Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.
National Health Commission Key Laboratory of Myopia (Fudan University), Shanghai, China.
Front Public Health. 2023 Jan 13;10:1051378. doi: 10.3389/fpubh.2022.1051378. eCollection 2022.
This retrospective study aims to present the characteristics of Posner-Schlossman syndrome (PSS) relapse following inactivated COVID-19 vaccination.
From 2020 to 2022, 12 out of 106 PSS patients undergoing relapses after any dose of inactivated COVID-19 vaccines were enrolled. Medical histories, information on the vaccination and systemic adverse events were collected. Patients were treated with corticosteroids, intraocular pressure (IOP)-lowering drugs and systemic immunosuppressive agents (if needed). Daily regimen and release course were noted.
The recurrence rate after vaccination was 11.32% (12/106, 95% CI: 5.29%-17.35%) among 106 PSS patients we surveyed. All the 12 patients were inoculated with inactivated COVID-19 vaccines developed by Sinopharm, China. The mean time of relapse was 5.27 ± 3.72 days (range: 1-13 days, median: 4 days). Higher IOP and more keratic precipitates (KPs) were seen in the relapse following vaccination (33.55 ± 12.99 mmHg, 91.67% had KPs compared to 25.38 ± 3.80 mmHg, 33.33% had KPs in previous relapse, = 0.009). The mean release course was 30.71 ± 34.74 days for the relapse following vaccination and 7.33 ± 6.51 days for previous relapses. The attack frequency before and after vaccination was 3.56 ± 2.07 and 9.11 ± 7.34 times per year ( = 0.044). Higher daily doses of corticosteroids, IOP-lowering drugs and ganciclovir were needed to maintain stable course, though the difference did not reach statistical significance.
More frequent relapses and harder control of IOP were found in PSS relapse following COVID-19 vaccination. Ophthalmologists need to be aware of the group vulnerability and take precautions, though the pathogenesis is still under investigation.
本回顾性研究旨在介绍感染新冠灭活疫苗后 Posner-Schlossman 综合征（PSS）复发的特点。
2020 年至 2022 年，我们纳入了 106 例 PSS 患者中 12 例在接受任何剂量的新冠灭活疫苗后出现复发的患者。收集了他们的病史、疫苗接种信息和全身不良反应的信息。对患者进行了皮质类固醇、降眼压药物和全身免疫抑制剂（如有需要）的治疗。记录了每日治疗方案和缓解过程。
在我们调查的 106 例 PSS 患者中，疫苗接种后的复发率为 11.32%（12/106，95%CI：5.29%-17.35%）。所有 12 例患者均接种了由中国国药集团研发的新冠灭活疫苗。复发的平均时间为 5.27 ± 3.72 天（范围：1-13 天，中位数：4 天）。与之前的复发相比，接种疫苗后的复发时眼压更高，角膜后沉着物（KPs）更多（33.55 ± 12.99mmHg，91.67%有 KPs 相比 25.38 ± 3.80mmHg，33.33%有 KPs， = 0.009）。接种疫苗后的缓解过程平均为 30.71 ± 34.74 天，而之前的复发为 7.33 ± 6.51 天。接种疫苗前后的发作频率分别为 3.56 ± 2.07 和 9.11 ± 7.34 次/年（ = 0.044）。尽管差异没有达到统计学意义，但需要更高的皮质类固醇、降眼压药物和更昔洛韦的每日剂量来维持稳定的缓解过程。
感染新冠灭活疫苗后 PSS 复发的频率更高，眼压更难控制。眼科医生需要意识到这一群体的易感性并采取预防措施，尽管其发病机制仍在研究中。
