Ocular inflammatory events following COVID-19 vaccination: a multinational case series
Ilaria Testi, Camilo Brandão‐de‐Resende, Rupesh Agrawal, Carlos Pavésio, for the COVID-19 Vaccination Ocular Inflammatory Events Study Group, Laura R Steeples, Balini Balasubramaniam, Peter McCluskey, Francesco Pichi, Aniruddha Agarwal, Carl P. Herbort, Luca Cimino, Salam Iriqat, Jennifer E. Thorne, J Carnero Echegaray, Kalpana Babu, A. Bialasiewicz, Debra A. Goldstein, Nima Ghadiri, Alex Fonollosa Calduch, Gabriel Costa de Andrade, Padmamalini Mahendradas, J.J. González‐López, Ester Carreño, Rola N. Hamam, Nicole Stübiger, Bahram Bodaghi, Yu-Jang Chao, Masaru Takeuchi, Mei‐Ling Tay‐Kearney, Alejandro Portero, Hiroshi Keino, Mar Esteban-Ortega, Joanna Przeździecka-Dołyk, Aleksandra Radosavljević, I. Gonzalez Paredes, Rupesh Agrawal, Ho Su Ling, Wei Kiong, Melissa Chih-Hui Tien, Xin Le Ng, Carlos Pavésio, Ilaria Testi, Soon‐Phaik Chee, Jay Siak, Inés Hernanz-Rodríguez, Víctor Menezo, Christoph Tappeiner, Franz Marie Cruz, P H Addison, Robert W. A. M. Kuijpers, Daniel V. Vasconcelos-Santos
Abstract
BACKGROUND: Inflammatory adverse events following COVID-19 vaccination are being reported amidst the growing concerns regarding vaccine's immunogenicity and safety, especially in patients with pre-existing inflammatory conditions. METHODS: Multinational case series of patients diagnosed with an ocular inflammatory event within 14 days following COVID-19 vaccination collected from 40 centres over a 3 month period in 2021. RESULTS: Seventy patients presented with ocular inflammatory events within 14 days following COVID-19 vaccination. The mean age was 51 years (range, 19-84 years). The most common events were anterior uveitis (n = 41, 58.6%), followed by posterior uveitis (n = 9, 12.9%) and scleritis (n = 7, 10.0%). The mean time to event was 5 days and 6 days (range, 1-14 days) after the first and second dose of vaccine, respectively. Among all patients, 36 (54.1%) had a previous history of ocular inflammatory event. Most patients (n = 48, 68.6%) were managed with topical corticosteroids. Final vision was not affected in 65 (92.9%), whereas 2 (2.9%) and 3 (4.3%) had reduction in visual acuity reduced by ≤3 lines and > 3 lines, respectively. Reported complications included nummular corneal lesions (n = 1, 1.4%), cystoid macular oedema (n = 2, 2.9%) and macular scarring (n = 2, 2.9%). CONCLUSION: Ocular inflammatory events may occur after COVID-19 vaccination. The findings are based on a temporal association that does not prove causality. Even in the possibility of a causal association, most of the events were mild and had a good visual outcome.