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Title Vitritis within 24h after AstraZeneca COVID19 1st vaccine injection
PurposeTo report 2 cases of vitritis within 24 h after the 1st COVID19 AstraZeneca vaccine injection, with a focus on clinical manifestations and potential association with underlying conditions affecting the blood retinal barrier (BRB) (i.e. RPE affected by inherited retinal dystrophy, previous multiple evanescent white dot syndrome-MEWDS).
MethodsRetrospective description of 2 cases. We collected clinical and laboratory data, and assessed for autoimmune diseases (AID).
ResultsTwo young women in their 20s-30s presented with severe symptoms of visual haze and increased floaters following the 1st injection of AstraZeneca COVID19 vaccine. They had vitritis without any signs of inflammation in surrounding tissues but previous condition affecting the BRB.The time latency between injection and symptoms was 7 and 24 h. The mechanism is unclear. An underlying RPE/BRB disruption suggests easier entry for substances from blood into the usually immune-privileged intraocular environment. None of them had a diagnosed systemic autoimmune condition. Both recovered spontaneously without anti-inflammatories. Both decided not to have the 2nd vaccine injection.
ConclusionIntraocular autoimmune/inflammatory reaction induced by vaccines is an identified condition, in which exposure to virus particles and/or adjuvants leads to an aberrant autoimmune response. Clinical features differ depending on the type of vaccine or adjuvant used, as well as underlying ocular or AID. This report may increase awareness of this reaction and help health professionals identify patients at greater risk. An international registry would be a useful tool.
Conflict of interestNo
Authors 1
Last nameUGARTE
Initials of first name(s)M
DepartmentManchester Royal Eye Hospital
CityManchester
CountryUnited Kingdom
Authors 2
Last nameJALIL
Initials of first name(s)A
DepartmentManchester Royal Eye Hospital
CityManchester
CountryUnited Kingdom