COVID-19 Vaccination and Uveitis: Epidemiology, Clinical Features and Visual Prognosis

Ferrand, Nawfel; Accorinti, Massimo; Agarwal, Mamta; Spartalis, Christoph; Manni, Priscilla; Stuebiger, Nicole; Zierhut, Manfred

doi:10.1080/09273948.2022.2058964

Cited by 15 publications

(28 citation statements)

References 38 publications

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“…Findings of this study extend our understanding of the possible association between COVID-19 vaccination and onset of uveitis flares [ [8] , [9] , [10] , [11] ], particularly with regard to potential host factors that could modify the relationship. The precise mechanism of vaccine-associated uveitis remains unclear in most patients but is recognized to be closely linked to overactive host immune responses or inflammatory processes that may similarly occur in the development of autoimmune or autoinflammatory conditions [ 19 , 20 ].…”

Section: Discussionsupporting

confidence: 52%

“…Uveitis is a vision-threatening inflammatory condition, often associated with a variety of autoimmune or autoinflammatory diseases, such as ankylosing spondylitis, juvenile idiopathic arthritis, Behçet's disease, inflammatory bowel disease, psoriasis, systemic lupus erythematosus and sarcoidosis [ 12 ]. Although the causal link has not yet been confirmed, certain findings were consistent across these reports suggesting the close temporal association between COVID-19 vaccination and uveitis flares [ [8] , [9] , [10] , 13 ]. Nevertheless, uveitis flares following COVID-19 vaccination appear to be an unusual event, which was estimated to occur merely in 0.9 cases per million doses or less varied by vaccine types [ 13 ].…”

Section: Introductionmentioning

confidence: 64%

“…In this study, the event of interest was uveitis relapse occurring after the administration of any dose of COVID-19 vaccine within 30 days. The 30-day observation window was chosen based on published studies [ [8] , [9] , [10] ], beyond which the relapse was considered unlikely to be related to COVID-19 vaccination. We determined each participant's status of having or not having uveitis relapse at enrollment and collected their vaccination history as well as other demographic and historical clinical factors.…”

Section: Methodsmentioning

confidence: 99%

“…Results of several case reports, case series or cohorts described the newly active or worsening uveitis after inoculation with various COVID-19 vaccines worldwide [ [5] , [6] , [7] , [8] , [9] , [10] , [11] ]. Uveitis is a vision-threatening inflammatory condition, often associated with a variety of autoimmune or autoinflammatory diseases, such as ankylosing spondylitis, juvenile idiopathic arthritis, Behçet's disease, inflammatory bowel disease, psoriasis, systemic lupus erythematosus and sarcoidosis [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Risk for uveitis relapse after COVID-19 vaccination

Zhong¹,

Wu²,

Lai³

et al. 2022

Journal of Autoimmunity

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Section: Discussionsupporting

confidence: 52%

Section: Introductionmentioning

confidence: 64%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Risk for uveitis relapse after COVID-19 vaccination

Zhong¹,

Wu²,

Lai³

et al. 2022

Journal of Autoimmunity

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“…The most common associations are with the Hepatitis B vaccine, but also HPV vaccine, influenza vaccine, BCG, MMR, and varicella vaccine ( 68 – 70 ). Recently, transient uveitis has been described following COVID-19 vaccination with no significant impact on visual outcome ( 71 ). A causal link is still debated, and these side-effects of vaccines should not modify the general vaccine calendar.…”

Section: Non-infectious Uveitismentioning

confidence: 99%

Pediatric uveitis: Role of the pediatrician

et al. 2022

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The challenges of childhood uveitis lie in the varied spectrum of its clinical presentation, the often asymptomatic nature of disease, and the evolving nature of the phenotype alongside normal physiological development. These issues can lead to delayed diagnosis which can cause significant morbidity and severe visual impairment. The most common ocular complications include cataracts, band keratopathy, glaucoma, and macular oedema, and the various associated systemic disorders can also result in extra-ophthalmic morbidity. Pediatricians have an important role to play. Their awareness of the various presentations and etiologies of uveitis in children afford the opportunity of prompt diagnosis before complications arise. Juvenile Idiopathic Arthritis (JIA) is one of the most common associated disorders seen in childhood uveitis, but there is a need to recognize other causes. In this review, different causes of uveitis are explored, including infections, autoimmune and autoinflammatory disease. As treatment is often informed by etiology, pediatricians can ensure early ophthalmological referral for children with inflammatory disease at risk of uveitis and can support management decisions for children with uveitis and possible underling multi-system inflammatory disease, thus reducing the risk of the development of irreversible sequelae.

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Early vs Deferred Non–Messenger RNA COVID-19 Vaccination Among Chinese Patients With a History of Inactive Uveitis

Zhong

Lai

et al. 2023

JAMA Netw Open

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ImportanceImproper host response to COVID-19 vaccines could trigger immune-mediated adverse events. The question remains whether COVID-19 vaccination should be postponed until complete remission in patients with uveitis, a preexisting immune-related condition.ObjectiveTo compare recommendations for early and deferred COVID-19 vaccination with respect to uveitis outcomes.Design, Setting, and ParticipantsThis open-label, randomized clinical trial at a large, specialized teaching center for uveitis care in China enrolled unvaccinated patients with inactive uveitis between August 10, 2021, and February 22, 2022, with follow-up to June 6, 2022.InterventionsParticipants were randomly assigned to receive recommendation for early or deferred COVID-19 vaccination after complete remission of uveitis. Non–messenger RNA (non-mRNA) COVID-19 vaccines were available in China during the trial.Main Outcomes and MeasuresThe primary outcome was the time to symptomatic uveitis worsening during 3 months of follow-up. Secondary outcomes included uveitis activity and best-corrected visual acuity at 3 months.ResultsOf the 543 participants (304 women [56.0%]; median age, 35 [IQR, 26-49] years), 262 were recommended for early vaccination and 281 for deferred vaccination. By month 3, 109 patients (41.6%) in the early group had been vaccinated compared with 14 (5.0%) in the deferred recommendation group. In the intention-to-treat population, the time to symptomatic uveitis worsening was shorter in the early group than in the deferred group (hazard ratio, 1.68 [95% CI, 1.09-2.59]; P = .01 by log-rank test). Changes in anterior chamber cells, vitreous haze, and best-corrected visual acuity from baseline to month 3 appeared similar in the 2 groups in the evaluable population after the month 3 in-person visit.Conclusions and RelevanceIn this randomized clinical trial of patients with inactive uveitis, recommendation for early non-mRNA COVID-19 vaccination resulted in a higher incidence of self-reported symptomatic uveitis worsening with possible reporting bias compared with recommendation for deferred vaccination, but no adverse effects were observed in disease and visual prognosis at 3 months. These findings would be useful to guide the individual timing choices of non-mRNA COVID-19 vaccination in this clinically vulnerable population.Trial RegistrationChinese Clinical Trial Registry: ChiCTR2100049467

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COVID-19 Vaccination and Uveitis: Epidemiology, Clinical Features and Visual Prognosis

Cited by 15 publications

References 38 publications

Risk for uveitis relapse after COVID-19 vaccination

Risk for uveitis relapse after COVID-19 vaccination

Pediatric uveitis: Role of the pediatrician

Early vs Deferred Non–Messenger RNA COVID-19 Vaccination Among Chinese Patients With a History of Inactive Uveitis

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