Case Report: Posterior Uveitis after Divalent Human Papillomavirus Vaccination in an Asian Female

Abstract

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.

Acute reduction of visual acuity and visual field after Pfizer-BioNTech COVID-19 vaccine 2nd dose: a case report

“…Interestingly, most of the cases of vaccine-induced uveitis are related to the Hepatitis B vaccine, which contains the HepB surface antigen, inserted into yeast cells using recombinant DNA technology [5]. In addition, a case of posterior uveitis [6] and a case of pan-uveitis with posterior retinal detachment [7] following HPV vaccination were recently described.…”

Probable Vogt–Koyanagi–Harada Disease after COVID-19 Vaccination: Case Report and Literature Review

“…With the pandemic of SARS-CoV-2 in recent years, COVID-19 infection has also been reported as a stimulator of VKH disease [ 17 , 18 ]. It is worth noting that the intense relationship between VKH disease and diversified vaccines has been more commonly recorded, including for vaccines against Bacillus Calmette-Guerin (BCG), yellow fever, hepatitis B, papillomavirus, and COVID-19 [ 16 , 19 , 20 , 21 , 22 ].…”

Resolution of Harada disease-like uveitis after quadrivalent human papillomavirus vaccination: a case report

“…This patient was treated with oral prednisone, as well as Ozurdex intravitreal injection. 10 These patients developed acute uveitis after HPV vaccination and showed serious symptoms without a tendency toward improvement; thus, they were treated with a relatively long-term administration of oral prednisone.…”