Department of Ophthalmology, Taichung Veterans General Hospital, 1650 Taiwan Boulevard Sect. 4, Taichung, Taiwan.
BMC Ophthalmol. 2023 Aug 18;23(1):360. doi: 10.1186/s12886-023-03103-z.
To report a case of simultaneous occurrence of acute exacerbation of ocular graft-versus-host disease (GVHD) and anterior uveitis following coronavirus disease 2019 (COVID-19) vaccination.
A 60-year-old man with primary myelofibrosis and GVHD after receiving allogeneic hematopoietic stem cell transplantation (HSCT), developed acute exacerbation of ocular GVHD and anterior uveitis after receiving first dose of COVID-19 vaccine. The patient developed erythema of the eyelids, conjunctival hyperemia, superficial punctate keratopathy, and prominent anterior chamber inflammation in both eyes. The ocular GVHD and anterior uveitis were managed with mainly topical corticosteroids, antibiotics, lubricants, and systemic corticosteroids, but were difficult to control. Intravitreal injection of dexamethasone was administered, and the inflammation gradually subsided 6 months after the onset of initial symptoms.
Clinicians should be aware of rare refractory anterior uveitis and acute exacerbation of ocular GVHD after COVID-19 vaccination in patients undergoing HSCT. Early diagnosis and aggressive treatment should be considered to reduce the likelihood of severe complications.
报告一例 COVID-19 疫苗接种后同时发生急性移植物抗宿主病（GVHD）和前葡萄膜炎。
一名 60 岁男性，患有原发性骨髓纤维化和异基因造血干细胞移植（HSCT）后发生 GVHD，在接受 COVID-19 疫苗第一剂后发生急性眼部 GVHD 和前葡萄膜炎。患者出现眼睑红斑、结膜充血、浅层点状角膜炎和双眼明显前房炎症。眼部 GVHD 和前葡萄膜炎主要采用局部皮质类固醇、抗生素、润滑剂和全身皮质类固醇治疗，但难以控制。给予玻璃体内注射地塞米松，初始症状出现 6 个月后炎症逐渐消退。
接受 HSCT 的患者 COVID-19 疫苗接种后应注意罕见的难治性前葡萄膜炎和急性眼部 GVHD。应考虑早期诊断和积极治疗，以降低严重并发症的可能性。
