additionally, this review addresses ocular side effects associated with COVID-19 vaccines, such as corneal graft rejection, uveitis, and retinal issues. These findings emphasize the need for ongoing surveillance and research to ensure vaccine safety.
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Affiliation(s)
- Uday Pratap Singh Parmar
- Department of Ophthalmology, Government Medical College and Hospital, Chandigarh 160047, India;
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Pier Luigi Surico
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
- Department of Ophthalmology, Campus Bio-Medico University, 00128 Rome, Italy
| | - Rohan Bir Singh
- Schepens Eye Research Institute of Mass Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
| | - Mutali Musa
- Department of Optometry, University of Benin, Benin City 300238, Nigeria
| | - Anna Scarabosio
- Department of Plastic Surgery, University Hospital of Udine, 33100 Udine, Italy
| | - Giorgio Surico
- Medicine and Surgery Department, University of Bari Aldo Moro, 70126 Bari, Italy
| | - Antonino Maniaci
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
| | - Salvatore Lavalle
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
| | - Fabiana D’Esposito
- Imperial College Ophthalmic Research Group (ICORG) Unit, Imperial College, 153-173 Marylebone Rd., London NW1 5QH, UK
- Department of Neurosciences, Reproductive Sciences and Dentistry, University of Naples Federico II, Via Pansini 5, 80131 Napoli, Italy
| | - Antonio Longo
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy
| | - Andrea Russo
- Faculty of Medicine, University of Catania, Piazza Università, 95123 Catania, Italy
| | - Caterina Gagliano
- Department of Medicine and Surgery, University of Enna “Kore”, Piazza dell’Università, 94100 Enna, Italy
- Eye Clinic Catania University San Marco Hospital, Viale Carlo Azeglio Ciampi, 95121 Catania, Italy
| | - Marco Zeppieri
- Department of Ophthalmology, University Hospital of Udine, 33100 Udine, Italy
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Ku JH, Nanji AA, Tubert JE, Joe C, Srikumaran D, Winthrop KL, Brunton AE, Florea A, Fraunfelder F, Tseng T, Luo YI. Risk of Corneal Graft Rejection and Vaccination: A Matched Case-Control Study From a United States Integrated Health Care System. Am J Ophthalmol 2024; 263:133-140. [PMID: 38417569 DOI: 10.1016/j.ajo.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/24/2024] [Accepted: 02/12/2024] [Indexed: 03/01/2024]
Abstract
PURPOSE Data on vaccine-associated corneal transplant rejections are limited. We examined the association between graft rejection and vaccination. DESIGN Matched case-control METHODS: We used electronic health records to identify corneal transplant recipients between January 2008 and August 2022 at Kaiser Permanente Southern California. Cases were transplant recipients who experienced a graft rejection (outcome) during the study period. Randomly selected controls who did not experience a corneal graft rejection at their matched cases' index date (rejection date) were matched in a 3:1 ratio to cases. For controls, index date was determined by adding the number of days between transplant and graft rejection of their matched case to the control's transplant date. RESULTS The study included 601 cases and 1803 matched controls (mean age 66 years [s.d. 17.0], 52% female, 47% non-Hispanic white). Twenty-three% of cases and 22% of controls received ≥1 vaccinations within 12 weeks prior to the index date. The adjusted odds ratio (aOR) for vaccination in the 12 weeks prior to index date, comparing cases to controls was 1.17 (95% CI: 0.91, 1.50]). The aOR was 1.09 (0.84, 1.43) for 1 vaccination, 1.53 (0.90, 2.61) for 2 vaccinations, and 1.79 (0.55, 5.57) for ≥3 vaccinations. The aOR was 1.60 (0.81, 3.14) for mRNA vaccines, and 1.19 (0.80, 1.78) for adjuvanted/high dose vaccines. CONCLUSIONS We found no evidence to suggest an association between vaccination and graft rejection. Our findings provide support for the completion of recommended vaccinations for corneal transplant recipients, without significantly increasing the risk of graft rejection.
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Affiliation(s)
- Jennifer H Ku
- From the Department of Research & Evaluation (J.K., J.T., C.J., A.F., Y.L.), Kaiser Permanente Southern California, Pasadena, California, USA.
| | - Afshan A Nanji
- Department of Ophthalmology (A.N., F.F.), Oregon Health & Science University, Portland, Oregon, USA
| | - Julia E Tubert
- From the Department of Research & Evaluation (J.K., J.T., C.J., A.F., Y.L.), Kaiser Permanente Southern California, Pasadena, California, USA
| | - Cynthia Joe
- From the Department of Research & Evaluation (J.K., J.T., C.J., A.F., Y.L.), Kaiser Permanente Southern California, Pasadena, California, USA
| | - Divya Srikumaran
- Department of Ophthalmology (D.S.), Johns Hopkins Medicine, Baltimore, Maryland, USA
| | - Kevin L Winthrop
- Oregon Health & Science University-Portland State University (K.W., A.B.), School of Public Health, Portland, Oregon, USA; Division of Infectious Diseases (K.W.), Oregon Health & Science University, Portland, Oregon, USA
| | - Amanda E Brunton
- Oregon Health & Science University-Portland State University (K.W., A.B.), School of Public Health, Portland, Oregon, USA
| | - Ana Florea
- From the Department of Research & Evaluation (J.K., J.T., C.J., A.F., Y.L.), Kaiser Permanente Southern California, Pasadena, California, USA
| | - Frederick Fraunfelder
- Department of Ophthalmology (A.N., F.F.), Oregon Health & Science University, Portland, Oregon, USA
| | - Tsaiyu Tseng
- From the Department of Research & Evaluation (J.K., J.T., C.J., A.F., Y.L.), Kaiser Permanente Southern California, Pasadena, California, USA; Department of Biostatistics, School of Public Health (T.T.), University of California, Los Angeles, Westwood, California, USA
| | - Y I Luo
- From the Department of Research & Evaluation (J.K., J.T., C.J., A.F., Y.L.), Kaiser Permanente Southern California, Pasadena, California, USA
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Kim HR, Kim S, Chang MS, Lee CS, Byeon SH, Kim SS, Lee SW, Kim YJ. Uveitis Risk After the First Dose of COVID-19 Vaccination Based on Uveitis History: Matched Cohort and Crossover Case Series Study. Am J Ophthalmol 2024; 262:125-133. [PMID: 38341167 DOI: 10.1016/j.ajo.2024.01.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 02/12/2024]
Abstract
PURPOSE To investigate the risk of noninfectious uveitis following the first dose of coronavirus disease 2019 (COVID-19) vaccination based on the uveitis history. DESIGN Retrospective matched cohort and crossover case series study. METHODS A random sample of 7 917 457 individuals who received COVID-19 vaccine between January 2021 and March 2022 in Korea, and had no recorded history of COVID-19 were categorized into the control and uveitis groups based on their uveitis history. After performing 3:1 propensity score matching, we assessed the cumulative incidence and risk of noninfectious uveitis in the 180 days after COVID-19 vaccination. Additionally, we performed a crossover case series analysis to compare the pre- and postvaccination incidence rate ratios (IRRs) of uveitis in individuals with and without a history of uveitis. RESULTS In the matched cohort analysis, uveitis group had a significantly higher cumulative incidence of uveitis (15.4%) than control group (0.10%). The uveitis group exhibited increased risks of all uveitis types, anterior, and nonanterior uveitis in the first 60 days (hazard ratio [HR]: 169, 158, and 253, respectively) and in days 61 to 180 (HR: 166, 164, and 143, respectively) after vaccination. In the crossover case series analysis, uveitis occurred with relatively equal frequency in 20-day intervals during the 180 days before and after vaccination, regardless of uveitis history. For uveitis group, the adjusted IRRs for early and late postvaccination events were 0.92 (95% CI, 0.88-0.96) and 0.83 (95% CI, 0.80-0.85), respectively. CONCLUSIONS COVID-19 vaccination did not increase the risk of uveitis, regardless of uveitis history.
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Affiliation(s)
- Hae Rang Kim
- From the Department of Ophthalmology, Ajou University School of Medicine (H.R.K.), Suwon, Republic of Korea
| | - Sunyeup Kim
- Department of Medical AI, Sungkyunkwan University School of Medicine (S.K.), Suwon, Republic of Korea
| | - Myung Soo Chang
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Seoul, Republic of Korea
| | - Christopher Seungkyu Lee
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Seoul, Republic of Korea
| | - Suk Ho Byeon
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Seoul, Republic of Korea
| | - Sung Soo Kim
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Seoul, Republic of Korea
| | - Seung Won Lee
- Department of Precision Medicine, Sungkyunkwan University School of Medicine (S.W.L.), Suwon, Republic of Korea.
| | - Yong Joon Kim
- Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Seoul, Republic of Korea.
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Caplash S, Paez-Escamilla M, Westcott M, Dansingani KK, Indermill C, Kisma N, Frau E, Sahel JA, Bodaghi B, Jhanji V, Errera MH. Mimickers of anterior uveitis, scleritis and misdiagnoses- tips and tricks for the cornea specialist. J Ophthalmic Inflamm Infect 2024; 14:14. [PMID: 38594487 PMCID: PMC11004105 DOI: 10.1186/s12348-024-00396-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 03/29/2024] [Indexed: 04/11/2024] Open
Abstract
BACKGROUND Anterior uveitis, inflammation of the anterior chamber and related structures, is a cohort of diseases that can present to almost any general or sub-specialty Ophthalmology practice. Its features classically involve anterior chamber cell and flare. Below the surface of these two signs exist a panoply of diagnoses. BODY: The purpose of this review is to provide a general framework for diagnoses of anterior uveitis that are often missed as well as non-uveitic pathologies that often mimic anterior uveitis. Diagnostic deviation in either direction can have vision-threatening and rarely life-threatening consequences for patients. Using a comprehensive literature review we have collected a broad spectrum of etiologies of anterior uveitis that are easily missed and non-uveitic pathologies that can masquerade as anterior uveitis. CONCLUSIONS We present a focused review on specific misdiagnosed anterior uveitis pathologies and some of the conditions that can masquerade as anterior uveitis and scleritis.
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Affiliation(s)
- Sonny Caplash
- Department of Ophthalmology, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Manuel Paez-Escamilla
- Department of Ophthalmology, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Mark Westcott
- NIHR Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust, 162 City Road, London, EC1V 2PD, UK
| | - Kunal K Dansingani
- Department of Ophthalmology, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Chad Indermill
- Department of Ophthalmology, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Nacima Kisma
- Universite Libre de Bruxelles, Hopital Universitaire de Bruxelles, 808 route de Lennik 1170, Bruxelles, Belgium
| | - Eric Frau
- Department of Ophthalmology, Centre hospitalier National des Quinze-Vingts, Paris, France
| | - Jose-Alain Sahel
- Department of Ophthalmology, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Bahram Bodaghi
- Department of Ophthalmology, Pitié-Salpêtrière University Hospital, Sorbonne Universités, F-75013, Paris, France
| | - Vishal Jhanji
- Department of Ophthalmology, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA
| | - Marie-Helene Errera
- Department of Ophthalmology, University of Pittsburgh, 203 Lothrop Street, Pittsburgh, PA, 15213, USA.
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Bijon J, Elahi S, Dubois M, Ghazal W, Courtin R, Panthier C, Gatinel D, Saad A. Descemet's membrane endothelial keratoplasty rejection after SARS-COV2 infection or vaccination: 2-year retrospective study. J Fr Ophtalmol 2024; 47:104117. [PMID: 38696860 DOI: 10.1016/j.jfo.2024.104117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 01/07/2024] [Accepted: 01/16/2024] [Indexed: 05/04/2024]
Abstract
PURPOSE To assess the incidence of Descemet's membrane endothelial keratoplasty (DMEK) rejection potentially associated with coronavirus disease 2019 (COVID-19) infection or vaccination, and its association with known rejection risk factors during the first two years of the pandemic. METHODS This retrospective study included patients with DMEK rejection between January 2020 and December 2021. Diagnostic criteria were based on symptoms, visual acuity, and other clinical assessments. Risk factors for graft rejection were considered, and a telephone survey was conducted to identify possible preceding COVID-19 infection or vaccination. RESULTS Of 58 patients, 44 were included. Six patients (14%) reported COVID-19 infection, with one immediate endothelial graft rejection (EGR) post-infection. After vaccine availability, 13 of 36 patients had EGR at an average of 2.7 months post-vaccination. Five (38%) had immediate EGR following vaccination, four of which had concomitant risk factors for rejection. CONCLUSION Although the risk of endothelial graft rejection (EGR) associated with COVID-19 infection or vaccination appears to be extremely low, there may be a causative relationship, especially in patients with pre-existing risk factors for EGR. A temporary increase in anti-rejection treatment following COVID-19 infection or vaccination is recommended, especially in patients with pre-existing risk factors, along with closer monitoring during the subsequent 4 to 8 weeks.
