SIGNIFICANCE
Vaccine-associated uveitis has appeared in recent years because of various vaccines, whereas cases for human papillomavirus (HPV) vaccination were rarely reported. With more and more females becoming aware of its importance and choosing HPV vaccination, much more attention should be paid on the adverse effects of it.
PURPOSE
The purpose of this study was to report a rare case of posterior uveitis after divalent HPV vaccination in an Asian female.
CASE REPORT
A 29-year-old woman presented with acute vision loss accompanied by symptoms of headache, tinnitus, and myalgia after the third injection of HPV vaccination. The best-corrected visual acuity dropped to 20/500 for both eyes, and optical coherence tomography revealed bilateral multifocal submacular fluid. A short course of oral prednisone as well as Ozurdex intravitreal injection resulted in the reversal of all signs and symptoms.
CONCLUSIONS
Although this case resembled Harada disease, we diagnosed it as vaccine-induced uveitis rather than coincidental autoimmune disease based on the rapid response to a short course of systemic corticosteroids. Because vaccine-induced uveitis is rare and difficult to distinguish from coincidental autoimmune disease, our case reminds eye care providers to be aware of the possible association between vaccination and a Harada-like reaction and to ask appropriately directed questions when obtaining history from young patients with uveitis. Based on this case, we also suggest Ozurdex intravitreal injection as a potential therapeutic choice, especially for patients with contraindication or personal concern to systemic corticosteroid.
Background:Laser in situ keratomileusis (LASIK) leads to inaccurate measurement of intraocular pressure (IOP). This study aimed to determine the efficacy and reliability of IOP measurement on the peripheral cornea after LASIK. Methods: The IOP was measured in 52 eyes of 26 subjects before LASIK and one week and one month after LASIK using non-contact tonometry. The measurements were made on the central and peripheral cornea and the results were subjected to statistical analysis. Results: The mean measured IOP on the central cornea was decreased by 6.425 Ϯ 2.544 mmHg at one week and 5.752 Ϯ 3.863 mmHg at one month post-operatively. The mean IOP measured on the peripheral cornea was decreased by only 0.921 Ϯ 2.054 mmHg at one week post-operatively. Most notably, the mean IOP measured on the peripheral cornea was increased by only 0.158 Ϯ 2.979 mmHg at one month post-operatively with no statistical significance (p > 0.05). Furthermore, a linear regression of ablation depth versus change in IOP measured on the central cornea was demonstrated, but the peripheral IOP did not display such a statistically significant correlation with the depth of ablation at both one week and one month after operation. Conclusion: The IOP measured on the peripheral cornea is closer to the actual IOP. Therefore, it is more accurate and reliable to measure IOP on the peripheral cornea than on the centre after LASIK.
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