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Vaccines Oct 2023The association between vaccines and ocular disorders has attracted significant attention in scientific research. Numerous mainstream vaccines are associated with a... (Review)
Review
The association between vaccines and ocular disorders has attracted significant attention in scientific research. Numerous mainstream vaccines are associated with a range of uveitis types, including anterior, intermediate, and posterior uveitis. Additionally, they are associated with distinct ocular diseases such as multifocal choroiditis, Vogt-Koyanagi-Harada (VKH) disease, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), and multiple evanescent white dot syndrome (MEWDS). These ocular conditions are often transient, with a vast majority of patients experiencing improvement after steroid intervention. To date, numerous cases of vaccine-induced uveitis have been reported. This study analyzed the correlation between antiviral vaccines, including the hepatitis B virus (HBV), human papillomavirus (HPV), measles-mumps-rubella (MMR), varicella zoster virus (VZV), and influenza vaccines, and different manifestations of uveitis. This is the first comprehensive study to offer a detailed analysis of uveitis types induced by antiviral vaccines. Through an extensive database search, we found a particularly strong link between influenza vaccines, followed by VZV and HPV vaccines. While anterior uveitis is common, conditions such as APMPPE, MEWDS, and VKH are particularly notable and merit careful consideration in clinical practice. Corticosteroid treatment was effective; however, half of the observed patients did not achieve full recovery, indicating potentially prolonged effects of the vaccine.
PubMed: 37897028
DOI: 10.3390/vaccines11101626 -
Ocular Immunology and Inflammation Aug 2023Following the pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, different vaccines were developed and... (Review)
Review
PURPOSE
Following the pandemic of coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2, different vaccines were developed and approved by the main medical authorities under emergency protocol regulations. Although highly effective and well-tolerated in most patients, vaccines can uncommonly cause ocular adverse effects. In this article, the current evidence related to vaccine-associated uveitis is reviewed.
METHODS
A literature review of uveitis post various SARS-CoV-2 vaccinations.
RESULTS
Uveitis was reported following various forms of vaccinations but was more commonly seen following the Pfizer mRNA vaccine which is the most used vaccination worldwide. In western countries, the most common uveitis is mild anterior uveitis, developing within a week of first or subsequent vaccination with good resolution following appropriate topical steroid therapy in most cases. Posterior uveitis and particularly Vogt-Koyanagi-Harada disease was more prevalent in Asia. Uveitis may develop among known uveitis patients and those with other autoimmune diseases.
CONCLUSION
Uveitis following Covid vaccinations is uncommon and has a good prognosis.
Topics: Humans; COVID-19; COVID-19 Vaccines; SARS-CoV-2; Uveitis; Vaccination; Vaccines
PubMed: 37145198
DOI: 10.1080/09273948.2023.2200858 -
Ocular Immunology and Inflammation Dec 2023Uveitis is uncommon in children and its diagnosis and treatment are challenging. Little is known of the epidemiology of pediatric uveitis. Indeed, population-based... (Review)
Review
Uveitis is uncommon in children and its diagnosis and treatment are challenging. Little is known of the epidemiology of pediatric uveitis. Indeed, population-based studies in the literature are rare. However, there are many tertiary referral center reports that describe the patterns of uveitis in childhood, although few are from developed countries, and their comparison presents some issues. Anterior uveitis is the most frequent entity worldwide, especially in Western countries, where juvenile idiopathic arthritis is diffuse. Most cases of intermediate uveitis do not show any association with infectious or noninfectious systemic diseases. In low- and middle-income countries, posterior uveitis and panuveitis are prevalent due to the higher rates of infectious etiologies and systemic diseases such as Behçet disease and Vogt-Koyanagi-Harada disease. In recent decades, idiopathic uveitis rate has decreased thanks to diagnostic improvements.
Topics: Humans; Child; Retrospective Studies; Uveitis; Behcet Syndrome; Uveomeningoencephalitic Syndrome; Uveitis, Posterior
PubMed: 37922466
DOI: 10.1080/09273948.2023.2271988 -
Progress in Retinal and Eye Research Nov 2023Behçet's disease is a systemic vasculitis frequently associated with intraocular inflammation. Recent findings identified independent clinical clusters in Behçet's... (Review)
Review
Behçet's disease is a systemic vasculitis frequently associated with intraocular inflammation. Recent findings identified independent clinical clusters in Behçet's disease, each involving distinct combinations of affected organs. Ocular Behçet's disease, mainly manifested as uveitis, is characterized as an independent cluster with a low likelihood of association with other system involvements, such as intestinal, cardiovascular, or central nervous system. A prevailing theory suggests that the pathogenesis of the disease is multifactorial, where a variety of genetic and infectious agents may interact with each other to cause the disease. Among sporadic cases, the human leukocyte antigen (HLA) genes, including HLA-B51, HLA-A26, HLA-B15, and HLA-B5701, have been found to be a key component conferring genetic susceptibility. Outside the HLA region, a set of susceptibility variants are identified, closely related to interleukin (IL)-23/IL-17 pathway, tumor necrosis factor (TNF) signaling, and pattern recognition receptor systems. Microbial infections, such as Streptococcus sanguinis, Mycobacterium tuberculosis, and Herpes simplex virus (HSV), are linked to play the triggering of disease in immunogenetically predisposed individuals. Clinically, due to the notable relapsing-remitting course of ocular Behçet's disease, the prevention of recurrent attack would be the primary treatment goal. Combination of corticosteroids and immunomodulatory drugs, such as anti-TNF agents, interferon, and conventional immunosuppressants (e.g. cyclosporine, azathioprine), have been the mainstream regimen for the disease. Future research may focus on comparing the effectiveness of immunomodulatory drugs and identifying the most suitable subgroups for a specific drug on the basis of the knowledge of the molecular heterogeneity of the disease.
Topics: Humans; Behcet Syndrome; Immunomodulating Agents; Tumor Necrosis Factor Inhibitors; Uveitis; Risk Factors
PubMed: 37734442
DOI: 10.1016/j.preteyeres.2023.101216 -
Retinal Cases & Brief Reports Jul 2023To report a case a patient of anterior uveitis, iris neovascularization, high IOP and vasculitis in a patient with subconjunctival and intra ocular caterpillar hair.
PURPOSE
To report a case a patient of anterior uveitis, iris neovascularization, high IOP and vasculitis in a patient with subconjunctival and intra ocular caterpillar hair.
METHOD
Case report.
RESULTS
A 30-year-old man complaining of episodes of blurring of vision and colored haloes in his LE was referred for high IOP that was uncontrolled despite maximum tolerable medication in LE. He was diagnosed as a case of Posner Schlossman syndrome in view of signs of anterior uveitis. He was also noted to have retinal hemorrhages in the peripheral fundus with peripheral vasculitis and capillary non perfusion areas. He underwent an uneventful trabeculectomy. During surgery caterpillar hair were noted in his inferior conjunctiva that were removed. Later a seta was also found in the vitreous in supertemporal quadrant.
CONCLUSION
The case is an unusual presentation of caterpillar hair masquerading as a Posner Sclhossman syndrome.
PubMed: 37487232
DOI: 10.1097/ICB.0000000000001457