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Affiliation(s)
- J Bijon
- Department of Ophthalmology, Rothschild Foundation, Paris, France
| | - S Elahi
- Department of Ophthalmology, Rothschild Foundation, Paris, France
| | - M Dubois
- Department of Ophthalmology, Rothschild Foundation, Paris, France
| | - W Ghazal
- Department of Ophthalmology, Rothschild Foundation, Paris, France
| | - R Courtin
- Department of Ophthalmology, Rothschild Foundation, Paris, France
| | - C Panthier
- Department of Ophthalmology, Rothschild Foundation, Paris, France
| | - D Gatinel
- Department of Ophthalmology, Rothschild Foundation, Paris, France
| | - A Saad
- Department of Ophthalmology, Rothschild Foundation, Paris, France.
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Chang MS, Kim HR, Kim S, Lee CS, Byeon SH, Kim SS, Lee SW, Kim YJ. Noninfectious Uveitis Risk After COVID-19 Vaccination: A Nationwide Retrospective Cohort Study. Am J Ophthalmol 2024; 258:22-31. [PMID: 37739204 DOI: 10.1016/j.ajo.2023.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Revised: 09/10/2023] [Accepted: 09/16/2023] [Indexed: 09/24/2023]
Abstract
PURPOSE To investigate the incidence and risk of noninfectious uveitis (NIU) following COVID-19 vaccination compared with an unvaccinated, uninfected control group. DESIGN Retrospective population-based cohort study. METHODS We included 5,185,153 individuals who received the first vaccine dose in the exposed group and 2,680,164 individuals in the unexposed, uninfected control group. The study observed for 180 days from their index date. Cumulative incidence and risk of NIU following COVID-19 vaccination, and attributable risk factors were assessed. RESULTS Multivariable analysis showed elevated risk of nonanterior NIU within 60 days (hazard ratio [HR] 1.27 [95% confidence interval {CI} 1.03-1.55] and 61-180 days (HR 1.39 [95% CI 1.20-1.62]). Subgroup analysis highlighted an increased risk in females for early and delayed nonanterior uveitis (HR 1.44 [95% CI 1.08-1.92]; HR 1.78 [95% CI 1.43-2.20], respectively). Regardless of the location and onset timing of uveitis, a history of NIU was identified as the most significant risk factor, with a high hazard ratio ranging from 100 to 200. CONCLUSIONS COVID-19 vaccination may modestly increase the risk of nonanterior uveitis especially in females. Despite adjustments, bias may persist in the exposed group, owing to significant differences between unexposed and exposed groups and low incidence of nonanterior uveitis in the unexposed group. Future research should aim to refine these findings by assessing uveitis risk in prior NIU patients and by enlarging the sample size or cohort matching.
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Affiliation(s)
- Myung Soo Chang
- From the Department of Ophthalmology (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Hae Rang Kim
- Department of Ophthalmology (H.R.K.), CHA Bundang Medical Center, CHA University College of Medicine, Seongnam, Republic of Korea
| | - Sunyeup Kim
- Department of Medical AI (S.K.), Sungkyunkwan University School of Medicine, Suwon, Republic of Korea
| | - Christopher Seungkyu Lee
- From the Department of Ophthalmology (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Suk Ho Byeon
- From the Department of Ophthalmology (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Sung Soo Kim
- From the Department of Ophthalmology (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seung Won Lee
- and the Department of Precision Medicine (S.W.L.), Sungkyunkwan University School of Medicine, Suwon, Republic of Korea..
| | - Yong Joon Kim
- From the Department of Ophthalmology (M.S.C., C.S.L., S.H.B., S.S.K., Y.J.K.), Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea.
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Hurissi EA, Abuallut II, Dibaji MQ, Jaly A, Alhazmi AH, Abuageelah BM, Alameer KM, Alyami YM. Ocular Complications after COVID-19 Vaccination: A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:249. [PMID: 38399537 PMCID: PMC10890211 DOI: 10.3390/medicina60020249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 01/07/2024] [Accepted: 01/27/2024] [Indexed: 02/25/2024]
Abstract
Background and Objectives: The COVID-19 pandemic affects various populations worldwide. The discovery of vaccinations was necessary for the prevention and elimination of the disease. Despite the high importance of these vaccinations, they may cause some complications, such as ocular complications. This study aims to draw attention to the possible complications of the vaccination and highlight its importance. Materials and Methods: Systematic review of the literature from January 2021 to January 2023. A total of 20 published articles were included and reported cases of ocular complications in patients who received COVID-19 vaccines. Results: A total of 243 patients with verified ocular complications following the COVID-19 vaccination were included, ranging in age from 18 to 84 years. The most common ocular complications reported in the current study were ocular inflammatory complications, which represented 47.3%, followed by optic neuritis (24.3%). Retinal artery occlusion, retinal vein occlusion, acute macular neuroretinopathy, and paracentral acute middle maculopathy represented 10.7%. Herpetic ocular infections and herpetic eye disease (14%). Nearly half (42%) of the patients with ocular problems received the Pfizer-BioNTech vaccination. Conclusions: Despite the high importance of the COVID-19 vaccination, it was found that it is associated with the occurrence of some ocular complications. Future projects should come with more extensive prospective studies to further elucidate the underlying mechanisms and risk factors associated with ocular complications following COVID-19 vaccination, thereby enhancing our understanding and guiding appropriate management strategies.
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Affiliation(s)
- Eman A. Hurissi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (E.A.H.); (K.M.A.)
| | - Ismail I. Abuallut
- Department of Surgery, Ophthalmology Division, Jazan University, Jazan 45142, Saudi Arabia;
| | | | - Abdulaziz Jaly
- Pharmacy, Jazan University Hospital, Jazan 45142, Saudi Arabia;
| | - Abdulaziz H. Alhazmi
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (E.A.H.); (K.M.A.)
| | - Bandar M. Abuageelah
- Department of Medicine and Surgery, Batterjee Medical College, Abha 62451, Saudi Arabia; (B.M.A.); (Y.M.A.)
| | - Khalid M. Alameer
- Faculty of Medicine, Jazan University, Jazan 45142, Saudi Arabia; (E.A.H.); (K.M.A.)
| | - Yousef M. Alyami
- Department of Medicine and Surgery, Batterjee Medical College, Abha 62451, Saudi Arabia; (B.M.A.); (Y.M.A.)
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Singh RB, Li J, Parmar UPS, Jeng BH, Jhanji V. Vaccine-associated corneal graft rejection following SARS-CoV-2 vaccination: a CDC-VAERS database analysis. Br J Ophthalmol 2023; 108:17-22. [PMID: 36575625 DOI: 10.1136/bjo-2022-322512] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Accepted: 11/26/2022] [Indexed: 12/13/2022]
Abstract
PURPOSE To evaluate the cases of corneal graft rejection following SARS-CoV-2 vaccination reported to Centers for Disease Control and Prevention Vaccine Adverse Event Reporting System. METHODS A descriptive analysis of the demographics, clinical history and presentation was performed. We evaluated the correlation between the vaccines and duration of vaccine-associated graft rejection (VAR) onset following vaccination using a one-way analysis of variance test. A post hoc analysis was performed between VAR onset-interval following vaccination dose and vaccine type. Finally, a 30-day cumulative incidence analysis was performed to assess the risk of VAR in short term following different doses, vaccines and type of corneal transplantation. RESULTS A total of 55 eyes of 46 patients were diagnosed with VAR following vaccination with BNT162b2 (73.91%) and mRNA-1273 (26.09%). The mean age of the patients was 62.76±15.83 years, and 28 (60.87%) were female. The patients diagnosed with VAR had undergone penetrating keratoplasty (61.82%), Descemet membrane endothelial keratoplasty (12.73%), descemet stripping endothelial keratoplasty (18.18%), anterior lamellar keratoplasty (3.64%) and corneal limbal allograft transplantation (1.82%). The mean time for VAR since penetrating and endothelial keratoplasty was 8.42±9.23 years and 4.18±4.40 years, respectively. 45.65% of the cases of VAR were reported after the second dose of vaccine. The duration of VAR onset was significantly shorter after the second dose compared with the first and booster doses (p=0.0165) and in patients who underwent endothelial keratoplasty compared with penetrating keratoplasty (p=0.041). CONCLUSIONS This study outlines a possible temporal relationship between corneal graft rejection and SARS-CoV-2 vaccination. An earlier onset of VAR was observed in patients who had a history of endothelial keratoplasty and following the second dose of vaccination.
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Affiliation(s)
- Rohan Bir Singh
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, Massachusetts, USA
- Ophthalmology and Visual Sciences, The University of Adelaide Faculty of Health and Medical Sciences, Adelaide, South Australia, Australia
| | - Jeffrey Li
- Jules Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California, USA
| | | | - Bennie H Jeng
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Vishal Jhanji
- Eye and Ear Insitute, Department of Ophthalmology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
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9
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Allen NE, Zhang J, McGhee CNJ. COVID-19 vaccination and corneal allograft rejection- a review. Front Cell Infect Microbiol 2023; 13:1307655. [PMID: 38162575 PMCID: PMC10757323 DOI: 10.3389/fcimb.2023.1307655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Accepted: 11/23/2023] [Indexed: 01/03/2024] Open
Abstract
Aim To provide a comprehensive literature review on the perceived correlation between COVID-19 vaccination and corneal allograft rejection, and to characterize risk factors, time course, graft outcomes and proposed immunological basis. Methods A literature review was conducted in August 2023 using 4 electronic databases: PubMed, EMBASE, MEDLINE and Scopus. Articles were sourced using key words associated with COVID-19 vaccination and corneal graft. All articles were screened for relevance by abstract review. Duplicates and articles related to COVID-19 infection were excluded. No time limits were set. Additional literature searches regarding cause of corneal graft rejection, rates of graft rejection associated with other vaccines and the cellular mechanism of rejection were also performed. Results 262 articles were identified from the literature search. 37 papers were included in the analysis based on defined inclusion criteria. This consisted of systematic reviews (n=6), review articles (n=5), retrospective studies (n=3), case series (n=8), letter to the editor (n=1) and case reports (n= 14). The majority of reported allograft rejections were in penetrating keratoplasties. Risk factors for COVID-19 vaccination associated rejection were previous allograft rejection episodes, repeat grafts and penetrating keratoplasty. Most reported rejection episodes were mild and resolved with treatment. Notably, several studies reported nil increase in corneal allograft rejection episodes over the COVID-19 vaccination period. Rejection episodes are associated with a broad spectrum of other vaccines and the complete pathophysiology is undetermined. Conclusion Corneal allograft rejection appears to be a rare complication of COVID-19 vaccination most frequently observed in high-risk corneal transplants. The true extent of this correlation remains controversial; however, clinician awareness of this risk is essential to its mitigation. Patient counselling around symptom monitoring following vaccination and discussion around topical steroid prophylaxis may be prudent.
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Affiliation(s)
| | | | - Charles N. J. McGhee
- Department of Ophthalmology, New Zealand National Eye Centre, Faculty of Medical and Health Sciences, University of Auckland, Auckland, New Zealand
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10
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Sidhu N, Vanathi M, Gupta N, Tandon R. COVID and COVID vaccine-related corneal morbidity: A review. Indian J Ophthalmol 2023; 71:3595-3599. [PMID: 37991289 PMCID: PMC10788745 DOI: 10.4103/ijo.ijo_765_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 07/24/2023] [Accepted: 07/30/2023] [Indexed: 11/23/2023] Open
Abstract
Systemic coronavirus disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus has had several ocular consequences. Many vaccines have been developed against the disease, with adverse events being reported as well. Various ocular adverse events secondary to coronavirus disease 2019 (COVID-19) vaccines have also featured in literature in recent times. This review features the reported corneal-related effects of COVID infection and vaccination. These include direct effects on corneal grafts and unilateral or bilateral corneal melts. The compilation of reported experiences from across the world in this systematic review will help clinicians recognize the possible presentations, pathogenesis, and management of the same.
