scholarly journals Ocular inflammatory events following COVID-19 vaccination: a multinational case series

Author(s):  
Ilaria Testi ◽  
Camilo Brandão-de-Resende ◽  
Rupesh Agrawal ◽  
Carlos Pavesio

Abstract Background Inflammatory adverse events following COVID-19 vaccination are being reported amidst the growing concerns regarding vaccine’s immunogenicity and safety, especially in patients with pre-existing inflammatory conditions. Methods Multinational case series of patients diagnosed with an ocular inflammatory event within 14 days following COVID-19 vaccination collected from 40 centres over a 3 month period in 2021. Results Seventy patients presented with ocular inflammatory events within 14 days following COVID-19 vaccination. The mean age was 51 years (range, 19-84 years). The most common events were anterior uveitis (n = 41, 58.6%), followed by posterior uveitis (n = 9, 12.9%) and scleritis (n = 7, 10.0%). The mean time to event was 5 days and 6 days (range, 1-14 days) after the first and second dose of vaccine, respectively. Among all patients, 36 (54.1%) had a previous history of ocular inflammatory event. Most patients (n = 48, 68.6%) were managed with topical corticosteroids. Final vision was not affected in 65 (92.9%), whereas 2 (2.9%) and 3 (4.3%) had reduction in visual acuity reduced by ≤ 3 lines and > 3 lines, respectively. Reported complications included nummular corneal lesions (n = 1, 1.4%), cystoid macular oedema (n = 2, 2.9%) and macular scarring (n = 2, 2.9%). Conclusion Ocular inflammatory events may occur after COVID-19 vaccination. The findings are based on a temporal association that does not prove causality. Even in the possibility of a causal association, most of the events were mild and had a good visual outcome.

Author(s):  
Ilaria Testi ◽  
Camilo Brandão-de-Resende ◽  
Rupesh Agrawal ◽  
Carlos Pavesio ◽  
Laura Steeples ◽  
...  

Abstract Background Inflammatory adverse events following COVID-19 vaccination are being reported amidst the growing concerns regarding vaccine’s immunogenicity and safety, especially in patients with pre-existing inflammatory conditions. Methods Multinational case series of patients diagnosed with an ocular inflammatory event within 14 days following COVID-19 vaccination collected from 40 centres over a 3 month period in 2021. Results Seventy patients presented with ocular inflammatory events within 14 days following COVID-19 vaccination. The mean age was 51 years (range, 19–84 years). The most common events were anterior uveitis (n = 41, 58.6%), followed by posterior uveitis (n = 9, 12.9%) and scleritis (n = 7, 10.0%). The mean time to event was 5 days and 6 days (range, 1–14 days) after the first and second dose of vaccine, respectively. Among all patients, 36 (54.1%) had a previous history of ocular inflammatory event. Most patients (n = 48, 68.6%) were managed with topical corticosteroids. Final vision was not affected in 65 (92.9%), whereas 2 (2.9%) and 3 (4.3%) had reduction in visual acuity reduced by ≤3 lines and > 3 lines, respectively. Reported complications included nummular corneal lesions (n = 1, 1.4%), cystoid macular oedema (n = 2, 2.9%) and macular scarring (n = 2, 2.9%). Conclusion Ocular inflammatory events may occur after COVID-19 vaccination. The findings are based on a temporal association that does not prove causality. Even in the possibility of a causal association, most of the events were mild and had a good visual outcome.


2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  

Abstract Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE, EMBASE, and CENTRAL was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 112 additional cases previously published. Of 115 patients, there were 101 exogenous endophthalmitis (87.8%) and 14 endogenous endophthalmitis (12.2%). The patients’ age ranged from 13 to 89 years with mean of 60.5±17.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (67.3%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (3.5%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.


2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  

Abstract Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE, EMBASE, and CENTRAL was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 112 additional cases previously published. Of 115 patients, there were 101 exogenous endophthalmitis (87.8%) and 14 endogenous endophthalmitis (12.2%). The patients’ age ranged from 13 to 89 years with mean of 60.5±17.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (67.3%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (3.5%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.


2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  

Abstract Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 95 additional cases previously published. Of 98 patients, there were 85 exogenous endophthalmitis (86.7%) and 13 endogenous endophthalmitis (13.3%). The patients’ age ranged from 13 to 89 years with mean of 61.1±18.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (62.4%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (4.1%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60.Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.


2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  

Abstract Background: To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis.Methods: Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE was performed. The clinical information and type of NTM from the previous studies and our cases were summarized.Results: We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 95 additional cases previously published. Of 98 patients, there were 85 exogenous endophthalmitis (86.7%) and 13 endogenous endophthalmitis (13.3%). The patients’ age ranged from 13 to 89 years with mean of 61.1±18.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (62.4%). In contrast, almost all endogenous endophthalmitis patients were either primary or secondary immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (4.1%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60. There were no significant differences of initial and final vision between exogenous and endogenous causes (p=1.000, 0.446, respectively).Conclusions: NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.


