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

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.