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Affiliation(s)
- Navneet Sidhu
- Dr. R. P. Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Murugesan Vanathi
- Dr. R. P. Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Noopur Gupta
- Dr. R. P. Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Radhika Tandon
- Dr. R. P. Center for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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11
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Lin TPH, Sen M, Gupta V, Agrawal R, Lanzetta P, Giannaccare G, Chan CKM, Agrawal K, Menia NK, Rojas-Carabali W, Arora A, Martinuzzi D, Taloni A, Rubinato L, Coco G, Sarao V, Veritti D, Chen L, Honavar SG, Lam DSC. Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination. Asia Pac J Ophthalmol (Phila) 2023; 12:512-536. [PMID: 38117598 DOI: 10.1097/apo.0000000000000647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 10/12/2023] [Indexed: 12/22/2023] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 was one of the most devastating public health issues in recent decades. The ophthalmology community is as concerned about the COVID-19 pandemic as the global public health community is, as COVID-19 was recognized to affect multiple organs in the human body, including the eyes, early in the course of the outbreak. Ophthalmic manifestations of COVID-19 are highly variable and could range from mild ocular surface abnormalities to potentially sight and life-threatening orbital and neuro-ophthalmic diseases. Furthermore, ophthalmic manifestations may also be the presenting or the only findings in COVID-19 infections. Meanwhile, global vaccination campaigns to attain herd immunity in different populations are the major strategy to mitigate the pandemic. As novel vaccinations against COVID-19 emerged, so were reports on adverse ophthalmic reactions potentially related to such. As the world enters a post-pandemic state where COVID-19 continues to exist and evolve as an endemic globally, the ophthalmology community ought to be aware of and keep abreast of the latest knowledge of ophthalmic associations with COVID-19 and its vaccinations. This review is a summary of the latest literature on the ophthalmic manifestations of COVID-19 and the adverse ophthalmic reactions related to its vaccinations.
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Affiliation(s)
- Timothy P H Lin
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Hong Kong, China
| | - Mrittika Sen
- Ocular Oncology and Ophthalmic Plastic Surgery Services, Raghunath Netralaya, Mumbai, India
| | - Vishali Gupta
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rupesh Agrawal
- Lee Kong Chiang School of Medicine, Nanyang Technological University, Singapore
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore
- Moorfields Eye Hospital, NHS Foundation Trust, London, UK
- Singapore Eye Research Institute, The Academia, Singapore, Singapore
- Duke NUS Medical School, National University of Singapore, Singapore
| | - Paolo Lanzetta
- Department of Medicine-Ophthalmology, University of Udine, Udine, Italy
- Istituto Europeo di Microchirurgia Oculare, Udine, Italy
| | - Giuseppe Giannaccare
- Department of Surgical Sciences, Eye Clinic, University of Cagliari, Cagliari, Italy
| | - Carmen K M Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Hong Kong Eye Hospital, Hong Kong, China
| | - Kajal Agrawal
- Lee Kong Chiang School of Medicine, Nanyang Technological University, Singapore
| | - Nitin Kumar Menia
- All India Institute of Medical Sciences, Jammu, Jammu and Kashmir, India
| | - William Rojas-Carabali
- Lee Kong Chiang School of Medicine, Nanyang Technological University, Singapore
- Department of Ophthalmology, Tan Tock Seng Hospital, Singapore
| | - Atul Arora
- Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Andrea Taloni
- University Magna Graecia of Catanzaro, Viale Europa, Catanzaro, Italy
| | - Leopoldo Rubinato
- Department of Medicine-Ophthalmology, University of Udine, Udine, Italy
| | - Giulia Coco
- Department of Clinical Science and Translational Medicine, University of Rome Tor Vergata, Rome, Italy
| | - Valentina Sarao
- Department of Medicine-Ophthalmology, University of Udine, Udine, Italy
- Istituto Europeo di Microchirurgia Oculare, Udine, Italy
| | - Daniele Veritti
- Department of Medicine-Ophthalmology, University of Udine, Udine, Italy
| | - Lizhen Chen
- C-MER (Shenzhen) Dennis Lam Eye Hospital, Shenzhen, China
| | - Santosh G Honavar
- Ocular Oncology and Ophthalmic Plastic Surgery Services, Centre for Sight Eye Hospital, Hyderabad, India
| | - Dennis S C Lam
- The International Eye Research Institute of The Chinese University of Hong Kong (Shenzhen), Shenzhen, China
- The C-MER Dennis Lam and Partners Eye Center, C-MER International Eye Care Group, Hong Kong, China
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12
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Yamamoto Y, Ogino K, Yasuhara S, Kawashima Y, Miki T. Three Cases of Arteritic Anterior Optic Neuropathy Several Months after COVID-19 Vaccination. Case Rep Ophthalmol Med 2023; 2023:8845850. [PMID: 37727533 PMCID: PMC10506880 DOI: 10.1155/2023/8845850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Revised: 08/29/2023] [Accepted: 09/02/2023] [Indexed: 09/21/2023] Open
Abstract
Background Vaccines have been approved worldwide to control the coronavirus disease-19 (COVID-19). However, the postvaccination side effects remain controversial. Here, we describe three Japanese cases of arteritic anterior ischaemic optic neuropathy (AAION) following COVID-19 vaccination. Case presentation. The first case involved an 87-year-old woman who presented with vision loss in the right eye 2 months after her second COVID-19 vaccine and in the left eye 2 days later. The second case involved an 88-year-old woman who presented with vision loss in both eyes 3 months after receiving a second vaccine. The third case involved an 80-year-old man who presented with vision loss in the right eye 5 months after receiving a second vaccine. The C-reactive protein level and erythrocyte sedimentation rate were elevated in all patients. Biopsy of the temporal artery or auricular cartilage showed arteritic occlusion in case 2 and polychondritis in case 3. These patients were referred to a local Japanese hospital in 2021 over a period of no longer than 3 months. Conclusion We observed three cases of AAION after the affected individuals received their second COVID-19 vaccine. Further long-term investigations of ophthalmological events after COVID-19 vaccination are warranted.
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Affiliation(s)
- Yuichi Yamamoto
- Department of Ophthalmology, Japanese Red Cross Wakayama Medical Centre, Wakayama, Japan
| | - Ken Ogino
- Department of Ophthalmology, Japanese Red Cross Wakayama Medical Centre, Wakayama, Japan
| | - Satoshi Yasuhara
- Department of Ophthalmology, Japanese Red Cross Wakayama Medical Centre, Wakayama, Japan
| | - Yu Kawashima
- Department of Ophthalmology, Japanese Red Cross Wakayama Medical Centre, Wakayama, Japan
| | - Toshiya Miki
- Department of Ophthalmology, Japanese Red Cross Wakayama Medical Centre, Wakayama, Japan
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13
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Chen KW, Chang EL, Sheridan AM, Papaliodis GN. Tubulointerstitial nephritis and uveitis syndrome (TINU) following COVID-19 vaccination. Am J Ophthalmol Case Rep 2023; 31:101869. [PMID: 37332677 PMCID: PMC10257335 DOI: 10.1016/j.ajoc.2023.101869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Revised: 05/01/2023] [Accepted: 05/31/2023] [Indexed: 06/20/2023] Open
Affiliation(s)
- Kevin W Chen
- Drexel University College of Medicine, Philadelphia, PA, United States
| | - Eileen L Chang
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States
- Stony Brook Medicine, Stony Brook, NY, United States
| | - Alice M Sheridan
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - George N Papaliodis
- Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, United States
- Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
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14
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Roberts HW, Wilkins MR, Malik M, Talachi-Langroudi M, Myerscough J, Pellegrini M, Yu AC, Busin M. A lack of an association between COVID-19 vaccination and corneal graft rejection: results of a large multi-country population based study. Eye (Lond) 2023; 37:2316-2319. [PMID: 36481958 PMCID: PMC9734330 DOI: 10.1038/s41433-022-02341-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 12/14/2022] Open
Abstract
PURPOSE The aim of the study was to present the rates of corneal transplant rejection from 2018 to 2022 at both Moorfields Eye Hospital UK, and Ospedali Privati Forli (OPF) "Villa Igea", Italy and evaluate the purported association between COVID-19 vaccination and rejection. METHODS We performed a retrospective review of rejection cases presenting to the two units. Monthly rates were correlated against regional vaccination programme rates. At OPF, conditional Poisson regression model was employed to estimate the incidence risk ratio (IRR) of graft rejection following COVID-19 vaccination risk period compared with the control period. RESULTS Between January 2018 and March 2022, there were 471 (Moorfields), 95 (OPF) episodes of rejection. From the start of vaccination programme in the UK in late January 2021, the median number of graft rejections per month at Moorfields was 6 (range: 5-9), which was not significantly different to post-lockdown, pre-vaccination programme (March 2020-January 2021), p = 0.367. At OPF, the median rates of rejection before and after initiation of the vaccination programme were not significantly different (p = 0.124). No significant increase in incidence rate of rejection in the risk period following COVID-19 vaccination was found (IRR = 0.53, p = 0.71). CONCLUSION No notable increase in rates of transplant rejection was noted in year 2021 when COVID-19 vaccination was broadly implemented. The apparent temporal relationship between COVID-19 vaccination and corneal graft rejection highlighted in several case reports may not represent a causative association.
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Affiliation(s)
- Harry W Roberts
- Corneal and External Diseases Unit, Moorfields Eye Hospital NHS Foundation Trust, London, UK.
- West of England Eye Unit, Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
| | - Mark R Wilkins
- Corneal and External Diseases Unit, Moorfields Eye Hospital NHS Foundation Trust, London, UK
- UCL Institute of Ophthalmology, London, UK
| | - Mohsan Malik
- Corneal and External Diseases Unit, Moorfields Eye Hospital NHS Foundation Trust, London, UK
| | | | - James Myerscough
- Southend University Hospital, Southend, UK
- Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", Forlì, Italy
| | - Marco Pellegrini
- Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", Forlì, Italy
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Angeli Christy Yu
- Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", Forlì, Italy
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
| | - Massimo Busin
- Department of Ophthalmology, Ospedali Privati Forlì "Villa Igea", Forlì, Italy
- Department of Translational Medicine, University of Ferrara, Ferrara, Italy
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15
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Cohen S, Olshaker H, Fischer N, Vishnevskia-Dai V, Hagin D, Rosenblatt A, Zur D, Habot-Wilner Z. Herpetic Eye Disease Following the SARS-CoV-2 Vaccinations. Ocul Immunol Inflamm 2023; 31:1151-1162. [PMID: 35914308 DOI: 10.1080/09273948.2022.2103831] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/16/2022] [Accepted: 07/14/2022] [Indexed: 10/16/2022]
Abstract
PURPOSE To describe herpetic ocular infections following SARS-CoV-2 vaccinations. METHODS A retrospective study of herpetic ocular infections after BNT162b2mRNA vaccination and a literature review. RESULTS A cohort of five patients: three varicella zoster virus (VZV) and two herpes simplex virus (HSV) cases, as well as 19 literature cases: 9 cases of VZV and 10 cases of HSV post BNT162b2mRNA, AZD1222, mRNA-1273, and CoronaVac vaccinations. All cases presented within 28 days post vaccination. Most VZV and HSV cases (15/19) reported in the literature presented post first vaccine dose, while in our cohort 2 VZV cases presented post second dose and both HSV cases and one VZV case post third dose. The most common presentations were HZO with ocular involvement and HSV keratitis. All eyes had complete resolution; however, one had retinal detachment and three corneal scars. CONCLUSION Herpetic ocular infections may develop shortly after SARS-CoV-2 vaccinations. Overall, the outcome is good.