2001 ◽  
Vol 20 (12) ◽  
pp. 611-617 ◽  
Author(s):  
A I Hatzitolios ◽  
M L Sion ◽  
N P Eleftheriadis ◽  
E Toulis ◽  
G Efstratiadis ◽  
...  

Objective: To study the epidemiology of acute poisoning patients presenting to an acute medical service ward in a Greek hospital between January 1998 and December 2000. Design: Prospective case series. Results: A total of 273 patients with self-poisoning were included in the study. This represented 3.8% of the overall admissions to the unit. The mean age of patients was 33, the most frequent age group being that aged 20–30 years (36.2% of total) with a male-to-female ratio of 1:1.97. Sixty per cent of patients was admitted within 4 h. Those from urban areas comprised 76.2% and 23.8% from rural areas. The most frequently ingested agents were psychopharmaceuticals (37.4%) and analgesics/anti-rheumatics (32.6%). Pesticides (7.7% of total) were most frequently used by patients coming from rural areas (32.3% of patients from rural areas). Alcohol was included in the overdose in 8.4%. Of the patients, 16.2% had a previous history of overdose. In this case series, psychiatric assessment suggested that 52% of the patients had a formal psychotic diagnosis, 21% had personality disorder and 27% had taken an overdose in response to stress. The most frequently documented precipitating factors were family problems and disputes (37%). Unusually, the seasonal distribution in these patients suggested a peak in summer (37.5% of presentations) with lower numbers in spring (30.2%), autumn (17.7%) and winter (14.6%). Of the patients, 23.7% presented in July. A total of 73.5% of patients was conscious, 16.4% was somnolent, 4.5% was in precoma and 5.6% was in coma (GCS <8). Patients who received antidotal therapy comprised 17.9%. Evidence of hepatic dysfunction was observed in 8.9% of patients and renal dysfunction in 3.6%. Extracorporeal techniques for drug removal (hemodialysis and hemoperfusion) were used in 2.2% of patients. Intensive care therapy was required in 11.4% of patients. The mean overall hospitalization time was 3.3 days. The mortality rate was 2.9%. Conclusions: This study shows that the epidemiology of self-harm by overdose in Greece is significantly different in terms of the seasonal presentation from other parts of Europe. The agents ingested and other features are similar to northern Europe. Psychiatric diagnoses are more common in our group than in those reported from northern Europe.


2020 ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsophon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  

Abstract Background : To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature of NTM endophthalmitis. Methods : Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE was performed. The clinical information and type of NTM from the previous studies and our cases were summarized. Results : We reported three cases of NTM endophthalmitis caused by M. haemophilum , M. fortuitum and M. abscessus and a summarized review of 95 additional cases previously published. Of 98 patients, there were 85 exogenous endophthalmitis (86.7%) and 13 endogenous endophthalmitis (13.3%). The patients’ age ranged from 13 to 89 years with mean of 61.1±18.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (62.4%). In contrast, almost all endogenous endophthalmitis patients were either primary or secondary immunocompromised, previous history of disseminated NTM infection was identified in 38.5% of cases. Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Initial and final vision were generally worse than 6/60. There were no significant differences of initial and final vision between exogenous and endogenous causes (p=1.000, 0.446, respectively). Conclusions : NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Warinyupa Pinitpuwadol ◽  
Nattaporn Tesavibul ◽  
Sutasinee Boonsopon ◽  
Darin Sakiyalak ◽  
Sucheera Sarunket ◽  
...  

Abstract Background To report three cases of nontuberculous mycobacterial (NTM) endophthalmitis following multiple ocular surgeries and to review previous literature in order to study the clinical profile, treatment modalities, and visual outcomes among patients with NTM endophthalmitis. Methods Clinical manifestation and management of patients with NTM endophthalmitis in the Department of Ophthalmology, Faculty of Medicine, Siriraj hospital, Mahidol University, Bangkok, Thailand were described. In addition, a review of previously reported cases and case series from MEDLINE, EMBASE, and CENTRAL was performed. The clinical information and type of NTM from the previous studies and our cases were summarized. Results We reported three cases of NTM endophthalmitis caused by M. haemophilum, M. fortuitum and M. abscessus and a summarized review of 112 additional cases previously published. Of 115 patients, there were 101 exogenous endophthalmitis (87.8%) and 14 endogenous endophthalmitis (12.2%). The patients’ age ranged from 13 to 89 years with mean of 60.5 ± 17.7 years with no gender predominance. Exogenous endophthalmitis occurred in both healthy and immunocompromised hosts, mainly caused by cataract surgery (67.3%). In contrast, almost all endogenous endophthalmitis patients were immunocompromised. Among all patients, previous history of tuberculosis infection was identified in 4 cases (3.5%). Rapid growing NTMs were responsible for exogenous endophthalmitis, while endogenous endophthalmitis were commonly caused by slow growers. Treatment regimens consisted of macrolides, fluoroquinolones or aminoglycosides, which were continued for up to 12 months. Initial and final vision were generally worse than 6/60. Conclusions NTM endophthalmitis is a serious intraocular infection that leads to irreversible loss of vision. The presentation can mimic a chronic recurrent or persistent intraocular inflammation. History of multiple intraocular surgeries or immune-deficiency in patient with chronic panuveitis should raise the practioner’s suspicion of NTM endophthalmitis. Appropriate diagnosis and treatment are important to optimize visual outcome.


