ABSTRACT
A 36-year-old Asian Indian male presented with redness and pain in his right eye of 1 week duration. He was diagnosed to have right acute anterior uveitis and had a history of being admitted at a local hospital for dengue hepatitis a month earlier. He had been on adalimumab 40 mg three weekly once and oral methotrexate 20 mg/week for human leucocyte antigen (HLA) B27 spondyloarthropathy and recurrent anterior uveitis. Our patient had re-activation of his anterior chamber inflammation on three distinct occasions: first, 3 weeks following recovery from coronavirus disease 2019 (COVID-19), the second after the second dose of COVID-19 vaccination, and the third after recovery from dengue fever-associated hepatitis. We propose molecular mimicry and bystander activation as the postulated mechanisms for the re-activation of his anterior uveitis. In conclusion, patients with auto-immune diseases can have recurrent ocular inflammation following COVID-19 or its vaccination or dengue fever as seen in our patient. The anterior uveitis is usually mild and responds to topical steroids. Additional immuno-suppression may not be needed. Mild ocular inflammation following vaccination should not deter individuals from getting COVID-19 vaccination.
Subject(s)
COVID-19 , Dengue , Hepatitis A , Hepatitis , Uveitis, Anterior , Uveitis , Humans , Male , Adult , COVID-19 Vaccines/adverse effects , Uveitis, Anterior/diagnosis , Uveitis, Anterior/etiology , Inflammation , HLA-B27 Antigen , Vaccination/adverse effects , Dengue/complications , Dengue/diagnosisABSTRACT
A 35-year-old Asian Indian female previously diagnosed with bilateral anterior uveitis and on oral methotrexate developed bilateral anterior uveitis following first/second dose of coronavirus disease 2019 (COVID-19) vaccination. She had skipped her weekly dose of oral methotrexate following first dose of vaccination. Following the second dose, she reduced her oral methotrexate from 25 to 15 mg on her own, but did not stop like the previous occasion. She had extensive workup for her uveitis in the past with only positive severe acute respiratory syndrome coronavirus (SARS-CoV-2) antibodies. She developed unilateral anterior uveitis after she had COVID-19 in July 2022, which resolved with topical steroids and continuation of immunosuppression. This report illustrates that COVID-19 or its vaccination may presumably play a role in triggering the immune system and can cause recurrent ocular inflammation even in the absence of an extraocular inflammation.
Subject(s)
COVID-19 , Uveitis, Anterior , Female , Humans , Adult , SARS-CoV-2 , COVID-19 Vaccines/adverse effects , Methotrexate , Uveitis, Anterior/diagnosis , Uveitis, Anterior/drug therapy , Uveitis, Anterior/etiology , Vaccination/adverse effects , Acute Disease , InflammationABSTRACT
PURPOSE: To describe two cases of herpetic anterior uveitis after inoculation of the first dose of Pfizer-BioNTech coronavirus disease 2019 vaccine. METHODS: Case 1: a healthy 92-year-old Caucasian woman developed symptomatic unilateral anterior uveitis for 3 days after Pfizer-BioNTech coronavirus disease 2019 vaccination (Pfizer Inc.). The episode fully resolved with topical and oral antiviral treatment. Case 2: a previously healthy 85-year-old Caucasian woman with left hemicranial signs of herpes zoster infection, associated with herpetic keratouveitis for 3 days after Pfizer-BioNTech coronavirus disease 2019 vaccination. Treatment with topical antibiotics and both oral and topical antiherpetic medication was administered, and she recovered successfully in 5 weeks. CONCLUSION: Clinicians should be aware of the possibility of eye inflammation in the form of herpetic reactivation after coronavirus disease 2019 vaccination.
Subject(s)
COVID-19 , Herpes Zoster , Uveitis, Anterior , Uveitis , Aged, 80 and over , COVID-19 Vaccines/adverse effects , Female , Herpes Zoster/complications , Humans , Uveitis, Anterior/diagnosis , Uveitis, Anterior/drug therapy , Uveitis, Anterior/etiologyABSTRACT
PURPOSE: COVID-19 vaccines are currently undergoing long-term safety monitoring, including for ocular side effects. Uveitis following vaccination has been described previously with other vaccines and warrants evaluation for COVID-19 vaccines, especially given their widespread use. CASE REPORTS: We present two cases of patients who developed anterior uveitis following the Moderna COVID-19 vaccine, as reported to the National Registry for Drug-Induced Ocular Side Effects. We also summarize reports of anterior uveitis following COVID-19 vaccination as reported to the World Health Organization global database of individual case safety reports. CONCLUSIONS: Based on the temporal pattern of ocular inflammation following vaccine delivery in these cases, an association may be present between uveitis and COVID-19 vaccination. Further investigation to explore this association is warranted to guide patient care.
Subject(s)
COVID-19 Vaccines , COVID-19 , Uveitis, Anterior , Uveitis , Vaccines , Humans , 2019-nCoV Vaccine mRNA-1273 , COVID-19/epidemiology , COVID-19/prevention & control , COVID-19 Vaccines/adverse effects , Uveitis/etiology , Uveitis, Anterior/chemically induced , Uveitis, Anterior/etiology , Vaccination/adverse effects , Vaccines/adverse effectsABSTRACT
PURPOSE: To describe a case of juvenile idiopathic arthritis (JIA)-associated anterior uveitis after receiving the Sinopharm COVID-19 vaccine. METHODS: A retrospective case report. RESULTS: An 18-year-old girl, with a history of antinuclear antibody positive oligoarticular JIA, presented with bilateral anterior uveitis 5 days after the second dose of the Sinopharm COVID-19 vaccine. Ocular examination revealed anterior uveitis with reduced visual acuity in both eyes. Anterior segment optical coherence tomography showed hyperreflective dots in the anterior chamber (AC) and fine endothelial granularities representing the circulating cells in the AC. Uveitis in both eyes resolved gradually after topical steroid treatment without recurrence. CONCLUSION: This report demonstrates a potential causal association of COVID-19 vaccine with anterior uveitis.
Subject(s)
COVID-19 Vaccines/adverse effects , COVID-19/prevention & control , SARS-CoV-2 , Uveitis, Anterior/etiology , Vaccination/adverse effects , Acute Disease , Administration, Ophthalmic , Adolescent , Female , Glucocorticoids/administration & dosage , Humans , Ophthalmic Solutions , Retrospective Studies , Tomography, Optical Coherence , Uveitis, Anterior/diagnosis , Uveitis, Anterior/drug therapy , Visual Acuity/physiologyABSTRACT
Purpose: To report bilateral anterior uveitis and corneal punctate epitheliopathy in children with multisystem inflammatory syndrome (MIS-C) secondary to coronavirus disease (COVID-19).Participants and methods: Five patients who were positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies and diagnosed with MIS-C were evaluated. Ophthalmologic examinations were performed in order to reveal ocular findings in MIS-C disease.Results: Slit lamp examinations showed bilateral non-granulomatous acute anterior uveitis in all patients and severe corneal punctuate epitheliopathy in three of the patients. These ocular findings mostly disappeared with treatment in about one week.Conclusion: Bilateral non-granulomatous acute anterior uveitis and dry eye can be detected in patients diagnosed with MIS-C secondary to COVID-19. Even if generally, COVID-19 is not a life threatening disease in children by itself, inflammatory ocular manifestations can be detected in MIS-C secondary to COVID-19.