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Affiliation(s)
- Shai Cohen
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Hagar Olshaker
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Naomi Fischer
- Department of Ophthalmology, Wolfson Medical Center, Holon, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Vicktoria Vishnevskia-Dai
- Goldschleger Eye Institute, Department of Ophthalmology, Sheba Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - David Hagin
- Allergy and Clinical Immunology Unit, Department of Medicine, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Amir Rosenblatt
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Dinah Zur
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Zohar Habot-Wilner
- Division of Ophthalmology, Tel Aviv Medical Center, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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16
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Dağ Y, Acet Y. Evaluation of the Effect of İnfection and İmmunity on the Tear Film by Scheimpflug-Placido Disc Topography- A Case Control Study. Photodiagnosis Photodyn Ther 2023; 41:103216. [PMID: 36470405 PMCID: PMC9719847 DOI: 10.1016/j.pdpdt.2022.103216] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 11/19/2022] [Accepted: 11/29/2022] [Indexed: 12/12/2022]
Abstract
PURPOSE We aimed to compare the tear film stability of individuals who had recovered from coronavirus disease (COVID-19), that of individuals vaccinated against COVID-19 and that of healthy individuals in a control group. METHODS This study included 61 eyes of 61 post-COVID-19 patients, 63 eyes of 63 participants who had received at least two doses of the SARS-CoV-2 mRNA BNT162b2 (Pfizer-BioNTech) vaccine, and 57 eyes of healthy individuals in a control group. We compared the groups' tear film stability. RESULTS The mean non-invasive first tear break-up time (NIF-BUT) value was 4.1±2.7 seconds in the post-COVID-19 group, 4.7±2.9 seconds in the vaccinated group, and 5.8±2.8 seconds in the control group. This value was statistically significantly lower in the post-COVID-19 and vaccinated groups than in the control group (p= 0.007). The rate of superotemporal (ST) quadrant breakup, statistically significantly higher in the vaccinated group than in the other two groups (p=0.001). According to a qualitative examination of the results, at least one breakup occurred in 47 (77%) of the post-COVID-19 participants' eyes, 50 (79.4%) of the vaccinated group's eyes, and 33 (57.9%) of the control group's eyes. In terms of this qualitative value, the post-COVID-19 and vaccinated groups had significantly higher breakup rates than the control group (p=0.018). CONCLUSIONS Destabilization in the tear film was more common in both the post covid group and the vaccinated group. In addition to individuals who have post-Covid, we think that post-vaccination individuals should be followed closely in terms of ocular surface diseases.
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Affiliation(s)
- Yaşar Dağ
- Department of Ophthalmology, Başakşehir çam ve sakura city hospital. Istanbul, Turkey, Mobile: +0905330188247.
| | - Yakup Acet
- Department of Ophthalmology, Mardin Training and Research Hospital. Mardin, Turkey, Mobile: +0905307849019.
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17
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Gurnani B, Kaur K, Lalgudi VG, Tripathy K. Risk Factors for Descemet Membrane Endothelial Keratoplasty Rejection: Current Perspectives- Systematic Review. Clin Ophthalmol 2023; 17:421-440. [PMID: 36755886 PMCID: PMC9899935 DOI: 10.2147/opth.s398418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 01/27/2023] [Indexed: 02/04/2023] Open
Abstract
Descemet membrane endothelial keratoplasty (DMEK) is a corneal endothelial transplantation procedure with selective removal of a patient's defective Descemet membrane and endothelium. It is replaced with a healthy donor Descemet membrane and endothelium without a stromal component. Corneal graft rejection can be at the level of epithelium, stroma as well endothelium. DMEK graft rejection is relatively less common than rejection with DSAEK or penetrating keratoplasty, and a good outcome may be achieved with prompt management. The clinical picture of DMEK rejection is usually similar to endothelial rejection in Descemet Stripping Endothelial Keratoplasty (DSEK/DSAEK), which generally manifests as pain, redness, reduction in visual acuity, stromal edema, endothelial rejection line, keratic precipitates at the back of the cornea and corneal neovascularization. However, more subtle forms of rejection or immune reactions are more common in DMEK compared to DSAEK eyes. Early clinical diagnosis, prompt intervention, and meticulous management safeguard visual acuity and graft survival in these cases. Intensive topical steroids form the mainstay in the management of DMEK rejection. Sometimes, oral or intravenous steroids or other systemic immunomodulators may be required. DMEK graft failure can be primary or secondary, and failure usually requires a second procedure in the form of repeat DMEK or DSEK or penetrating keratoplasty (PKP). A detailed literature search was performed using search engines such as Google Scholar, PubMed, and Google books, and a comprehensive review on DMEK rejection was found to be lacking. This review is a comprehensive update on the risk factors, pathophysiology, primary and secondary graft failure, recent advances in diagnosis, prevention of rejection, and updates in the management of DMEK rejection. The review also discusses the differential diagnosis of DMEK failure and rejection, prognosis, and future perspectives considering DMEK failure and rejection.
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Affiliation(s)
- Bharat Gurnani
- Department of Cornea and Refractive Surgery, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-kund, Madhya Pradesh, India,Correspondence: Bharat Gurnani, Consultant, Cataract, Cornea, External Diseases, Trauma, Ocular Surface, Uvea and Refractive Surgery, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-kund, Madhya Pradesh, 485334, India, Tel +919080523059, Email
| | - Kirandeep Kaur
- Department of Pediatric Ophthalmology, Sadguru Netra Chikitsalaya, Shri Sadguru Seva Sangh Trust, Janaki-kund, Madhya Pradesh, India
| | | | - Koushik Tripathy
- Department of Vitreoretinal and Cataract, ASG Eye Hospital, Kolkata, West Bengal, India
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18
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Park JM, Lee JH, Hwang JH, Kang MJ. Corneal Graft Rejection after Vaccination against COVID-19: A Case Report. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:85-87. [PMID: 36281573 PMCID: PMC9935065 DOI: 10.3341/kjo.2022.0105] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Ji Min Park
- Department of Ophthalmology, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Jee Hye Lee
- Department of Ophthalmology, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Je Hyung Hwang
- Department of Ophthalmology, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
| | - Min-Ji Kang
- Department of Ophthalmology, Inje University Sanggye Paik Hospital, College of Medicine, Inje University, Seoul, Korea
- E-mail (Min-Ji Kang):
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19
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Ghiasian L, Pourmousa Z, Hadi Y, Abdolalizadeh P. Corneal Allograft Endothelial Rejection after Sinopharm COVID-19 Vaccination; Report of Six Cases. Semin Ophthalmol 2023:1-7. [PMID: 36688666 DOI: 10.1080/08820538.2023.2169579] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
AIM To report the clinical characteristics of six patients with corneal allograft endothelial rejection after COVID-19 vaccination with Sinopharm and to review the literature. METHODS This is a prospective case series describing corneal allograft rejection among subjects having received Sinopharm (BBIBP-CorV) vaccine, coming to cornea clinic at a university-based hospital (Rassoul Akram Hospital, Tehran, Iran) from September 2021 to March 2022 for regular follow-up examinations. Data on demographics, vaccination (based on vaccine card), and graft condition (based on recent examination and previous medical documents) were recorded. RESULTS Out of 54 eyes (46 patients), 6 eyes (6 patients) had corneal allograft endothelial rejection after 3 to 117 days, post-vaccination. Three out of six rejections occurred within two weeks following vaccination. All of them were male with the mean age of 53.00 ± 19.66 years. The graft type of all patients was penetrating keratoplasty (PKP). The adverse event developed on average at 40.67 ± 34.33 months after surgery. Four patients were under maintenance treatment by topical steroid at the time of vaccination. One also received systemic immunomodulatory medication. Four grafts ended up with partial or complete graft failure. One case had received two doses of vaccine before undergoing the second corneal graft transplantation. CONCLUSION COVID-19 vaccination with Sinopharm may trigger corneal allograft endothelial rejection even in individuals with low-risk graft and under maintenance topical and/or systemic immunomodulatory medications.
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Affiliation(s)
- Leila Ghiasian
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Zahra Pourmousa
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Yasaman Hadi
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
| | - Parya Abdolalizadeh
- Eye Research Center, The Five Senses Institute, Rassoul Akram Hospital, Iran University of Medical Sciences, Tehran, Iran
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20
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Kuziez L, Eleiwa TK, Chauhan MZ, Sallam AB, Elhusseiny AM, Saeed HN. Corneal Adverse Events Associated with SARS-CoV-2/COVID-19 Vaccination: A Systematic Review. Vaccines (Basel) 2023; 11:vaccines11010166. [PMID: 36680010 PMCID: PMC9860789 DOI: 10.3390/vaccines11010166] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/09/2023] [Accepted: 01/10/2023] [Indexed: 01/14/2023] Open
Abstract
Vaccines against coronavirus disease 2019 (COVID-19) have played an important global role in reducing morbidity and mortality from COVID-19 infection. While the benefits of vaccination greatly outweigh the risks, adverse events do occur. Non-ocular adverse effects of the vaccines have been well-documented, but descriptions of ophthalmic effects remain limited. This systematic review aims to provide an overview of reported cases of corneal adverse events after receiving vaccination against COVID-19 and to compile existing clinical data to bring attention to these phenomena. Our review discusses corneal graft rejection, including proposed mechanisms, herpetic keratitis, and other reported corneal complications. Ophthalmologists and primary care physicians should be aware of such possible associations.
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Affiliation(s)
- Lana Kuziez
- Saint Louis University School of Medicine, St. Louis, MO 63104, USA
| | - Taher K. Eleiwa
- Department of Ophthalmology, Benha University, Benha 13518, Egypt
| | - Muhammad Z. Chauhan
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Ahmed B. Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
| | - Abdelrahman M. Elhusseiny
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USA
- Correspondence: (A.M.E.); (H.N.S.)
| | - Hajirah N. Saeed
- Department of Ophthalmology, Illinois Eye and Ear Infirmary, University of Illinois at Chicago, Chicago, IL 60661, USA
- Department of Ophthalmology, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA 02114, USA
- Department of Ophthalmology, Loyola University Medical Center, Maywood, IL 60611, USA
- Correspondence: (A.M.E.); (H.N.S.)
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21
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New onset of acute uveitis following COVID-19 vaccination. Graefes Arch Clin Exp Ophthalmol 2023; 261:555-560. [PMID: 35939122 PMCID: PMC9358066 DOI: 10.1007/s00417-022-05798-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 07/18/2022] [Accepted: 07/30/2022] [Indexed: 01/19/2023] Open
Abstract
PURPOSE This study reported 11 cases of new-onset acute uveitis following coronavirus disease 2019 (COVID-19) vaccination. METHODS This retrospective observational case study included 11 eyes of 11 patients with acute uveitis after the COVID-19 vaccination. We only included patients with new-onset uveitis. The medical records of the patients from January 2021 to January 2022 were reviewed. RESULTS The mean age of the participants was 51.81 years, and all patients demonstrated anterior chamber reaction with keratic precipitates in the affected eye. The mean duration between vaccination and uveitis was 8.27 days. Seven patients developed uveitis after receiving the second dose of vaccination, and four developed uveitis after receiving the third dose of vaccination. Five patients showed posterior synechiae, and three patients showed hypopyon. After treatment with topical 1% prednisolone acetate eye drops and systemic prednisolone, inflammation was adequately controlled and quickly resolved. CONCLUSIONS COVID-19 vaccination with messenger RNA and viral vector vaccines may cause acute anterior uveitis. Although initially severe, uveitis responded well to steroid therapy with no visual impairment.
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Tang H, Quan Y, Xiao P, Wu M. miR-155 Derived from Bone Marrow Mesenchymal Stem Cell-Secreted Exosomes Reduces Kidney Rejection in Rat Allogeneic Transplantation Model via SDF-1/CXCR4. J BIOMATER TISS ENG 2022. [DOI: 10.1166/jbt.2022.3200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Aberrantly expressed miR-155 is associated with renal rejection after allogeneic transplantation. This study mainly explored the mechanism of miR-155 derived from bone marrow mesenchymal stem cell-secreted exosomes (BMSC-exo) in renal rejection after allogeneic transplantation. Thirty
Fischer rats and 40 Lewis rats were used as donors and recipients, respectively. The Lewis rats were randomized into 4 groups (10 rats per group): Control group, miR-155 group, positive control group and CXCR4 agonist group. The following indicators were monitored in BMSC-exo: miR-155 expression,
serum creatinine level, renal histopathological changes, CADI score, number of cells that were positive for TGF-β, Smad3 and α-SMA, as well as the protein levels of Smad3, TGF-β, CXCR4 and SDF-1. miR-155 expression in BMSC-exo was significantly higher than
that in HKb-20 cells. On the 7th day after surgery, the serum creatinine levels of rats in the miR-155 group and positive control group reduced significantly, while decreasing slowly in the control group and CXCR4 agonist group. The CADI scores of rats in the miR-155 group and positive control
group were significantly higher than those in the control group and CXCR4 agonist group (P < 0.05). No significant difference was found either between the miR-155 group and positive control group, or between the control group and CXCR4 agonist group (P > 0.05). Rats in
the control group and CXCR4 agonist group had more cells that were positive for TGF-β, Smad3 and α-SMA, while those in the miR-155 group and positive control group showed less. The Smad3, TGF-β, CXCR4 and SDF-1 proteins were weakly expressed in the miR-155
group and positive control group, but strongly expressed in the control group and CXCR4 agonist group. No significant difference in the protein levels was found either between the miR-155 group and positive control group, or between the control group and CXCR4 agonist group (P >
0.05). miR-155 derived from BMSC-exo is protective against allogeneic kidney transplantation. Specifically, BMSC-exo-derived miR-155 blocked the activity of SDF-1/CXCR4 and TGF-β/Smad3 pathways, thereby downregulating the expression of α-SMA. As a result, it ameliorated
renal fibrosis and alleviated renal dysfunction, ultimately leading to the prevention and reduction of renal rejection following allograft transplantation.
