Ophthalmological Considerations for COVID-19 Vaccination in Patients with Inflammatory Eye Diseases and Autoimmune Disorders

Chau, Charlene Yat Che; Chow, Loraine L. W.; Sridhar, Siddharth; Shih, Kendrick Co

doi:10.1007/s40123-021-00338-1

Cited by 24 publications

(22 citation statements)

References 62 publications

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“…Concerning the controversial debate on the possibility of inducing or enhancing the autoimmune response by means of molecular mimicry between the viral antigen and host antigen [22,23], as previously evidenced in hepatitis B vaccinations [24], in our study we evidenced a low rate (5.7%) of disease relapse of Au/cIn-RD after the first dose of vaccine, as previously reported for influenza vaccines [25][26][27]. The rate of RD flare-up observed after BioNTech-Pfizer vaccination could be due to the highest frequency of this vaccine administration, although no significant differences in AEs between BioNTech-Pfizer and AstraZeneca were found (Table 2).…”

Section: Discussionmentioning

confidence: 99%

Preliminary Data on Post Market Safety Profiles of COVID 19 Vaccines in Rheumatic Diseases: Assessments on Various Vaccines in Use, Different Rheumatic Disease Subtypes, and Immunosuppressive Therapies: A Two-Centers Study

Rotondo

Cantatore

Fornaro³

et al. 2021

Vaccines

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An increased risk of developing severe infections has been evidenced in rheumatic disease (RD) patients, and anti-COVID-19 vaccination is strictly recommended for RD patients. However, up to now, no data are available on safety, immunogenicity and efficacy of COVID-19 vaccinations in RD patients. The possible development of adverse events (AEs), including the flare-up of underlying RD, represents a matter of growing importance. The aim of our study is to assess, in RD patients, the safety profile of different types of approved vaccines and the possible influence of immunosuppressive therapies and clinical or demographic characteristics of RD patients on development of AEs. Participants (n = 185; 30.7%) received anti-COVID-19 vaccinations, 137 with autoimmune/chronic inflammatory RD (Au/cIn-RD) and 48 with nonautoimmune/chronic inflammatory RD (no-Au/cIn-RD). AEs were recorded in 42% of patients after the first dose of vaccine, and in 26% of patients after the second dose. The most common reported AEs after anti-COVID 19 vaccines were site injection pain (17%), headache (12%), fever (12%), myalgia (10%) and fatigue (10%). Relapses of the underlying Au/c-In-RD were recorded in 2.2% of patients after the first dose of vaccine. In Au/c-In-RD the risk of developing AEs after the first dose of vaccine was lower in older patients (OR = 0.95; p = 0.001), and in the group of patients with complete control of RD (OR: 0.2; p = 0.010). A lower percentage of AEs was observed in patients with complete control of their Au/cIn-RD (29%) compared to those with low (57%) or moderate-high disease activity (63%) (p = 0.002 and p = 0.006 respectively). In this study all types of COVID-19 vaccines in use in Italy seemed safe in RD patients. The results of this study might provide reassuring information for Au/cIn RD patients and clinicians and could strengthen the data on vaccine safety to guide the use of COVID-19 vaccines in Au/cIn-RD on immunosuppressive agents.

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Section: Discussionmentioning

confidence: 99%

Preliminary Data on Post Market Safety Profiles of COVID 19 Vaccines in Rheumatic Diseases: Assessments on Various Vaccines in Use, Different Rheumatic Disease Subtypes, and Immunosuppressive Therapies: A Two-Centers Study

Rotondo

Cantatore

Fornaro³

et al. 2021

Vaccines

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“…In contrast, various adverse effects have been reported with COVID-19 vaccine [ 2 , 3 ], but these events' specific mechanism and frequency have not been investigated thoroughly. A previous case of arteritic anterior ischemic optic neuropathy following COVID-19 vaccination was reported [ 10 ]; however, this is the first reported case of NA-AION which was temporally related to the COVID-19 vaccination in Japan.…”

