Herpetic anterior uveitis following COVID-19 vaccines: a case series

Muriel Ott, Thanoosha Nagamany, Souska Zandi, Francesco Pichi, Aniruddha Agarwal, Ester Carreño, Vishali Gupta, Dilraj S Grewal, Emmett T Cunningham, Marion R Munk*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: To report a case series of herpetic uveitis following COVID-19 vaccinations. Methods: Demographic, clinical and treatment-related data of herpetic anterior uveitis cases was collected at five tertiary eye hospitals between January 2021 and June 2022. A retrospective database review at one of the centers comparing the number of cases of herpetic eye disease before and after the introduction of COVID-19 vaccination was performed as well. Results: Twenty-four patients (9 female, 15 male) with a mean age of 54 years (range 28–83 years) were diagnosed with herpetic uveitis, reporting an onset of symptoms 3–42 days after the first, second or third dose of COVID-19 vaccination. Median time between vaccination and onset of herpetic eye disease was 10 days (mean 12.7 ± 10.15 days) days. The administered vaccines were BNT162b2, mRNA-1273, BBIBP-CorV and Ad26.COV2.S. The cases included 11 HSV, 10 VZV and 1 CMV anterior uveitis, 2 were not further specified. There was an equal number of first episodes (n = 12, 50%) and recurrent episodes (n = 12, 50%). Response to established regimens was generally good. The retrospective database review revealed the exact same incidence of herpetic uveitis during the pandemic and ongoing vaccination compared to prior SARS-CoV-2. Conclusion: This report includes 24 cases of herpetic anterior uveitis in a temporal relationship to various COVID-19 vaccines. This study supports the potential risk of herpetic eye disease following COVID-19 vaccines, but proof of a direct, causal relationship is missing.

Original languageEnglish
Article number1242225
Number of pages7
JournalFrontiers in medicine
Volume10
Issue number1
DOIs
Publication statusPublished - 22 Sept 2023

Keywords

  • COVID-19 vaccines
  • SARS-CoV-2 vaccination
  • herpes zoster ophthalmicus
  • herpetic eye disease
  • keratitis
  • mRNA vaccination
  • ocular herpes simplex
  • uveitis

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