Search

PURPOSE To describe uveitis cases after the BNT162b2 mRNA SARS-CoV-2 vaccination. METHODS This is a multicenter, retrospective study. Vaccine-related uveitis diagnosis was supported by the classification of the World Health Organization Adverse Drug Terminology and the Naranjo criteria. RESULTS Twenty-one patients (23 eyes) with a mean age of 51.3 years (23-78 years) were included. Eight of the 21 patients had a known history of uveitis. The median time from previous to current attack was 1 year (0.5-15 years). There were 21 anterior uveitis cases, two with bilateral inflammation. Eight cases occurred after the first vaccination and 13 after the second vaccination. All but three presented as mild to moderate disease. Two patients developed multiple evanescent white dot syndrome after the second vaccination. The mean time from vaccination to uveitis onset was 7.5 ± 7.3 days (1-30 days). At final follow-up, complete resolution was achieved in all but two eyes, which showed significant improvement. One case of severe anterior uveitis developed vitritis and macular edema after the second vaccination, which completely resolved after an intravitreal dexamethasone injection. CONCLUSION Uveitis may develop after the administration of the BNT162b2 mRNA vaccine. The most common complication was mild to moderate anterior uveitis, while multiple evanescent white dot syndrome can also occur less frequently.

PURPOSE To report a unique ocular manifestation of immunoglobulin G4-related disease (IgG4-RD) as choroidal effusion. METHODS Case report. RESULTS An 81-year-old man presented with clinical manifestations of choroidal effusion, confirmed by fluorescein angiography, ophthalmic ultrasound (posterior segment), high-frequency ultrasound biomicroscopy, Heidelberg Spectralis spectral domain optical coherence tomography, and enhanced depth imaging spectral domain optical coherence tomography. Systemic multi-organ findings included chronic pancreatitis, irregularity of the intrahepatic bile ducts, lymphadenopathy, aortitis, fibrotic changes of the lungs, hypophysitis, and sialadenitis. Extensive workup revealed elevated IgG4 serum levels, and lymph nodes biopsy showed reactive pattern with polyclonal IgG4 positive plasma cells. These findings were compatible with IgG4-related disease. Treatment with oral corticosteroids resulted in complete resolution of the choroidal effusion. CONCLUSION Choroidal effusion may be an ocular manifestation of IgG4-related disease. Oral corticosteroids is an effective treatment. Ophthalmologists should be aware of this possible finding.

To investigate the characteristics and long-term outcome of patients with noninfectious retinal vasculitis.This was a retrospective multicenter study. Main outcome measures included patients' characteristics, ocular findings, treatment modalities, and best-corrected visual acuity. All patients had at least 12-month follow-up time.Eighty-two eyes (45 patients) were included. Median follow-up was 46 months (range, 12-210 months). At presentation, 12 of the 45 patients (26.6%) had a known associated systemic or ocular disease. A diagnosis of a new systemic disease was found in additional 14 of 33 patients (42.5%) and birdshot chorioretinopathy in 3 of 33 patients (9.1%). The most common systemic disease was Behcet disease (17/24 patients; 70.8%). Laboratory tests had a low diagnostic value. The most common clinical findings were vitritis (58.5%) and perivascular sheathing (50.5%). Most patients were treated with immunosuppressive medications. Mean best-corrected visual acuity improved significantly during follow-up, patients with Behcet disease and worse visual acuity at baseline were more likely to have visual acuity improvement (P0.001).A new systemic or ocular disease associated with retinal vasculitis was found in more than half of the patients. Behcet disease was the most common newly diagnosed disease. Specific diagnosis leading to proper management is important to maintain favorable long-term visual outcome.

Purpose: To evaluate retinal toxicity of intravitreal rituximab. Methods: Twelve albino rabbits were included in the study. 1 mg/0.1 mL of rituximab was injected to the right (experimental) eye of each rabbit, and 0.1 mL of saline was injected into the left (control) eye. Electroretinogram was recorded before injection and 3 hours, 4 days, 1 week, 2 weeks and 4 weeks after injection (12 rabbits), and visual evoked potential was recorded before injection and 4 weeks after injection (10 rabbits). Histology and glial fibrillary acidic protein immunocytochemistry (12 rabbits) were performed at 4 weeks after injection. Clinical examination was conducted at all time points in all rabbits. Results: The average dark-adapted electroretinogram b-wave Vmax ratios, and the average light-adapted b-wave amplitude ratios were approximately 1, and the average log σ difference was around zero throughout the follow-up period. The average visual evoked potential amplitude ratio and the average visual evoked potential implicit time difference were approximately 1 and 0, respectively. No histologic damage was seen, but glial fibrillary acidic protein was mildly expressed in 6 of 12 experimental eyes. Results of clinical examination were normal in all the eyes. Conclusion: Intravitreal injection of 1 mg rituximab does not cause functional or histologic signs of retinal toxicity in albino rabbits. Mild glial fibrillary acidic protein expression in Muller cells probably indicates a mild degree of retinal stress.