Department of Ophthalmology, Gil Medical Center, Gachon University College of Medicine, Incheon, Korea.
Cornea. 2022 May 1;41(5):649-650. doi: 10.1097/ICO.0000000000002999.
The purpose of this study was to report a case of acute exacerbation in varicella-zoster virus (VZV) keratitis after SARS-CoV-2 vaccination.
An 87-year-old man, with a history of herpes zoster ophthalmicus 10 years ago, was referred for sudden visual impairment in his left eye that started 2 days after his second dose of SARS-CoV-2 mRNA vaccine BNT162b2.
At presentation, his visual acuity was hand motion. Slitlamp examination revealed diffuse corneal stromal edema and nasal stromal infiltration. After treatment for 2 weeks with oral valacyclovir and topical corticosteroids, the problematic lesion was recovered and his visual acuity was restored to 20/30.
We believe that this is the first report of possible association between recurrence of VZV keratitis and SARS-CoV-2 vaccination. We believe that T-cell activation by the host response after vaccination may affect the recurrence of VZV keratitis. Physicians should be aware of the potential of recurrence of VZV keratitis associated with the SARS-CoV-2 messenger RNA vaccine.
本研究报告了一例接种 SARS-CoV-2 疫苗后水痘带状疱疹病毒（VZV）角膜炎急性加重的病例。
一名 87 岁男性，10 年前患有带状疱疹性眼病，因左眼突然视力下降就诊，症状始于第二剂 SARS-CoV-2 mRNA 疫苗 BNT162b2 接种后 2 天。
就诊时，他的视力为手动。裂隙灯检查显示弥漫性角膜基质水肿和鼻侧基质浸润。经 2 周的口服伐昔洛韦和局部皮质类固醇治疗后，问题病灶得到恢复，视力恢复至 20/30。
我们认为这是首例可能与 SARS-CoV-2 疫苗接种后 VZV 角膜炎复发相关的报道。我们认为，疫苗接种后宿主反应引起的 T 细胞激活可能影响 VZV 角膜炎的复发。医生应意识到与 SARS-CoV-2 信使 RNA 疫苗相关的 VZV 角膜炎复发的可能性。