Section: Discussionmentioning

confidence: 99%

“…Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the resulting coronavirus disease 2019 (COVID-19) pandemic hit the world by storm, and Japan was no exception. Currently, there has been a tremendous increase in reports of ophthalmic manifestations related with COVID-19 and its vaccination [ 1 – 3 ].…”

Section: Introductionmentioning

confidence: 99%

Nonarteritic Anterior Ischemic Optic Neuropathy following COVID-19 Vaccination: Consequence or Coincidence

Tsukii

Kasuya

Makino

2021

Case Reports in Ophthalmological Medicine

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To report a patient with nonarteritic anterior ischemic optic neuropathy (NA-AION) occurring soon after the COVID-19 vaccination. A 55-year-old woman presented with a 4-day history of inferior visual field disturbance in the right eye 7 days after receiving the first dose of Pfizer-BioNTech COVID-19 vaccine. Examination revealed a best-corrected visual acuity of 20/20 in both eyes. A relative afferent pupillary defect was observed in the right eye. Fundoscopy revealed diffuse optic disc swelling in the right eye, which was prominent above the optic disc. Goldmann visual field testing identified an inferior altitudinal visual field defect with I/2 isopter in the right eye. Although typical complete inferior visual field defect was not detected, a diagnosis of NA-AION was made. The patient was followed without any treatment. During the 2-month follow-up period, the optic disc swelling was gradually improved, and visual acuity was maintained 20/20; however, the optic disc looked diffusely pale in the right eye. Although it is uncertain whether the development of NA-AION after COVID-19 vaccination was consequential or coincidental, we speculate that the close temporal relationship with COVID-19 vaccination suggests the possibility of vasculopathy on the microvascular network of optic nerve head as background of inflammatory or immune-mediated element to the timing of the onset of NA-AION. The aim of this case report is to present this biological plausibility and to elucidate potential ophthalmological complications.

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“… 4 Others have postulated that the immunogenicity of COVID-19 vaccines could potentially induce ophthalmic antibody-dependent enhancement with ocular adverse effects. 5 As of this date, the Vaccine Adverse Event Reporting System (VAERS) has 285 instances of visual adverse events including vision blurred (178), visual impairment (91), visual field defect (15), and abnormal visual tracking test (1). 6…”

Section: Discussionmentioning

confidence: 99%

Acute macular neuroretinopathy following Pfizer-BioNTech COVID-19 vaccination

Valenzuela

Groth

Taubenslag

2021

American Journal of Ophthalmology Case Reports

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Purpose To describe a case of acute macular neuroretinopathy (AMN) in a patient immediately following administration of the Pfizer-BioNTech COVID-19 vaccine. Observations The patient complained of paracentral scotoma supported by paracentral visual field loss on multiple Humphrey visual fields that corresponded to outer retinal pathology on optical coherence tomography. The patient's symptoms resolved without treatment. Conclusions and Importance We conclude that the clinical testing demonstrated findings consistent with AMN. AMN may be an exceedingly rare adverse ocular effect of a novel vaccine and likely only in the setting of multiple other risk factors. Despite this, we strongly recommend vaccination against COVID-19.

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Ophthalmological Considerations for COVID-19 Vaccination in Patients with Inflammatory Eye Diseases and Autoimmune Disorders

Cited by 24 publications

References 62 publications

Preliminary Data on Post Market Safety Profiles of COVID 19 Vaccines in Rheumatic Diseases: Assessments on Various Vaccines in Use, Different Rheumatic Disease Subtypes, and Immunosuppressive Therapies: A Two-Centers Study

Preliminary Data on Post Market Safety Profiles of COVID 19 Vaccines in Rheumatic Diseases: Assessments on Various Vaccines in Use, Different Rheumatic Disease Subtypes, and Immunosuppressive Therapies: A Two-Centers Study

Nonarteritic Anterior Ischemic Optic Neuropathy following COVID-19 Vaccination: Consequence or Coincidence

Acute macular neuroretinopathy following Pfizer-BioNTech COVID-19 vaccination

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