Zou Yaru, Kamoi Koju, Zong Yuan, Zhang Jing, Yang Mingming, Ohno-Matsui Kyoko
Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo 113-8510, Japan.
Vaccines (Basel). 2023 Oct 23;11(10):1626. doi: 10.3390/vaccines11101626.
The association between vaccines and ocular disorders has attracted significant attention in scientific research. Numerous mainstream vaccines are associated with a range of uveitis types, including anterior, intermediate, and posterior uveitis. Additionally, they are associated with distinct ocular diseases such as multifocal choroiditis, Vogt-Koyanagi-Harada (VKH) disease, acute posterior multifocal placoid pigment epitheliopathy (APMPPE), and multiple evanescent white dot syndrome (MEWDS). These ocular conditions are often transient, with a vast majority of patients experiencing improvement after steroid intervention. To date, numerous cases of vaccine-induced uveitis have been reported. This study analyzed the correlation between antiviral vaccines, including the hepatitis B virus (HBV), human papillomavirus (HPV), measles-mumps-rubella (MMR), varicella zoster virus (VZV), and influenza vaccines, and different manifestations of uveitis. This is the first comprehensive study to offer a detailed analysis of uveitis types induced by antiviral vaccines. Through an extensive database search, we found a particularly strong link between influenza vaccines, followed by VZV and HPV vaccines. While anterior uveitis is common, conditions such as APMPPE, MEWDS, and VKH are particularly notable and merit careful consideration in clinical practice. Corticosteroid treatment was effective; however, half of the observed patients did not achieve full recovery, indicating potentially prolonged effects of the vaccine.
疫苗与眼部疾病之间的关联在科学研究中已引起了极大关注。众多主流疫苗与一系列葡萄膜炎类型相关,包括前葡萄膜炎、中间葡萄膜炎和后葡萄膜炎。此外,它们还与多灶性脉络膜炎、伏格特-小柳-原田(VKH)病、急性后极多灶性鳞状色素上皮病变(APMPPE)和多发性一过性白点综合征(MEWDS)等不同的眼部疾病相关。这些眼部病症通常是短暂的,绝大多数患者在接受类固醇干预后病情会有所改善。迄今为止,已有大量疫苗诱导性葡萄膜炎的病例报告。本研究分析了包括乙型肝炎病毒(HBV)、人乳头瘤病毒(HPV)、麻疹-腮腺炎-风疹(MMR)、水痘带状疱疹病毒(VZV)和流感疫苗在内的抗病毒疫苗与葡萄膜炎不同表现之间的相关性。这是第一项对由抗病毒疫苗诱导的葡萄膜炎类型进行详细分析的综合性研究。通过广泛的数据库检索,我们发现流感疫苗与葡萄膜炎之间的关联尤为紧密,其次是VZV和HPV疫苗。虽然前葡萄膜炎较为常见,但APMPPE、MEWDS和VKH等病症尤其值得关注,在临床实践中需要仔细考量。皮质类固醇治疗是有效的;然而,半数观察到的患者并未完全康复,这表明疫苗的影响可能具有持久性。