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Affiliation(s)
- Hongmei Tang
- Department of Nephrology, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, Hunan, 410000, China
| | - Yangya Quan
- Department of Gastroenterology, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, Hunan, 410000, China
| | - Pengfei Xiao
- Department of Scientific Research, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, Hunan, 410000, China
| | - Meili Wu
- Department of Nephrology, Brain Hospital of Hunan Province (The Second People’s Hospital of Hunan Province), Changsha, Hunan, 410000, China
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Huang LY, Chiang CC, Li YL, Lai HY, Hsieh YC, Wu YH, Tsai YY. Corneal Complications after COVID-19 Vaccination: A Systemic Review. J Clin Med 2022; 11:6828. [PMID: 36431307 PMCID: PMC9698276 DOI: 10.3390/jcm11226828] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 11/17/2022] [Accepted: 11/17/2022] [Indexed: 11/22/2022] Open
Abstract
Multiple vaccines are now being used across the world, and several studies have described cases of corneal graft rejection following the administration of the COVID-19 vaccine. The purpose of this article is to review the corneal adverse event that occurred following COVID-19 vaccine administration. The literature search was conducted in March 2022 using MEDLINE, PubMed, and the Cochrane Database of Systematic Reviews. A total of 27 articles, including 37 cases, have documented corneal adverse events that occurred following COVID-19 vaccination. The mean age was 60 ± 14.9 years (range, 27-83 years). The most common events were acute corneal graft rejection (n = 21, 56.8%), followed by herpes zoster ophthalmicus (n = 11, 29.7%) and herpes simplex keratitis (n = 2, 5.4%). The mean time from vaccination to the event was 10 ± 8.5 days (range, 1-42 days) after the first or second dose of vaccine. All patients with corneal graft rejection, immune-mediated keratolysis, and peripheral ulcerative keratitis (PUK) (n = 24, 64.9%) were managed topically with or without oral corticosteroids. Patients with herpes zoster ophthalmicus and herpes simplex keratitis were managed with oral antiviral agents. Two patients received penetrating keratoplasty due to keratolysis after invalid topical treatment. Disease resolution was noted in 29 patients (78.3%), whereas 3 (8.1%) had persistent corneal edema after graft rejection, 1 (2.7%) had corneal infiltration after HZO, and 4 (10.8%) were not mentioned in the articles. Corneal adverse events could occur after COVID-19 vaccination. After timely treatment with steroids or antiviral agents, most of the events were mild and had a good visual outcome. Administrating or increasing steroids before vaccination may be useful for the prevention of corneal graft rejection. However, the prophylactic use of antiviral treatments in patients with a herpes viral infection history is not recommend.
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Affiliation(s)
- Li-Ying Huang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Chun-Chi Chiang
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Optometry, Asia University, Taichung 413305, Taiwan
| | - You-Ling Li
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Hung-Yin Lai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Yi-Ching Hsieh
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Ying-Hsuen Wu
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
| | - Yi-Yu Tsai
- Department of Ophthalmology, China Medical University Hospital, China Medical University, Taichung 404327, Taiwan
- School of Medicine, College of Medicine, China Medical University, Taichung 406040, Taiwan
- Department of Optometry, Asia University, Taichung 413305, Taiwan
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Ichhpujani P, Parmar UPS, Duggal S, Kumar S. COVID-19 Vaccine-Associated Ocular Adverse Effects: An Overview. Vaccines (Basel) 2022; 10:1879. [PMID: 36366386 PMCID: PMC9697513 DOI: 10.3390/vaccines10111879] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 10/24/2022] [Accepted: 11/01/2022] [Indexed: 07/29/2023] Open
Abstract
BACKGROUND To address the pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), vaccination efforts were initiated across the globe in December 2020 and are continuing. We report the onset interval and clinical presentations of ocular adverse effects following SARS-CoV-2 vaccination. METHODS For this narrative review, articles in the English language, published between 1 January 2020 to 1 September 2022, were included to formulate a list of the reported ocular adverse effects of different COVID-19 vaccines. RESULTS During this period, ocular adverse effects have been reported with BNT162b2 (Pfizer), mRNA-1273 (Moderna), AZD-1222 (AstraZeneca), and Ad26.COV2.S (Johnson & Johnson) vaccines. Endothelial graft rejection, herpes simplex virus keratitis, herpes zoster ophthalmicus, anterior uveitis, eyelid edema, purpuric rashes, ischemic optic neuropathy, and cranial nerve palsies were the most reported with BNT163b2. Retinal hemorrhages, vascular occlusions, and angle closure glaucoma were the most reported with AZD-1222. Most of the ocular adverse effects reported in the literature had a good to fair prognosis with appropriate management. CONCLUSIONS Evidence regarding the ocular adverse effects does not outweigh the benefits of SARS-CoV-2 vaccination in patients with pre-existing systemic or ophthalmic diseases. This review provides insights into the possible temporal association between reported ocular adverse events and SARS-CoV-2 vaccines; however, further investigations are required to identify the link between potential causality and pathological mechanisms.
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Shah PP, Glidai Y, Braunstein R, Gorski M, Lee J, Anwar F, Schrier A, Winokur J, Steiner AS. Reports of New and Recurrent Keratitis following mRNA-based COVID-19 Vaccination. Ocul Immunol Inflamm 2022:1-6. [PMID: 36345233 DOI: 10.1080/09273948.2022.2133730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
PURPOSE As ophthalmic side effects of messenger RNA (mRNA)-based COVID-19 vaccination are not well understood, it is crucial to document and report such instances should they occur. METHODS In this observational case series, we report nine patients (55.6% male, mean age 58.9) who received either the BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) COVID-19 vaccinations from January to June of 2021, and presented with symptoms of keratitis within 14 days. All patients underwent slit-lamp examination and histories were taken. RESULTS Most subjects (66.7%) had a history of corneal inflammatory diseases and resolved under antiviral and/or steroidal treatment. Patients who reported symptoms after their second vaccine dose presented earlier than those who reported symptoms after the first dose (mean 4.4 days vs 10.5 days, respectively). CONCLUSIONS The immunological reaction following mRNA-based COVID-19 vaccinations may trigger new-onset or reactivation of keratitis, though causality cannot be proven. Despite its rarity, clinicians should be aware of this possible complication and be prepared to treat.
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Affiliation(s)
- Paras P. Shah
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
| | - Yoav Glidai
- Department of Ophthalmology, Northwell Health, Great Neck, New York, USA
| | - Richard Braunstein
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Ophthalmology, Northwell Health, Great Neck, New York, USA
| | - Matthew Gorski
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Ophthalmology, Northwell Health, Great Neck, New York, USA
| | - Jung Lee
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Ophthalmology, Northwell Health, Great Neck, New York, USA
| | - Farihah Anwar
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Ophthalmology, Northwell Health, Great Neck, New York, USA
| | - Amelia Schrier
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Ophthalmology, Northwell Health, Great Neck, New York, USA
| | - Jules Winokur
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Ophthalmology, Northwell Health, Great Neck, New York, USA
| | - Anne S. Steiner
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York, USA
- Department of Ophthalmology, Northwell Health, Great Neck, New York, USA
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SPIRITO F, MAZZOCCOLI G, DI COSOLA M, LO MUZIO L. Solid organ transplantation and SARS-CoV-2 vaccines: is there a possible alternative? GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2022. [DOI: 10.23736/s0393-3660.22.04907-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022]
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Scalabrin S, Becco A, Vitale A, Nuzzi R. Ocular effects caused by viral infections and corresponding vaccines: An overview of varicella zoster virus, measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2. Front Med (Lausanne) 2022; 9:999251. [PMID: 36388944 PMCID: PMC9643669 DOI: 10.3389/fmed.2022.999251] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/30/2022] [Indexed: 09/19/2023] Open
Abstract
Many viral infections can affect vision and the visual system. Vaccination to prevent diseases is commonplace today, acting by stimulating an immune response without developing the pathology. It involves the production of persisting antibodies against the pathogen and the activation of T cells. Certain diseases have already been eradicated by rigorous vaccination campaigns, while others are hoped to be eliminated soon. Vaccines currently available on the market are largely safe, even if they can rarely cause some adverse effects, such as ocular complications. Analyzing existing literature, we aimed to compare the pathological effects on the eye due to the most common viral infections [in particular varicella zoster virus (VZV), measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2] with the possible ocular adverse effects of their relative vaccines, in order to establish a risk-benefit relationship from an ophthalmological point of view.
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Affiliation(s)
| | | | | | - Raffaele Nuzzi
- Department of Surgical Sciences, Eye Clinic, University of Turin, Turin, Italy
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COVID-19 Vaccine-Associated Optic Neuropathy: A Systematic Review of 45 Patients. Vaccines (Basel) 2022; 10:vaccines10101758. [PMID: 36298623 PMCID: PMC9609672 DOI: 10.3390/vaccines10101758] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2022] [Revised: 10/15/2022] [Accepted: 10/19/2022] [Indexed: 11/20/2022] Open
Abstract
We provide a systematic review of published cases of optic neuropathy following COVID-19 vaccination. We used Ovid MEDLINE, PubMed, and Google Scholar. Search terms included: “COVID-19 vaccination”, “optic neuropathy”, “optic neuritis”, and “ischemic optic neuropathy”. The titles and abstracts were screened, then the full texts were reviewed. Sixty eyes from forty-five patients (28 females) were included. Eighteen eyes from fourteen patients (31.1%) were diagnosed with anterior ischemic optic neuropathy (AION), while 34 eyes from 26 patients (57.8%) were diagnosed with optic neuritis (ON). Other conditions included autoimmune optic neuropathy and Leber hereditary optic neuropathy. Fifteen patients (33.3%) had bilateral involvement. The mean age of all patients was 47.4 ± 17.1 years. The mean age of AION patients was 62.9 ± 12.2 years and of ON patients was 39.7 ± 12.8 years (p < 0.001). The mean time from vaccination to ophthalmic symptoms was 9.6 ± 8.7 days. The mean presenting visual acuity (VA) was logMAR 0.990 ± 0.924. For 41 eyes with available follow-up, the mean presenting VA was logMAR 0.842 ± 0.885, which improved to logMAR 0.523 ± 0.860 at final follow-up (p < 0.001). COVID-19 vaccination may be associated with different forms of optic neuropathy. Patients diagnosed with ON were more likely to be younger and to experience visual improvement. More studies are needed to further characterize optic neuropathies associated with COVID-19 vaccination.
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Kung TPH, Zhang C, Sieminski SF. Acute panuveitis after COVID-19 mRNA booster vaccination following cataract surgery. Am J Ophthalmol Case Rep 2022; 28:101726. [PMID: 36267387 PMCID: PMC9557133 DOI: 10.1016/j.ajoc.2022.101726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 08/22/2022] [Accepted: 10/09/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose To report a case of presumed COVID-19 Pfizer third dose (booster) vaccination leading to severe panuveitis mimicking acute endophthalmitis in the early postoperative period following routine cataract extraction and intraocular lens implantation. Observations A 68-year-old female with mild refractive error who previously received 2 doses of the BNT162b2 vaccine underwent routine cataract extraction and intraocular lens implantation in the right eye. On postoperative day (POD) 2 the patient received her BNT162b2 booster vaccination. On POD 3 the patient's vision was hand motion at face with photophobia. Anterior segment examination was significant for 2+ conjunctival injection, mild stromal edema, 4+ cell and flare with trace hypopyon, and 4+ anterior vitreous cell without any wound leak. Subsequent Gram staining, culture for aerobic and anaerobic bacteria, KOH preparation, and PCR testing for infectious organisms were also obtained, all of which were found to be negative. ESR and CRP values were also negative. The patient was started on intravitreal injections of vancomycin and ceftazidime, as well as oral moxifloxacin, fortified vancomycin and tobramycin drops, prednisolone acetate 1%, and atropine 1%. On POD 5 the patient reported significant improvement of her vision and was found to have 20/80 vision. On POD 12 her vision improved to 20/25, and improved further on POD 19 to 20/20 vision with a completely normal examination. Cultures remained negative throughout the entire course. Conclusions and importance This is the first report to suggest a possible association between the BNT162b2 booster vaccination and development of acute panuveitis in the postoperative period after routine cataract extraction and intraocular lens implantation. This condition may mimic acute bacterial postoperative endophthalmitis and may portend a more favorable prognosis, but the authors believe such cases should nonetheless be treated aggressively as presumed infection.
