Fujio Kenta, Sung Jaemyoung, Nakatani Satoru, Yamamoto Kazuko, Iwagami Masao, Fujimoto Keiichi, Shokirova Hurramhon, Okumura Yuichi, Akasaki Yasutsugu, Nagino Ken, Midorikawa-Inomata Akie, Hirosawa Kunihiko, Miura Maria, Huang Tianxiang, Morooka Yuki, Kuwahara Mizu, Murakami Akira, Inomata Takenori
Department of Ophthalmology, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo 113-0033, Japan.
J Clin Med. 2022 Aug 2;11(15):4500. doi: 10.3390/jcm11154500.
This study aimed to determine the characteristics and clinical ocular manifestations of acute corneal graft rejection after coronavirus disease 2019 (COVID-19) vaccination. We conducted an online search of the PubMed and EMBASE databases. Data on recipients' characteristics, corneal transplantation types, interval between vaccination and allograft rejection, clinical manifestations, and graft rejection medication were extracted. Thirteen articles on 21 patients (23 eyes) with acute corneal graft rejection after COVID-19 vaccination, published between April and December 2021, were included. The median (interquartile range) age at the onset of rejection was 68 (27-83) years. Types of transplantation included penetrating keratoplasty (12 eyes), Descemet membrane endothelial keratoplasty (six eyes), Descemet stripping automated endothelial keratoplasty (four eyes), and living-related conjunctival-limbal allograft (one eye). The interval between vaccination and rejection ranged from 1 day to 6 weeks. Corneal edema was the leading clinical manifestation (20 eyes), followed by keratic precipitates (14 eyes) and conjunctival or ciliary injection (14 eyes). Medications included frequently applied topical corticosteroids (12 eyes), followed by a combination of topical and oral corticosteroids (four eyes). In addition, the clinical characteristics of corneal allograft rejection after COVID-19 vaccination were identified. Corneal transplant recipients may require further vaccination, necessitating appropriate management and treatment.
本研究旨在确定2019冠状病毒病（COVID-19）疫苗接种后急性角膜移植排斥反应的特征和临床眼部表现。我们对PubMed和EMBASE数据库进行了在线检索。提取了关于受者特征、角膜移植类型、疫苗接种与同种异体移植排斥反应之间的间隔、临床表现以及移植排斥反应用药的数据。纳入了2021年4月至12月发表的13篇关于21例（23只眼）COVID-19疫苗接种后发生急性角膜移植排斥反应患者的文章。排斥反应发作时的中位（四分位间距）年龄为68（27 - 83）岁。移植类型包括穿透性角膜移植术（12只眼）、Descemet膜内皮角膜移植术（6只眼）、Descemet剥脱自动内皮角膜移植术（4只眼）和活体亲属结膜-角膜缘同种异体移植术（1只眼）。疫苗接种与排斥反应之间的间隔为1天至6周。角膜水肿是主要的临床表现（20只眼），其次是角膜后沉着物（14只眼）和结膜或睫状充血（14只眼）。用药包括频繁应用的局部皮质类固醇（12只眼），其次是局部和口服皮质类固醇联合应用（4只眼）。此外，还确定了COVID-19疫苗接种后角膜同种异体移植排斥反应的临床特征。角膜移植受者可能需要进一步接种疫苗，因此需要进行适当的管理和治疗。
