Uveitis reactivation following recombinant zoster vaccination

Richards, Paige; Armbrust, Karen R; Kopplin, Laura J.

doi:10.1016/j.ajoc.2021.101115

Cited by 7 publications

(10 citation statements)

References 9 publications

(12 reference statements)

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“…Uveitis recurrence is an infrequent but serious potential ocular side effect of recombinant zoster vaccination. Three cases 10.3389/fmed.2022.999251 of uveitis reactivation following Shingrix have been reported: one patient developed a reactivation of a previously controlled multifocal choroiditis within 1 week of receiving vaccine, and two patients with a previously controlled anterior uveitis developed new anterior segment inflammation (65).…”

Section: Varicella Zoster Virus Vaccines (Varivax Zostavax Shingrix)mentioning

confidence: 99%

Ocular effects caused by viral infections and corresponding vaccines: An overview of varicella zoster virus, measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2

Scalabrin

Becco²,

Vitale³

et al. 2022

Front. Med.

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Many viral infections can affect vision and the visual system. Vaccination to prevent diseases is commonplace today, acting by stimulating an immune response without developing the pathology. It involves the production of persisting antibodies against the pathogen and the activation of T cells. Certain diseases have already been eradicated by rigorous vaccination campaigns, while others are hoped to be eliminated soon. Vaccines currently available on the market are largely safe, even if they can rarely cause some adverse effects, such as ocular complications. Analyzing existing literature, we aimed to compare the pathological effects on the eye due to the most common viral infections [in particular varicella zoster virus (VZV), measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2] with the possible ocular adverse effects of their relative vaccines, in order to establish a risk-benefit relationship from an ophthalmological point of view.

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Section: Varicella Zoster Virus Vaccines (Varivax Zostavax Shingrix)mentioning

confidence: 99%

Ocular effects caused by viral infections and corresponding vaccines: An overview of varicella zoster virus, measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2

Scalabrin

Becco²,

Vitale³

et al. 2022

Front. Med.

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“…Previously, a pathological examination of an excised eye with HZO showed chronic inflammatory cell infiltration of the long posterior ciliary artery and nerves [ 20 ]. A case of uveitis after vaccination with an inactivated recombinant herpes zoster vaccine has also been reported [ 21 ]. It can be said that inflammation due to immune response may be stronger in delayed ocular complications than the direct damage by VZV itself.…”

Section: Discussionmentioning

confidence: 99%

A Case of Herpes Zoster Ophthalmicus With Multiple Delayed Ocular Complications

Takai¹,

Yamagami²,

Iwasa³

et al. 2023

Cureus

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Herpes zoster ophthalmicus (HZO) presents a variety of ocular complications, most of which occur simultaneously as skin lesions. We report a case of HZO with delayed onset of multiple ocular complications. A 72-year-old man developed HZO, blepharitis, iritis, and conjunctivitis in the left eye, which resolved after topical ocular treatment and systemic acyclovir administration. However, six weeks after the first onset of the rash, the patient came to our hospital because of recurrent blepharitis, iritis, scleritis, conjunctivitis, eye pain, ptosis, and blurred vision in the left eye. Best corrected visual acuity (BCVA) in the left eye had decreased to hand motion, and the Goldmann visual field test showed only mild residual peripheral vision on the lateral side. Intraocular pressure showed 25 mmHg in the left eye and inflammation in the anterior chamber with paralytic mydriasis. Orbital magnetic resonance imaging (MRI) showed the contrast effects with the lacrimal gland, superior ophthalmic vein, supraorbital nerve, optic nerve, and around optic nerve sheath. The patient was diagnosed with optic neuritis, optic perineuritis, ptosis, paralytic mydriasis, trigeminal neuralgia, lacrimal gland inflammation, blepharitis, iritis, scleritis, and ocular hypertension after HZO, and three courses of steroid pulse therapy were administered. Thereafter, BCVA improved to 0.3 in the left eye, with improvement in central vision, and MRI lesions and other symptoms also improved. The patient has had no complications or recurrence of HZO. HZO can cause a variety of ocular complications. Since autoimmune mechanisms might be involved, combined immunotherapy should be considered.

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“…After conducting a comprehensive review, a total of 51 reported cases (involving 61 patients), spanning from 1978 to 2023, have been associated with uveitis following various vaccinations (Table 1), including 4 case reports (5 patients) related to hepatitis B virus (HBV) vaccination [28][29][30][31]; 7 case reports (8 patients) related to human papillomavirus (HPV) vaccination [21][22][23][32][33][34][35]; 16 cases (18 patients) regarding uveitis after influenza vaccination [36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51]; 3 cases (4 patients) related to measles-mumps-rubella (MMR) vaccination [52][53][54]; 12 cases (16 patients) related to varicella zoster virus (VZV) vaccination [24][25][26][27][55][56][57][58][59][60][61][62]; 4 cases (5 patients) for yellow fever [63][64]…”

Section: General Analysis Regarding Cases Of Uveitis Post-vaccinationmentioning

confidence: 99%

“…The average age of the affected individuals was 38.5 years (range, 1-86 years), with a female predominance (female:male = 35:26). Based on the site of infection, this study included 11 cases of anterior uveitis [27,35,37,45,52,54,56,58,63], 1 case of intermediate uveitis [63], 8 cases of posterior uveitis [21,22,27,28,32,42], 3 cases of uveitis involving both anterior and intermediate segments [27,55,64], 1 case of anterior and posterior uveitis [38], and 7 cases of pan-uveitis [23,34,40,43,48,53]. Distinct types of uveitis, such as acute posterior multifocal placoid pigment epitheliopathy (APMPPE) [36,41,46,47,57], Vogt-Koyanagi-Harada syndrome (VKH) [31,39,49,51,65,66], multiple evanescent white dot syndrome (MEWDS) [30,33,50,[67][68][69][70], acute retinal necrosis (ARN) [24]…”

Section: General Analysis Regarding Cases Of Uveitis Post-vaccinationmentioning

confidence: 99%

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Ocular Inflammation Post-Vaccination

Zou,

Kamoi,

Zong

et al. 2023

Vaccines

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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.

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Uveitis reactivation following recombinant zoster vaccination

Cited by 7 publications

References 9 publications

Ocular effects caused by viral infections and corresponding vaccines: An overview of varicella zoster virus, measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2

Ocular effects caused by viral infections and corresponding vaccines: An overview of varicella zoster virus, measles virus, influenza viruses, hepatitis B virus, and SARS-CoV-2

A Case of Herpes Zoster Ophthalmicus With Multiple Delayed Ocular Complications

Ocular Inflammation Post-Vaccination

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