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Affiliation(s)
- Timothy-Paul H. Kung
- Jacobs School of Medicine and Biomedical Sciences, State University of New York at Buffalo, 955 Main St, Buffalo, NY, 14203, USA
| | - Charles Zhang
- Department of Ophthalmology, Ross Eye Institute, University at Buffalo, 1176 Main St, Buffalo, NY, 14209, USA
- Corresponding author. 1176 Main St, Buffalo, NY, 14209, USA.
| | - Sandra F. Sieminski
- Department of Ophthalmology, Ross Eye Institute, University at Buffalo, 1176 Main St, Buffalo, NY, 14209, USA
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Singh RB, Parmar UPS, Cho W, Ichhpujani P. Glaucoma Cases Following SARS-CoV-2 Vaccination: A VAERS Database Analysis. Vaccines (Basel) 2022; 10:1630. [PMID: 36298495 PMCID: PMC9610013 DOI: 10.3390/vaccines10101630] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 09/26/2022] [Accepted: 09/26/2022] [Indexed: 07/25/2023] Open
Abstract
Background: To counter the rapidly spreading severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), global vaccination efforts were initiated in December 2020. We assess the risk of glaucoma following SARS-CoV-2 vaccination and evaluate its onset interval and clinical presentations in patients. Methods: We performed a retrospective analysis of the glaucoma cases reported to the Vaccine Adverse Event Reporting System (VAERS) database between 16 December 2020, and 30 April 2022. We assessed the crude reporting rate of glaucoma, clinical presentations, onset duration, and associated risk factors. Results: During this period, 161 glaucoma cases were reported, with crude reporting rates (per million doses) of 0.09, 0.06, and 0.07 for BNT162b2, mRNA-1273, and Ad26.COV2.S, respectively. The mean age of the patients was 60.41 ± 17.56 years, and 67.7% were women. More than half (56.6%) of the cases were reported within the first week of vaccination. The cumulative-incidence analysis showed a higher risk of glaucoma in patients who received the BNT162b2 vaccines compared with mRNA-1273 (p = 0.05). Conclusions: The incidence of glaucoma following vaccination with BNT162b2, mRNA-1273, or Ad26.COV2.S is extremely rare. Amongst the patients diagnosed with glaucoma, the onset interval of adverse events was shorter among those who received the BNT162b2 and rAd26.COV2.S vaccines compared with mRNA-1273. Most glaucoma cases were reported within the first week following vaccination in female patients and from the fifth to seventh decade. This study provides insights into the possible temporal association between reported glaucoma events and SARS-CoV-2 vaccines; however, further investigations are required to identify the potential causality link and pathological mechanisms.
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Affiliation(s)
- Rohan Bir Singh
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
- Department of Ophthalmology, Leiden University Medical Center, 2333 Leiden, The Netherlands
- Discipline of Ophthalmology and Visual Sciences, Faculty of Health and Medical Sciences, Adelaide Medical School, University of Adelaide, Adelaide 5000, Australia
| | - Uday Pratap Singh Parmar
- Glaucoma Service, Department of Ophthalmology, Government Medical College and Hospital, Chandigarh 160019, India
| | - Wonkyung Cho
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA 02114, USA
| | - Parul Ichhpujani
- Glaucoma Service, Department of Ophthalmology, Government Medical College and Hospital, Chandigarh 160019, India
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Thakkar J, Jeria S, Thakkar A. A Review of Corneal Transplantation: An Insight on the Overall Global Post-COVID-19 Impact. Cureus 2022; 14:e29160. [PMID: 36258928 PMCID: PMC9563971 DOI: 10.7759/cureus.29160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
The coronavirus disease 2019 (COVID-19) pandemic made us reframe a lot of the strategies followed in medical practice and ophthalmological services and procedures were also not spared, including corneal transplantation or keratoplasty, the most routine procedure performed worldwide. The prevalence of viral presence in the ocular tissue necessitates a focus on the handling of donor ocular tissue and the functioning of eye banks, ensuring it doesn't risk the patient and the doctor's safety. Restrictions in the movement of people during the pandemic limited the number of donations, causing a shortage of tissues, with a large number of people already waitlisted for tissue needs. The lesson from the COVID-19 pandemic directs us to look for long-term corneal storage techniques taking into consideration the tissue viability time and the possibility of post-pandemic shortages. Although there is not a significant number of reports, the cases of corneal graft rejection post-vaccination against COVID-19 are highlighted and thus should form a part of the lookout while evaluating the possible cause of rejection of grafts. This article summarises the overall impact of the pandemic on corneal transplantation and the possible future of storage techniques, which need to evolve and be adapted.
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COVID-19 Vaccination May Not Increase Rates of Corneal Graft Rejection. Cornea 2022; 41:1536-1538. [PMID: 35965396 DOI: 10.1097/ico.0000000000003101] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of the study was to present the rates of rejection from 2018 to 2021 and evaluate the purported association between COVID-19 vaccination and corneal graft rejection. METHODS Cases of corneal graft rejection diagnosed between January 2018 and December 2021 were reviewed. The conditional Poisson regression model of the self-controlled case series method was used to estimate the incidence risk ratio of graft rejection after COVID-19 vaccination risk period compared with the control period. Based on outcomes of eyes that underwent keratoplasty from January 2018 to December 2020, Cox proportional hazard models were fitted with previous COVID-19 vaccination as a time-varying covariate. RESULTS Over the past 4 years, the annual tally of diagnosed cases of graft rejection (19 cases in year 2018, 19 cases in year 2019, 21 cases in year 2020, and 18 cases in year 2021) has remained relatively stable. Using the conditional Poisson regression analysis, no significant increase in the incidence rate of rejection in the risk period after COVID-19 vaccination was found (incidence risk ratio = 0.56, 95% confidence interval [CI] = 0.13-2.28, P = 0.70). Fitted as a time-varying covariate, previous COVID-19 vaccination was not associated with graft rejection in both unadjusted (hazard ratio =0.77, 95% CI = 0.29-5.46, P = 0.77) and adjusted Cox models (hazard ratio = 0.75, 95% CI = 0.10-5.52, P = 0.78). CONCLUSIONS No notable increase in rates of corneal graft rejection was noted in year 2021 when COVID-19 vaccination was broadly implemented. The apparent temporal relationship between COVID vaccination and corneal graft rejection may not represent a causative association.
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Solid Organ Rejection following SARS-CoV-2 Vaccination or COVID-19 Infection: A Systematic Review and Meta-Analysis. Vaccines (Basel) 2022; 10:vaccines10081289. [PMID: 36016180 PMCID: PMC9412452 DOI: 10.3390/vaccines10081289] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 02/06/2023] Open
Abstract
Background: Solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection is extremely rare but can occur. T-cell recognition of antigen is the primary and central event that leads to the cascade of events that result in rejection of a transplanted organ. Objectives: To describe the results of a systematic review for solid organ rejections following SARS-CoV-2 vaccination or COVID-19 infection. Methods: For this systematic review and meta-analysis, we searched Proquest, Medline, Embase, Pubmed, CINAHL, Wiley online library, Scopus and Nature through the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) guidelines for studies on the incidence of solid organ rejection post-SARS-CoV-2 vaccination or COVID-19 infection, published from 1 December 2019 to 31 May 2022, with English language restriction. Results: One hundred thirty-six cases from fifty-two articles were included in the qualitative synthesis of this systematic review (56 solid organs rejected post-SARS-CoV-2 vaccination and 40 solid organs rejected following COVID-19 infection). Cornea rejection (44 cases) was the most frequent organ observed post-SARS-CoV-2 vaccination and following COVID-19 infection, followed by kidney rejection (36 cases), liver rejection (12 cases), lung rejection (2 cases), heart rejection (1 case) and pancreas rejection (1 case). The median or mean patient age ranged from 23 to 94 years across the studies. The majority of the patients were male (n = 51, 53.1%) and were of White (Caucasian) (n = 51, 53.7%) and Hispanic (n = 15, 15.8%) ethnicity. A total of fifty-six solid organ rejections were reported post-SARS-CoV-2 vaccination [Pfizer-BioNTech (n = 31), Moderna (n = 14), Oxford Uni-AstraZeneca (n = 10) and Sinovac-CoronaVac (n = 1)]. The median time from SARS-CoV-2 vaccination to organ rejection was 13.5 h (IQR, 3.2–17.2), while the median time from COVID-19 infection to organ rejection was 14 h (IQR, 5–21). Most patients were easily treated without any serious complications, recovered and did not require long-term allograft rejection therapy [graft success (n = 70, 85.4%), graft failure (n = 12, 14.6%), survived (n = 90, 95.7%) and died (n = 4, 4.3%)]. Conclusion: The reported evidence of solid organ rejections post-SARS-CoV-2 vaccination or COIVD-19 infection should not discourage vaccination against this worldwide pandemic. The number of reported cases is relatively small in relation to the hundreds of millions of vaccinations that have occurred, and the protective benefits offered by SARS-CoV-2 vaccination far outweigh the risks.
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Fujio K, Sung J, Nakatani S, Yamamoto K, Iwagami M, Fujimoto K, Shokirova H, Okumura Y, Akasaki Y, Nagino K, Midorikawa-Inomata A, Hirosawa K, Miura M, Huang T, Morooka Y, Kuwahara M, Murakami A, Inomata T. Characteristics and Clinical Ocular Manifestations in Patients with Acute Corneal Graft Rejection after Receiving the COVID-19 Vaccine: A Systematic Review. J Clin Med 2022; 11:jcm11154500. [PMID: 35956115 PMCID: PMC9369681 DOI: 10.3390/jcm11154500] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 07/30/2022] [Accepted: 07/31/2022] [Indexed: 02/04/2023] Open
Abstract
This study aimed to determine the characteristics and clinical ocular manifestations of acute corneal graft rejection after coronavirus disease 2019 (COVID-19) vaccination. We conducted an online search of the PubMed and EMBASE databases. Data on recipients’ characteristics, corneal transplantation types, interval between vaccination and allograft rejection, clinical manifestations, and graft rejection medication were extracted. Thirteen articles on 21 patients (23 eyes) with acute corneal graft rejection after COVID-19 vaccination, published between April and December 2021, were included. The median (interquartile range) age at the onset of rejection was 68 (27–83) years. Types of transplantation included penetrating keratoplasty (12 eyes), Descemet membrane endothelial keratoplasty (six eyes), Descemet stripping automated endothelial keratoplasty (four eyes), and living-related conjunctival-limbal allograft (one eye). The interval between vaccination and rejection ranged from 1 day to 6 weeks. Corneal edema was the leading clinical manifestation (20 eyes), followed by keratic precipitates (14 eyes) and conjunctival or ciliary injection (14 eyes). Medications included frequently applied topical corticosteroids (12 eyes), followed by a combination of topical and oral corticosteroids (four eyes). In addition, the clinical characteristics of corneal allograft rejection after COVID-19 vaccination were identified. Corneal transplant recipients may require further vaccination, necessitating appropriate management and treatment.
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Affiliation(s)
- Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Morsani College of Medicine, University of South Florida, Tampa, FL 33612, USA
| | - Satoru Nakatani
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
| | - Kazuko Yamamoto
- Department of Respiratory Medicine, Nagasaki University Hospital, Nagasaki 852-8102, Japan;
| | - Masao Iwagami
- Department of Health Services Research, Faculty of Medicine, University of Tsukuba, Tsukuba 305-8575, Japan;
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Hurramhon Shokirova
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
| | - Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Yasutsugu Akasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Ken Nagino
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Kunihiko Hirosawa
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Maria Miura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Tianxiang Huang
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Yuki Morooka
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Mizu Kuwahara
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan; (K.F.); (J.S.); (S.N.); (K.F.); (H.S.); (Y.O.); (Y.A.); (K.H.); (M.M.); (T.H.); (Y.M.); (M.K.); (A.M.)
