The Characteristics of COVID-19 Vaccine-Associated Uveitis: A Summative Systematic Review

Abstract

Numerous complications following COVID-19 vaccination has been reported in the literature, with an increasing body of evidence reporting vaccination-associated uveitis (VAU). In this systematic review, we searched six electronic databases for articles reporting the occurrence of VAU following COVID-19 vaccination. Data were synthesized with emphasis on patients’ characteristics [age, gender], vaccination characteristics [type, dose], and outcome findings [type, nature, laterality, course, location, onset, underlying cause, and associated findings]. Data are presented as numbers (percentages) for categorical data and as mean (standard deviation) for continuous data. Sixty-five studies were finally included [43 case reports, 16 case series, four cohort, one cross-sectional, and one registry-based study]. VAU occurred in 1526 cases, most commonly in females (68.93%) and middle-aged individuals (41–50 years: 19.71%), following the first dose (49.35%) of vaccination, especially in those who received Pfizer (77.90%). VAU occurred acutely (71.77%) as an inflammatory reaction (88.29%) in unilateral eyes (77.69%), particularly in the anterior portion of the uvea (54.13%). Importantly, most cases had a new onset (69.92%) while only a limited portion of cases had a reactivation of previous uveitis condition. In conclusion, although rare, uveitis following COVID-19 vaccination should be considered in new-onset and recurrent cases presenting with either acute or chronic events.

Unilateral branch retinal artery occlusion in association with COVID-19: a case report

“…Although rare, there is an association between COVID-19 vaccination and an immunemediated prothrombotic state [10][11] . Ocular comorbidities related to COVID-19 vaccination include corneal transplant rejection [12] , uveitis [13] , and RAO [14] . Additionally, direct COVID-19 infection may dysregulate multiple components of the Virchow's triad, including vascular endothelial injury, by inducing proinflammatory cytokines [15][16] .…”

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

“…The most common presentation was acute, anterior, unilateral, and noninfectious uveitis. However, cases of choroiditis, retinitis, retinochoroiditis, and pars planitis have been reported 85 . The manifestations of uveitis are diverse and can be categorized based on their locations (Table 2).…”

“…However, cases of choroiditis, retinitis, retinochoroiditis, and pars planitis have been reported. 85 The manifestations of uveitis are diverse and can be categorized based on their locations (Table 2). The expansive range of these manifestations underscores the need for comprehensive monitoring and further research into the ocular side effects associated with the COVID-19 vaccine.…”

“…The expansive range of these manifestations underscores the need for comprehensive monitoring and further research into the ocular side effects associated with the COVID-19 vaccine. 85,86 Despite all the cases of ocular inflammation reported in observational studies after the administration of the COVID-19 vaccine, a large epidemiological study in the USA did not find an increased risk of noninfectious uveitis after COVID-19 vaccination in individuals without a history of the disease. 87 Moreover, although cases of noninfectious uveitis have been reported after vaccination with any type of vaccine, most cases have been reported in patients who received the mRNA-based BNT162b2 vaccine, with most cases occurring within the first 14 days and after the first dose of vaccination.…”

Features of the Course and Rare Ophthalmic Manifestations of Post-COVID Syndrome

“…ВАУ возникал остро (71,77 %) как воспалительная реакция (88,29 %), односторонняя (77,69 %), особенно в передних отделах сосудистой оболочки глаза (54,13 %). Важно отметить, что в большинстве случаев ВАУ проявился как впервые выявленное заболевание (69,92 %), в то время как лишь в ограниченной части случаев имела место реактивация предсуществующего увеита [51].…”