THE HETEROGENEOUS PRESENTATIONS OF DE NOVO AND RECURRENT OCULAR INFLAMMATION AFTER COVID-19 VACCINATION : A Multicenter Report and a Review of the Literature.

Abstract

Purpose: To describe the patterns of ocular inflammation after coronavirus disease 2019 vaccination, assess underlying commonalities, and understand outcomes.

Methods: Retrospective, multicenter cohort study, conducted between 2020 and 2021. Patients with no previous uveitis history ( de novo ) or a known uveitis history (recurrent) who developed ocular inflammation within 42 days of coronavirus disease 2019 vaccination were identified. Characteristics of the uveitis, treatment approaches, and clinical outcomes were assessed.

Results: Fifty-five eyes of 39 patients with ocular inflammation temporally related to vaccination were identified. Twenty-two patients (36 eyes) were de novo , while 17 (19 eyes) were recurrent. Anterior uveitis was most common. HLA-B27 positivity was found in 6 (27.2%) de novo patients, and 5 (29.4%) recurrent patients. Most patients required only observation, topical, or systemic corticosteroids. Among vaccinated patients, 12.3% of new uveitis referrals during the study period were related to coronavirus disease 2019 vaccination. Among patients with a history of quiescent uveitis, only 0.85% experienced a flare after vaccination.

Conclusion: Most inflammation thought to be secondary to coronavirus disease 2019 vaccination achieved quiescence with observation or steroids, and the overall incidence is low. Anterior uveitis was the most common. HLA-B27 positivity occurred at a higher rate than reported in the baseline population.