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan;
- AI Incubation Farm, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan
- Correspondence: ; Tel.: +81-3-3813-3111; Fax: +81-3-3817-0260
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Eduarda Andrade E Andrade M, Rodrigues JC, Junior EF, de Lima MHC. Keratoplasty rejection after messenger RNA vaccine (BNT162b2) for COVID-19. Indian J Ophthalmol 2022; 70:3134-3136. [PMID: 35918988 PMCID: PMC9672786 DOI: 10.4103/ijo.ijo_1021_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
This report shows a case of corneal transplant rejection after vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), short after receiving the BNT162b2 vaccine, in a patient who had undergone keratoplasty more than 20 years ago, with no previous episodes of rejection and no other factor that could lead to the findings on his examinations. After treatment with high doses of topic, oral, and sub-conjunctival corticoids, the patient had a favorable therapeutic response. The signs of corneal transplant rejection must be oriented to the patients and the causing factors actively searched by ophthalmologists so that treatment is rapidly initiated and sequels are avoided. This report raises the question if these events are correlated and whether the patient should receive the second dose of the vaccine against SARS-CoV-2 or not.
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Affiliation(s)
| | | | - Elvio Ferreira Junior
- Clínica Oftalmológica do Complexo Hospitalar Padre Bento de Guarulhos, Guarulhos, São Paulo, Brazil
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Marziali E, Pasqualetti R, Bacci G, de Libero C, Caputo R. Acute Rejection Following COVID-19 Vaccination in Penetrating Keratoplasty in a Young Male - A Case Report and Review of Literature. Ocul Immunol Inflamm 2022:1-4. [PMID: 35914312 DOI: 10.1080/09273948.2022.2106248] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
PURPOSE To report a case of a boy with acute keratoplasty rejection manifesting 12 days after receiving BNT162b2 messenger RNA (mRNA) vaccine for COVID-19. STUDY DESIGN A case report. RESULTS A 15-year-old boy with a history of penetrating keratoplasty due to acanthamoeba keratitis developed corneal decompensation 12 days after BNT162b2 messenger RNA vaccine for COVID-19 disease. One-week treatment with topical Dexamethasone 2% eye drops resulted in a complete resolution of corneal edema. CONCLUSIONS This case suggests that BNT162b2 messenger RNA (mRNA) vaccine can be associated with acute keratoplasty rejection in children, which responds completely to topical steroids. Ophthalmologists should be aware of this risk of cornea decompensation after COVID-19 vaccine in children who received a cornea transplant.
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Affiliation(s)
- Elisa Marziali
- Pediatric Ophthalmology Unit A, Meyer Children's Hospital, Florence, Italy
| | | | - Giacomo Bacci
- Pediatric Ophthalmology Unit A, Meyer Children's Hospital, Florence, Italy
| | - Cinzia de Libero
- Pediatric Ophthalmology Unit A, Meyer Children's Hospital, Florence, Italy
| | - Roberto Caputo
- Pediatric Ophthalmology Unit A, Meyer Children's Hospital, Florence, Italy
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Abstract
RATIONALE To report a case of bilateral transient corneal edema presumably associated with adenovirus-vectored coronavirus disease 2019 (COVID-19) vaccination that resolved with eye drops treatment. PATIENT CONCERNS A 55-year-old Asian woman presented with sudden onset of bilateral visual disturbance developed 6 days after immunization with an adenovirus-vectored COVID-19 vaccine (AstraZeneca, London, United Kingdom). She underwent uneventful cataract surgery in right and left eyes 2 months ago and maintained good visual acuity bilaterally. Slit-lamp examination showed bilateral mild corneal edema that was confirmed with anterior segment optical coherent tomography. Anterior chamber and vitreous were clear bilaterally. Both fundi were normal. DIAGNOSES The patient was diagnosed with corneal edema following adenovirus-vectored COVID-19 vaccination. INTERVENTIONS She was prescribed with prednisolone acetate 1% eye drops bilaterally. OUTCOMES Treatment with topical steroid for 2 weeks resulted in resolution of the corneal edema and improvement of the visual acuity bilaterally. LESSONS This case suggests that transient corneal edema can develop following adenovirus-vectored COVID-19 vaccination. Prompt ophthalmologic evaluation and treatment may improve the corneal edema.
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Affiliation(s)
- Jae Yeon Lee
- Department of Ophthalmology, Kangwon National University College of Medicine, Kangwon National University Hospital, Chuncheon, Korea
| | - Sang Beom Han
- Department of Ophthalmology, Kangwon National University College of Medicine, Kangwon National University Hospital, Chuncheon, Korea
- *Correspondence: Sang Beom Han, Department of Ophthalmology, Kangwon National University College of Medicine, Kangwon National University Hospital, 156 Baengnyeong-ro, Chuncheon, Kangwon 200-722, Korea (e-mail: )
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Abstract
PURPOSE OF REVIEW Corneal graft rejection has been reported after coronavirus disease 2019 (COVID-19) vaccination. The purpose of this review is to evaluate the literature regarding corneal graft rejection after vaccination, including rejection rates and risk factors. We aim to create a framework to identify patients who are at higher risk for graft rejection and may warrant consideration of prophylactic interventions. RECENT FINDINGS Graft rejection has been reported following administration of mRNA, viral vector, and inactivated whole-virion COVID-19 vaccines. Most cases had additional risk factors associated with rejection. Vaccination increases circulation of proinflammatory cytokines, CD4+ and CD8+ T-cell responses, and antispike neutralizing antibody, all of which may contribute to graft rejection. Two prospective studies have found no relationship between recent vaccination and rejection but 20% of cornea specialists report to have seen a vaccine-associated rejection and 22% recommend delaying vaccination in certain circumstances. Many specialists recommend prophylactic topical corticosteroids before and after vaccination to mitigate rejection risk but there is no evidence to support this practice on a wider scale. SUMMARY Our framework identified 96.8% of penetrating keratoplasty patients with vaccine-associated rejection as higher risk. Further research is needed in order to develop evidence-based guidelines.
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Affiliation(s)
- Sarah P Dugan
- Department of Ophthalmology and Visual Sciences, W. K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA
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Abrishami M, Hosseini SM, Shoeibi N, Heidarzadeh HR. Unilateral Acute Central Serous Chorioretinopathy with Inactivated Coronavirus Disease 2019 Vaccination: A Case Report and Review of Literature. J Curr Ophthalmol 2022; 34:373-378. [PMID: 36644462 PMCID: PMC9832452 DOI: 10.4103/joco.joco_41_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 05/28/2022] [Accepted: 05/28/2022] [Indexed: 12/12/2022] Open
Abstract
Purpose To report unilateral acute-onset central serous chorioretinopathy (CSC) following vaccination with inactivated coronavirus disease 2019 (COVID-19) vaccine in a healthy patient. Methods Case report and review of literature. Results A 39-year-old male was referred with sudden-onset, painless, unilateral blurred vision in the right eye. His first dose of the Sinopharm vaccine was injected 2 days before. A complete ocular examination revealed central subretinal fluid (SRF) accumulation in favor of CSC in the right eye. Systemic workup disclosed no previous COVID-19 infection or any systemic involvement. After 3 weeks, SRF decreased remarkably without treatment. Conclusions It is proposed that CSC development can be an ocular adverse effect of COVID-19 vaccination, although it is infrequent. Ophthalmologists should be aware of the possible association between COVID-19 vaccination and ocular adverse effects, but vaccination is the best effectual measure against COVID-19.
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Affiliation(s)
- Mojtaba Abrishami
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
- Ocular Oncology Service, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Canada
| | | | - Nasser Shoeibi
- Eye Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Prasad N, Bansal SB, Yadav B, Manhas N, Yadav D, Gautam S, Kushwaha R, Singh A, Bhadauria D, Yachha M, Behera MR, Kaul A. Seroconversion Rate After SARS-CoV-2 Infection and Two Doses of Either ChAdOx1-nCOV COVISHIELD™ or BBV-152 COVAXIN™ Vaccination in Renal Allograft Recipients: An Experience of Two Public and Private Tertiary Care Center. Front Immunol 2022; 13:911738. [PMID: 35844596 PMCID: PMC9280041 DOI: 10.3389/fimmu.2022.911738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Accepted: 06/02/2022] [Indexed: 11/21/2022] Open
Abstract
Introduction Vaccination is an effective strategy for preventing SARS-CoV-2 infection and associated mortality. Renal Transplant Recipients (RTRs) are vulnerable to acquiring infection and high mortality due to their immunocompromised state. Varying responses to the different vaccines, depending on types of vaccines and population, have been reported. Vaccines supply is also limited. The current study evaluated the seroconversion rate after SARS-CoV-2 infection and 2 doses of either COVAXIN™ or COVISHIELD™ vaccination in RTR. Methods The serum anti-SARS-CoV-2 spike protein neutralizing antibody titer was measured in 370 RTRs who acquired SARS-CoV-2 infection (n=172), yet not vaccinated; and those vaccinated with COVAXIN™ (n=78), and COVISHIELD™ (n=120) by chemiluminescence microparticle immunoassay methods from serum. Result Overall, the seroconversion rate either after vaccination or infection was 85.13% (315/370). The vaccine-associated seroconversion was 80.30% (159/198). SARS-CoV-2 infection-associated seroconversion was 90.69% (156/172), COVISHIELD™ associated seroconversion was 79.2% (95/120), and COVAXIN™ associated seroconversion was 82.05% (64/78). The median IgG titer in the SARS-CoV-2 infection group was 646.50 AU/ml (IQR: 232.52-1717.42), in the COVAXIN™ group was 1449.75 AU/ml (IQR: 400.0-3068.55), and the COVISHIELD™ vaccination group was 1500.51 AU/ml (IQR: 379.47-4938.50). The seroconversion rate and antibody titers were similar irrespective of the place of sampling. Patient’s age-associated seroconversion in <45 years was 88.01% (213/242), 45.1-60 years was 83.18% (94/113), and > 60 years was 58.3% (7/12). Conclusions Both infection and vaccination induce robust antibody formation in RTRs. The seroconversion rate after SARS-CoV-2 infection was higher but with a lower antibody titer than vaccines. The vaccines, COVAXIN™ and COVISHIELD™, induce more elevated antibody titers than natural infection. The seroconversion rate and antibody titer in Indian RTRs appears to be better than in the western population, irrespective of their vaccination status.
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Affiliation(s)
- Narayan Prasad
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
- *Correspondence: Narayan Prasad,
| | | | - Brijesh Yadav
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Neha Manhas
- Medanta The Medicity Hospital, Gurgaon, India
| | - Deependra Yadav
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Sonam Gautam
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Ravishankar Kushwaha
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Ankita Singh
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Dharmendra Bhadauria
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Monika Yachha
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Manas Ranjan Behera
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Anupama Kaul
- Department of Nephrology and Renal Transplantation, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Rama Raj P, Adler PA, Chalasani R, Wan SL. Acute Unilateral Central Serous Chorioretinopathy after Immunization with Pfizer-BioNTech COVID-19 Vaccine: A Case Report and Literature Review. Semin Ophthalmol 2022; 37:690-698. [PMID: 35657058 DOI: 10.1080/08820538.2022.2082255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION A 43-year-old Caucasian male presented to our ophthalmology clinic with blurry vision and metamorphopsia in his right eye, 24 hours after receiving the first dose of the Pfizer-BioNTech COVID-19 vaccine. METHODS Clinical examination and imaging tests were consistent with acute unilateral central serous chorioretinopathy (CSCR) that completely resolved after 2 months without any treatment. He had no significant ophthalmic or medical history. He also lacked the classical risk factors for CSCR such as recent psychosocial stressors, Type-A personality traits, history of exogenous steroid use, connective tissue disorders and obstructive sleep apnea. RESULTS This appears to be only the second reported case of CSCR, temporally associated with a recombinant COVID-19 mRNA vaccine. We also present a summary of published reports demonstrating intraocular complications associated with the novel recombinant COVID-19 mRNA vaccines. CONCLUSION Findings in this report should not deter COVID-19 vaccinations given the rarity of aforementioned ocular complications and the greater benefit of protection from COVID-19 infection. Medical practitioners, however, should remain mindful of potential ocular complications, given the greater likelihood of occurrence with increasing vaccination booster rates.