2020 ◽  
Vol 161 (45) ◽  
pp. 1927-1935
Author(s):  
Zsuzsanna Géhl ◽  
Béla Tamási ◽  
András Bánvölgyi ◽  
Zoltán Zsolt Nagy

Összefoglaló. Bevezetés és célkitűzés: A syphiliseredetű uveitis szemészeti és általános tüneteinek ismertetése, a prognózis elemzése olyan esetek kapcsán, amelyekben az uveitis kivizsgálása során derült fény a syphilisre. Módszer: 2011 és 2019 között 14 uveitises beteg vizsgálata során derült fény syphilisre (13 férfi, 1 nő), a tünetek 25 szemen jelentkeztek. A betegek adatait retrospektíven elemeztük. Eredmények: A betegek átlagéletkora 46 év volt (23–72 év). A szemészeti diagnózis felállítását követően 2 beteg nem jelent meg a további bőrgyógyászati és szemészeti vizsgálaton, 1 beteget más intézetben kezeltek. A gondozott 11 betegnél a gyulladásban érintett szemeken az első alkalommal észlelt átlagolt látóélesség a jobb szemen 0,71 (0,001–1,0), a bal szemen 0,53 (0,04–1,0) volt. A követési idő átlagosan 22 hónap (1–72) volt. A követési idő végén az átlagolt látóélesség a jobb szemen 0,9 (0,15–1,0), a bal szemen 0,82 (0,08–1,0) volt. A leggyakoribb szemészeti manifesztáció a hátsó uveitis volt, amely papillitis, chorioretinitis vagy kombinált formákban volt megfigyelhető, összesen 20 szemen. A neurosyphilis-protokoll alapján alkalmazott penicillinkezelés után a gyulladásos tünetek minden betegnél megszűntek, a követési idő végén a betegek többségénél a látóélesség teljes volt. A gyengébb látóélesség hátterében látóideg-atrophia, illetve a macula károsodása állt. Következtetés: Eseteinkben a betegek főként középkorú férfiak voltak. Bár jellemző volt a hátsószegmentum-érintettség, megfelelő kezelés mellett a prognózis jónak volt mondható. Orv Hetil. 2020; 161(45): 1927–1935. Summary. Introduction and objective: To describe the ocular and general characteristics and to assess prognosis of patients with uveitis, whose syphilis infection was revealed during uveitis workup. Method: Between 2011 and 2019, 14 uveitis patients were diagnosed with syphilis (13 males, 1 female) with symptoms in 25 eyes. Patients’ clinical records were analyzed retrospectively. Results: The mean age of patients was 46 years (range 23–72 years). 2 patients did not show up for further dermatological and ophthalmic examinations, and 1 patient was treated at another institute. In the 11 patients we treated, the mean visual acuity observed for the first time in the eyes affected by inflammation was 0.71 (0.001–1.0) in the right eye and 0.53 (0.04–1.0) in the left eye. The mean follow-up was 22 months (1–72). At the end of the follow-up period, the mean visual acuity was 0.9 (0.15–1.0) in the right eye and 0.82 (0.08–1.0) in the left eye. The most common ocular manifestation was posterior uveitis (papillitis, chorioretinitis, or in combined forms) in a total of 20 eyes. After receiving penicillin therapy according the neurosyphilis protocol, inflammatory symptoms resolved in all patients, and at the end of the follow-up, the majority of patients had complete visual recovery. Lower visual acuity was due to optic nerve atrophy and macular damage. Conclusion: In our case series, the patients were predominantly middle-aged men. Although most patients showed posterior segment involvement, with appropriate treatment the visual outcome was good. Orv Hetil. 2020; 161(45): 1927–1935.


2020 ◽  
pp. 004947552098130
Author(s):  
Fabián R Carreño-Almánzar ◽  
Adán Coronado-Galán ◽  
Sonia A Cala-Gómez ◽  
Agustín Vega-Vera

Imported malaria has increased in Colombia since 2015 and has been attributed to migrants coming from Venezuela. We present a series of malaria cases, nested in a retrospective cross-sectional study between 2017 and 2018, aimed at calculating the prevalence of medical diseases among immigrants in a University Hospital in Colombia. Among 154 immigrants admitted for medical causes between 2017 and 2018, 8 were diagnosed with malaria, all due to Plasmodium vivax. Of these, seven had uncomplicated malaria, five had a previous history of malaria, one was critically ill, but none died. We highlight that, similar to other case series of imported malaria, Latin American migrants were young, with similar clinical profiles, having a low proportion of severe cases, and P. vivax was the most frequent cause.


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