Acute Corneal Transplant Rejection After COVID-19 Vaccination

Shah, Anita N.; Dzhaber, Daliya; Kenyon, Kenneth R.; Riaz, Kamran M.; Ouano, Dean P; Koo, Ellen

doi:10.1097/ico.0000000000002878

Cited by 33 publications

(50 citation statements)

References 18 publications

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“…115 There have also been case reports of acute corneal graft rejections occurring after vaccination, which may be due to allorecognition by the direct pathway or incitation of the antibody response; fortunately, most rejection episodes resolved with topical and/or systemic steroids. 105,112,[116][117][118][119][120] Physicians may therefore consider reviewing the potential signs of graft rejection with corneal transplant recipients in order to improve earlier detection and treatment.…”

Section: Potential Systemic and Ocular Side Effectsmentioning

confidence: 99%

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Leung¹,

Fan²,

Flynn³

et al. 2022

OPTH

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There is increasing information available about the effects of the SARS-CoV-2 virus on the systemic and ocular health of patients, as well as the effects of delayed health care. This mini-review summarizes the potential complications and treatments of COVID-19. Systemic findings include respiratory illness, risk of thromboembolic events, and neurologic findings. Some patients may develop persistent symptoms even after the infection resolves. Effective treatment options include glucocorticoids, antivirals, interleukin-6 antagonists, monoclonal antibodies, Janus kinase inhibitors and vaccines. Potential ocular findings of COVID-19 include conjunctivitis, cranial nerve palsies, and microvascular changes in the retina; most symptoms resolved over time. During the lockdown periods, teleophthalmology was utilized to triage non-urgent issues; patients who did present to emergency departments tended to have more severe disease with worse visual prognoses. While transient delays in outpatient ophthalmic care may be tolerated in some patients, others experienced significant vision loss with interruptions in treatments. Resumption of ophthalmic care as soon as possible may help mitigate the effects of delayed care due to the pandemic.

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Section: Potential Systemic and Ocular Side Effectsmentioning

confidence: 99%

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Leung¹,

Fan²,

Flynn³

et al. 2022

OPTH

View full text Add to dashboard Cite

show abstract

“…Clearly, a patient aware of this possible adverse event may be more inclined to check his/her medical condition. Considering the widespread use of COVID-19 vaccination, it is likely that further cases of corneal graft rejection will be reported in the next future [41,42].…”

Section: Practical Implicationsmentioning

confidence: 99%

Dual Corneal-Graft Rejection after mRNA Vaccine (BNT162b2) for COVID-19 during the First Six Months of Follow-Up: Case Report, State of the Art and Ethical Concerns

et al. 2021

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Present mass vaccination against Coronavirus Disease-19 (COVID-19) is the most widely used health policy and the most promising approach to curb the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic globally. However, new side effects are emerging from the mass vaccination not described during the experimental stages. In the present study, we discuss a case of acute corneal graft rejection, which has occurred 25 years after transplantation and 13 days after the administration of the BNT162b2 vaccine (Comirnaty, BioNTech/Pfizer), which was followed-up for a period of six months. In this period, the corneal inflammation appeared twice but was successfully managed with topical therapy and supplementation of Vitamin D. A risk of corneal graft rejection must be included in the list of potential vaccine complications, in order to inform the transplanted patient to undergo a preliminary and a follow-up ocular examination, and eventually to include corneal graft in the list of contraindications to vaccination.

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“…Figure 1 illustrates the screening process. Twenty-four articles were identified through the database search on 13 February 2022 [ 20 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 ]. After reviewing the titles and abstracts of the 24 articles, 10 were excluded based on the article type (letter to the editor and review) [ 44 , 47 ], corneal graft rejection after COVID-19 [ 45 , 46 , 48 , 50 ], eye banking issues during the COVID-19 pandemic [ 42 , 49 ], and other unrelated topics [ 43 , 51 ].…”

Section: Resultsmentioning

confidence: 99%

Characteristics and Clinical Ocular Manifestations in Patients with Acute Corneal Graft Rejection after Receiving the COVID-19 Vaccine: A Systematic Review

Fujio

Sung

Nakatani

et al. 2022

JCM

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This study aimed to determine the characteristics and clinical ocular manifestations of acute corneal graft rejection after coronavirus disease 2019 (COVID-19) vaccination. We conducted an online search of the PubMed and EMBASE databases. Data on recipients’ characteristics, corneal transplantation types, interval between vaccination and allograft rejection, clinical manifestations, and graft rejection medication were extracted. Thirteen articles on 21 patients (23 eyes) with acute corneal graft rejection after COVID-19 vaccination, published between April and December 2021, were included. The median (interquartile range) age at the onset of rejection was 68 (27–83) years. Types of transplantation included penetrating keratoplasty (12 eyes), Descemet membrane endothelial keratoplasty (six eyes), Descemet stripping automated endothelial keratoplasty (four eyes), and living-related conjunctival-limbal allograft (one eye). The interval between vaccination and rejection ranged from 1 day to 6 weeks. Corneal edema was the leading clinical manifestation (20 eyes), followed by keratic precipitates (14 eyes) and conjunctival or ciliary injection (14 eyes). Medications included frequently applied topical corticosteroids (12 eyes), followed by a combination of topical and oral corticosteroids (four eyes). In addition, the clinical characteristics of corneal allograft rejection after COVID-19 vaccination were identified. Corneal transplant recipients may require further vaccination, necessitating appropriate management and treatment.

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Acute Corneal Transplant Rejection After COVID-19 Vaccination

Cited by 33 publications

References 18 publications

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Ocular and Systemic Complications of COVID-19: Impact on Patients and Healthcare

Dual Corneal-Graft Rejection after mRNA Vaccine (BNT162b2) for COVID-19 during the First Six Months of Follow-Up: Case Report, State of the Art and Ethical Concerns

Characteristics and Clinical Ocular Manifestations in Patients with Acute Corneal Graft Rejection after Receiving the COVID-19 Vaccine: A Systematic Review

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