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Affiliation(s)
- Palaniraj Rama Raj
- Department of Ophthalmology, Parke Street Specialist Centre, Katoomba, NSW, Australia.,Discipline of Clinical Ophthalmology and Eye Health/Save Sight Institute, The University of Sydney, Sydney, NSW, Australia
| | - Paul A Adler
- Department of Ophthalmology, Parke Street Specialist Centre, Katoomba, NSW, Australia
| | - Rajeev Chalasani
- Department of Ophthalmology, Parke Street Specialist Centre, Katoomba, NSW, Australia
| | - Sue Ling Wan
- Department of Ophthalmology, Parke Street Specialist Centre, Katoomba, NSW, Australia
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Beyond GWAS-Could Genetic Differentiation within the Allograft Rejection Pathway Shape Natural Immunity to COVID-19? Int J Mol Sci 2022; 23:ijms23116272. [PMID: 35682950 PMCID: PMC9181155 DOI: 10.3390/ijms23116272] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/26/2022] [Accepted: 05/30/2022] [Indexed: 01/25/2023] Open
Abstract
COVID-19 infections pose a serious global health concern so it is crucial to identify the biomarkers for the susceptibility to and resistance against this disease that could help in a rapid risk assessment and reliable decisions being made on patients' treatment and their potential hospitalisation. Several studies investigated the factors associated with severe COVID-19 outcomes that can be either environmental, population based, or genetic. It was demonstrated that the genetics of the host plays an important role in the various immune responses and, therefore, there are different clinical presentations of COVID-19 infection. In this study, we aimed to use variant descriptive statistics from GWAS (Genome-Wide Association Study) and variant genomic annotations to identify metabolic pathways that are associated with a severe COVID-19 infection as well as pathways related to resistance to COVID-19. For this purpose, we applied a custom-designed mixed linear model implemented into custom-written software. Our analysis of more than 12.5 million SNPs did not indicate any pathway that was significant for a severe COVID-19 infection. However, the Allograft rejection pathway (hsa05330) was significant (p = 0.01087) for resistance to the infection. The majority of the 27 SNP marking genes constituting the Allograft rejection pathway were located on chromosome 6 (19 SNPs) and the remainder were mapped to chromosomes 2, 3, 10, 12, 20, and X. This pathway comprises several immune system components crucial for the self versus non-self recognition, but also the components of antiviral immunity. Our study demonstrated that not only single variants are important for resistance to COVID-19, but also the cumulative impact of several SNPs within the same pathway matters.
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Rallis KI, Ting DSJ, Said DG, Dua HS. Corneal graft rejection following COVID-19 vaccine. Eye (Lond) 2022; 36:1319-1320. [PMID: 34426655 PMCID: PMC8380858 DOI: 10.1038/s41433-021-01671-2] [Citation(s) in RCA: 31] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2021] [Revised: 06/22/2021] [Accepted: 06/23/2021] [Indexed: 11/18/2022] Open
Affiliation(s)
- Konstantinos I. Rallis
- grid.415598.40000 0004 0641 4263Department of Ophthalmology, Queen’s Medical Centre, Nottingham, UK
| | - Darren S. J. Ting
- grid.415598.40000 0004 0641 4263Department of Ophthalmology, Queen’s Medical Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
| | - Dalia G. Said
- grid.415598.40000 0004 0641 4263Department of Ophthalmology, Queen’s Medical Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK ,grid.419139.70000 0001 0529 3322Research Institute of Ophthalmology, Cairo, Egypt
| | - Harminder S. Dua
- grid.415598.40000 0004 0641 4263Department of Ophthalmology, Queen’s Medical Centre, Nottingham, UK ,grid.4563.40000 0004 1936 8868Academic Ophthalmology, Division of Clinical Neuroscience, School of Medicine, University of Nottingham, Nottingham, UK
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Lee EH, Li JY. Immunization-Associated Corneal Transplantation Rejection: A Review. Cornea 2022; 41:660-663. [PMID: 34629440 DOI: 10.1097/ico.0000000000002898] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 08/24/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE The purpose of this review was to examine and characterize the available literature regarding immunization-associated corneal graft rejection. METHODS A Literature search was conducted using PubMed keywords relevant to corneal transplantation, graft rejection, and immunization to find relevant publications through July 2021. Nine studies were included in this review. Data including patient demographics, type of transplant, chronology of disease, type of immunization, treatment, and outcomes were evaluated. RESULTS Twenty-three cases of corneal graft rejection associated temporally with immunizations have been described in the literature. Most of these patients were female, and most commonly had received the influenza vaccine before the rejection episode. Most episodes resulted in graft preservation with intensive corticosteroid therapy. CONCLUSIONS Immunization-associated corneal graft rejection is a rare but likely underreported phenomenon. Patients and surgeons should be aware of this possible risk, although the evidence is inconclusive. Conclusions are limited because of the small sample size and the retrospective nature of all existing literature on this subject. Surgeons should be encouraged to document and report these episodes.
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Affiliation(s)
- Edward H Lee
- Department of Ophthalmology and Vision Science, University of California, Davis, Sacramento CA
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Tomkins-Netzer O, Sar S, Barnett-Griness O, Friedman B, Shyriaieva H, Saliba W. Association between vaccination with the BNT162b2 mRNA COVID-19 vaccine and non-infectious uveitis: a population-based study. Ophthalmology 2022; 129:1087-1095. [PMID: 35643168 PMCID: PMC9132378 DOI: 10.1016/j.ophtha.2022.05.015] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 12/22/2022] Open
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Molero-Senosiain M, Houben I, Savant S, Savant V. Five Cases of Corneal Graft Rejection After Recent COVID-19 Vaccinations and a Review of the Literature. Cornea 2022; 41:669-672. [PMID: 35383622 DOI: 10.1097/ico.0000000000002980] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 11/30/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to report 5 cases of acute corneal graft rejection after COVID-19 vaccination and perform a review of the literature. METHODS This was a case series and review of literature dated on the October 10, 2021. RESULTS We describe 5 cases-2 patients with Descemet stripping automated endothelial keratoplasty (for Fuchs endothelial dystrophy) who presented with acute corneal graft rejection after their first dose of mRNA (BNT162) vaccine. The other 3 patients who had penetrating keratoplasty performed more than 10 years ago for keratoconus presented with acute graft rejection-2 patients after their second dose of adenovirus vector (AZD1222) vaccine and 1 patient after first dose of mRNA (BNT162) vaccine. Three patients were not using any topical steroid treatment at the time of diagnosis of graft rejection. The mean duration between vaccination and onset of symptoms was 16.86 ± 6.96 days for the mRNA vaccine and 17 ± 11.89 days for the adenovirus vector vaccine. CONCLUSIONS Corneal graft rejection has recently been reported after COVID-19 vaccination. Patients with keratoplasty need to be advised regarding the risk of corneal graft rejection and warning symptoms of rejection after COVID-19 vaccination. Seeking early referral to the emergency department and increasing topical steroids pre-COVID-19 and post-COVID-19 vaccination may reduce the risk of rejection.
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Affiliation(s)
| | | | | | - Vijay Savant
- University Hospitals of Leicester, United Kingdom; and
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Gouvea L, Slomovic AR, Chan CC. "Smoldering" Rejection of Keratolimbal Allograft. Cornea 2022; 41:651-653. [PMID: 35383621 DOI: 10.1097/ico.0000000000002978] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Accepted: 11/29/2021] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of this study was to report a case of "smoldering" keratolimbal allograft (KLAL) rejection in a patient with subtherapeutic levels of systemic immunosuppression in temporal association with BNT162b2 messenger RNA vaccination for severe acute respiratory syndrome coronavirus 2. METHODS This was a case report. OBSERVATIONS A 72-year-old man presented with circumferential perilimbal engorgement, stagnation, and tortuosity of vessels with mild chemosis in his right eye KLAL segments 1 month after receiving the BNT162b2 messenger RNA vaccine while his tacrolimus trough blood levels were subtherapeutic measuring <2 ng/mL. He had undergone KLAL 6.5 years before for total limbal stem cell deficiency from a chemical injury and had been stable without any history of rejection. The donor was blood type O, and the patient had no systemic comorbidities. The patient was treated with hourly difluprednate 0.05% and increasing of his oral tacrolimus dose to 2 mg twice a day with improvement of rejection signs. CONCLUSIONS There may be a temporal association between KLAL rejection after immunization against severe acute respiratory syndrome coronavirus 2 in patients with subtherapeutic levels of systemic immunosuppression. Patients should be on alert for any ocular signs or symptoms postimmunization and present for treatment immediately.
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Affiliation(s)
- Larissa Gouvea
- Department of Ophthalmology Vision Sciences, University of Toronto, Toronto, ON, Canada
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Ryu KJ, Kim DH. Recurrence of Varicella-Zoster Virus Keratitis After SARS-CoV-2 Vaccination. Cornea 2022; 41:649-650. [PMID: 35383620 DOI: 10.1097/ico.0000000000002999] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Accepted: 12/26/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to report a case of acute exacerbation in varicella-zoster virus (VZV) keratitis after SARS-CoV-2 vaccination. METHODS An 87-year-old man, with a history of herpes zoster ophthalmicus 10 years ago, was referred for sudden visual impairment in his left eye that started 2 days after his second dose of SARS-CoV-2 mRNA vaccine BNT162b2. RESULTS At presentation, his visual acuity was hand motion. Slitlamp examination revealed diffuse corneal stromal edema and nasal stromal infiltration. After treatment for 2 weeks with oral valacyclovir and topical corticosteroids, the problematic lesion was recovered and his visual acuity was restored to 20/30. CONCLUSIONS We believe that this is the first report of possible association between recurrence of VZV keratitis and SARS-CoV-2 vaccination. We believe that T-cell activation by the host response after vaccination may affect the recurrence of VZV keratitis. Physicians should be aware of the potential of recurrence of VZV keratitis associated with the SARS-CoV-2 messenger RNA vaccine.
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Affiliation(s)
- Kyung Jae Ryu
- Department of Ophthalmology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea
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Mahendradas P, Mishra SB, Mangla R, Sanjay S, Kawali A, Shetty R, Dharmanand B. Reactivation of juvenile idiopathic arthritis associated uveitis with posterior segment manifestations following anti-SARS-CoV-2 vaccination. J Ophthalmic Inflamm Infect 2022; 12:15. [PMID: 35476156 PMCID: PMC9043884 DOI: 10.1186/s12348-022-00294-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2021] [Accepted: 04/07/2022] [Indexed: 11/17/2022] Open
Abstract
Background/purpose Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in the pediatric population and anterior uveitis is its commonest extra-articular manifestation. Typically the uveitis presents as chronic anterior uveitis and there is limited literature of the posterior segment manifestations of the disease. Similar to other vaccines, anti-SARS-CoV-2 vaccination that began as an urgent measure to control the spread of the SARS-CoV-2 pandemic has not been without adverse events. We are reporting a 19-year-old Asian Indian female who was diagnosed and treated for JIA associated anterior uveitis that was unilateral and was under anti-inflammatory control but showed worsening of uveitis with posterior segment inflammation in both eyes following anti-SARS-CoV-2 vaccination. Case report A 19-year-old Asian Indian female with a history of juvenile idiopathic arthritis on treatment with methotrexate, presented with right eye chronic anterior uveitis with peripheral subclinical retinal vasculitis and macular edema which was brought under control following administration of adalimumab. She was inflammation free for 6 months until she received anti-SARS-CoV-2 vaccination and developed new onset floaters in both eyes that were initially noted after the first dose and increased after the second dose. Clinical examination revealed presence of keratic precipitates and grade 1+ anterior chamber inflammation along with vitiritis in both eyes. Fundus fluorescein angiography revealed angiographically active retinal vasculitis without the presence of macular edema in both eyes. This was managed with a short course of topical difluprednate and continuation of systemic immunosuppressive therapy with adalimumab and methotrexate. Conclusion JIA associated uveitis results from an autoimmune process which can be controlled with timely immunosuppressive treatment. It is important to be aware of the potential risk of flare up of uveitis with posterior segment manifestations following anti- SARS-CoV-2 vaccination.
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Affiliation(s)
| | - Sai Bhakti Mishra
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Rubble Mangla
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Srinivasan Sanjay
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Ankush Kawali
- Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bangalore, India
| | - Rohit Shetty
- Department of Cornea and Refractive Surgery, Narayana Nethralaya, Bangalore, India
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Momenaei B, Cheraqpour K, Soleimani M, Tabatabaei SA, Shahriari M, Etesali H, Hussein A, Vaseghi Y, Ramezani B, Djalilian AR. Ophthalmic side effects of COVID-19 vaccines. EXPERT REVIEW OF OPHTHALMOLOGY 2022. [DOI: 10.1080/17469899.2022.2066523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Bita Momenaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Kasra Cheraqpour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Soleimani
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Seyed Ali Tabatabaei
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Mansoor Shahriari
- Imam Hossein Medical Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hamed Etesali
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmed Hussein
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
| | - Yasaman Vaseghi
- School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Ramezani
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Ali R Djalilian
- Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, Illinois, USA
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