Intraocular inflammation following COVID-19 vaccination: the clinical presentations

Int Ophthalmol. 2023 Aug;43(8):2971-2981. doi: 10.1007/s10792-023-02684-4. Epub 2023 Mar 31.

Abstract

Purpose: The purpose of the study was to describe the cases of intraocular inflammation following COVID-19 vaccination (Comirnaty mRNA vaccine and CoronaVac vaccine) in Hong Kong.

Methods: This was a retrospective case series.

Results: This series includes 16 eyes among 10 female patients, with a mean age of 49.4 ± 17.4 years. Eight patients (80%) received the Pfizer-BioNTech mRNA vaccination. Anterior uveitis was the most common presentation of postvaccination uveitis (50%) observed in our series, followed by intermediate uveitis (30%) and posterior uveitis (20%), respectively. A case of retinal vasculitis in the form of frosted branch angiitis, previously only reported following COVID-19 infection, was observed following COVID-19 vaccination. The median time from vaccination to uveitis onset was 15.2 days (range: 0-6 weeks). Inflammation in 11 out 16 eyes (68.75%) was completely resolved with topical steroids.

Conclusion: Anterior uveitis was the predominant presentations of uveitis flare-ups following COVID-19 in our case series, followed by intermediate uveitis. Aligning with the current global literature concerning this issue, most of the uveitis attacks presented as anterior uveitis and were completely resolved with topical steroids. Consequently, the risk of uveitis flare-ups should not deter the public from receiving COVID-19 vaccines.

Keywords: BioNTech mRNA vaccine; COVID-19 vaccines; CoronaVac vaccine; Ocular inflammation; Postvaccination uveitis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • COVID-19 Vaccines / adverse effects
  • COVID-19* / prevention & control
  • Female
  • Humans
  • Inflammation / etiology
  • Middle Aged
  • Retrospective Studies
  • Uveitis* / diagnosis
  • Uveitis* / etiology
  • Uveitis, Anterior* / diagnosis
  • Uveitis, Anterior* / etiology
  • Uveitis, Intermediate*
  • Vaccination / adverse effects

Substances

  • sinovac COVID-19 vaccine
  • COVID-19 Vaccines