Risk for uveitis relapse after COVID-19 vaccination

Zhong, Zhenyu; Wu, Qiuying; Lai, Yuxian; Dai, Lingyu; Gao, Yu Tang; Liao, Weiting; Xue, Feng; Yang, Peizeng

doi:10.1016/j.jaut.2022.102925

Cited by 8 publications

(13 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…This trial extends prior observations linking COVID-19 vaccination with an increased risk of newly active or worsening uveitis and in particular provides randomized evidence for such an effect. However, our findings suggest that COVID-19 vaccination might temporarily affect the symptoms but would not modify the disease and visual prognosis at 3 months.…”

Section: Discussionsupporting

confidence: 81%

“… 17 Nevertheless, observational studies indicated that COVID-19 vaccination was associated with an increased incidence of new-onset or relapse of uveitis. 18 , 19 , 20 , 21 Due to concerns about the potential worsening activity of uveitis, patient counseling on the appropriate timing of COVID-19 vaccination frequently occurs during patient-clinician encounters, particularly when a patient has achieved and maintained inactive disease with medication use. Guidance from clinicians would be expected to have an impact on public health, such as affecting the coverage of COVID-19 immunization, the course of population immunity, and the protection of special groups.…”

Section: Introductionmentioning

confidence: 99%

“…COVID-19 vaccination was found to provide some extent of protection against SARS-CoV-2 infection among individuals who were taking glucocorticoids and immunosuppressive agents . Nevertheless, observational studies indicated that COVID-19 vaccination was associated with an increased incidence of new-onset or relapse of uveitis . Due to concerns about the potential worsening activity of uveitis, patient counseling on the appropriate timing of COVID-19 vaccination frequently occurs during patient-clinician encounters, particularly when a patient has achieved and maintained inactive disease with medication use.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

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

Self Cite

View full text Add to dashboard Cite

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

show abstract

Section: Discussionsupporting

confidence: 81%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

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

Self Cite

View full text Add to dashboard Cite

show abstract

“…The median time to uveitis flare was 0.53 months after the first vaccination, 1.74 months after the second vaccination, and 1.35 months after the third vaccination 32 . Likewise, concomitant treatment with either systemic glucocorticoids [hazard ratio (HR) = 0.24 (95% CI = 0.09–0.69); P = 0.008] or cyclosporine [HR = 0.36 (95% CI = 0.14–0.93); P = 0.034] for uveitis at the time of COVID-19 vaccination was associated with a lower risk of uveitis relapse after vaccination 89 . However, in a randomized clinical trial conducted at a specialized uveitis centre in China, 543 unvaccinated patients with inactive uveitis were studied to assess early versus deferred non-mRNA COVID-19 vaccination recommendations.…”

Section: Uveitis-related To Coronavirus Disease 2019 Vaccinationmentioning

confidence: 99%

“…32 Likewise, concomitant treatment with either systemic glucocorticoids [hazard ratio (HR) = 0.24 (95% CI = 0.09-0.69); P = 0.008] or cyclosporine [HR = 0.36 (95% CI = 0.14-0.93); P = 0.034] for uveitis at the time of COVID-19 vaccination was associated with a lower risk of uveitis relapse after vaccination. 89 However, in a randomized clinical trial conducted at a specialized uveitis centre in China, 543 unvaccinated patients with inactive uveitis were studied to assess early versus deferred non-mRNA COVID-19 vaccination recommendations. By 3 months, 41.6% in the early vaccination group had been vaccinated compared with 5.0% in the deferred vaccination group.…”

Section: Uveitis-related To Coronavirus Disease 2019 Vaccinationmentioning

confidence: 99%

Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

Lin,

Sen,

Gupta

et al. 2023

Asia-Pacific Journal of Ophthalmology

View full text Add to dashboard Cite

The coronavirus disease 2019 (COVID-19) pandemic caused by the severe acute respiratory syndrome coronavirus 2 was one of the most devastating public health issues in recent decades. The ophthalmology community is as concerned about the COVID-19 pandemic as the global public health community is, as COVID-19 was recognized to affect multiple organs in the human body, including the eyes, early in the course of the outbreak. Ophthalmic manifestations of COVID-19 are highly variable and could range from mild ocular surface abnormalities to potentially sight and life-threatening orbital and neuro-ophthalmic diseases. Furthermore, ophthalmic manifestations may also be the presenting or the only findings in COVID-19 infections. Meanwhile, global vaccination campaigns to attain herd immunity in different populations are the major strategy to mitigate the pandemic. As novel vaccinations against COVID-19 emerged, so were reports on adverse ophthalmic reactions potentially related to such. As the world enters a post-pandemic state where COVID-19 continues to exist and evolve as an endemic globally, the ophthalmology community ought to be aware of and keep abreast of the latest knowledge of ophthalmic associations with COVID-19 and its vaccinations. This review is a summary of the latest literature on the ophthalmic manifestations of COVID-19 and the adverse ophthalmic reactions related to its vaccinations.

show abstract

Advances in Extracellular-Vesicles-Based Diagnostic and Therapeutic Approaches for Ocular Diseases

Su,

Chen,

et al. 2024

ACS Nano

View full text Add to dashboard Cite

Extracellular vesicles (EVs) are nanoscale membrane vesicles of various sizes that can be secreted by most cells. EVs contain a diverse array of cargo, including RNAs, lipids, proteins, and other molecules with functions of intercellular communication, immune modulation, and regulation of physiological and pathological processes. The biofluids in the eye, including tears, aqueous humor, and vitreous humor, are important sources for EV-based diagnosis of ocular disease. Because the molecular cargos may reflect the biology of their parental cells, EVs in these biofluids, as well as in the blood, have been recognized as promising candidates as biomarkers for early diagnosis of ocular disease. Moreover, EVs have also been used as therapeutics and targeted drug delivery nanocarriers in many ocular disorders because of their low immunogenicity and superior biocompatibility in nature. In this review, we provide an overview of the recent advances in the field of EV-based studies on the diagnosis and therapeutics of ocular disease. We summarized the origins of EVs applied in ocular disease, assessed different methods for EV isolation from ocular biofluid samples, highlighted bioengineering strategies of EVs as drug delivery systems, introduced the latest applications in the diagnosis and treatment of ocular disease, and presented their potential in the current clinical trials. Finally, we briefly discussed the challenges of EV-based studies in ocular disease and some issues of concern for better focusing on clinical translational studies of EVs in the future.

show abstract

Risk for uveitis relapse after COVID-19 vaccination

Cited by 8 publications

References 34 publications

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

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

Update on coronavirus disease 2019: Ophthalmic Manifestations and Adverse Reactions to Vaccination

Advances in Extracellular-Vesicles-Based Diagnostic and Therapeutic Approaches for Ocular Diseases

Contact Info

Product

Resources

About