Age: 60.0
Sex: F
Vaccine: COVID19
Symptoms: Antinuclear antibody, C-reactive protein, Double stranded DNA antibody, HLA-B*27 assay, Iridocyclitis
Clinical narrative: This literature-non-study case was reported in a literature article and describes the occurrence of IRIDOCYCLITIS (Anterior Uveitis/three other flares of anterior uveitis) in a 60-year-old female patient who received mRNA-1273 (Moderna COVID-19 Vaccine) for COVID-19 vaccination. LITERATURE REFERENCE: Anterior uveitis following COVID vaccination: a summary of cases from global reporting systems. Ocul Immunol Inflammation. 2022:1-3. The patient's past medical history included COVID-19 in November 2020. Concurrent medical conditions included Lichen planus (Female patient with a history of lichen planus without active symptoms or treatment). On 15-Jan-2021, the patient received first dose of mRNA-1273 (Moderna COVID-19 Vaccine) (unknown route) 1 dosage form. On an unknown date,  after starting mRNA-1273 (Moderna COVID-19 Vaccine), the patient experienced IRIDOCYCLITIS (Anterior Uveitis/three other flares of anterior uveitis) (seriousness criterion medically significant). The patient was treated with PREDNISOLONE ACETATE (topical) for Anterior uveitis, at an unspecified dose and frequency and CYCLOPENTOLATE HYDROCHLORIDE (CYCLOGYL) (topical) for Anterior uveitis, at an unspecified dose and frequency. At the time of the report, IRIDOCYCLITIS (Anterior Uveitis/three other flares of anterior uveitis) had not resolved. DIAGNOSTIC RESULTS (normal ranges are provided in parenthesis if available): On an unknown date, Antinuclear antibody: normal (normal) normal, normal (normal) normal, normal (normal) normal, normal (normal) normal and positive (Positive) low-titer (1:80) antinuclear antibody positivity. On an unknown date, C-reactive protein: normal (normal) normal. On an unknown date, Double stranded DNA antibody: normal (normal) normal. On an unknown date, HLA-B*27 assay: positive (Positive) Positive. On an unknown date, Red blood cell sedimentation rate: normal (normal) normal. The action taken with mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown) was unknown. For mRNA-1273 (Moderna COVID-19 Vaccine) (Unknown), the reporter considered IRIDOCYCLITIS (Anterior Uveitis/three other flares of anterior uveitis) to be related. Concomitant product use was not provided by the reporter. Three days after the first dose of Moderna COVID-19 vaccine, patient developed pain and redness of the right eye. She was initially diagnosed with episcleritis but had continued symptoms and was found on day 10 after vaccination to have 1+ anterior chamber cell, anterior chamber fibrin, and posterior synechiae. Treatment also included subconjunctival Kenalog injection with resolution of her anterior uveitis over the following 6 weeks. Patient had no prior history of ocular inflammation, no history of allergies to other vaccines, and no known history of allergies to any of the Moderna COVID-19 vaccine ingredients. At the initial submission of her information she was not planning to receive a second dose of the COVID-19 vaccine; however, she has since done so due to vaccine mandates and did not develop a uveitis flare. She has, however, had three other flares of anterior uveitis, all treated with topical steroids, the last of which remains currently active. Company Comment: This literature non-study case concerns a 60-year-old female patient, with no relevant medical history, who experienced the serious (medically significant), unexpected event of anterior uveitis. The patient developed pain and redness of the right eye 3 days after receiving the first dose of mRNA 1273 COVID-19 vaccine and was initially diagnosed with episcleritis. Symptoms persisted and 10 days after vaccination, patient noted to have 1+ anterior chamber cell, anterior chamber fibrin, and posterior synechiae. Patient was diagnosed with Anterior Uveitis and treated with topical prednisolone acetate 1%, cyclogyl 1% and subconjunctival Kenalog injection with resolution after 6 weeks. Patient had work up done, of significance was the HLA-B27 and low-titer (1:80) antinuclear antibody positivity. Patient received the second dose of COVID-19 vaccine (brand unspecified) on unknown date and did not develop a uveitis flare. Patient however, had 3 other flares of anterior uveitis all treated with topical steroids, last flare is still ongoing. Re-challenge is unknown since second dose brand was not specified. The benefit-risk relationship of mRNA 1273 vaccine is not affected by this report. This case was linked to MOD-2022-513460 (Patient Link). Sender's Comments: This literature non-study case concerns a 60-year-old female patient, with no relevant medical history, who experienced the serious (medically significant), unexpected event of anterior uveitis. The patient developed pain and redness of the right eye 3 days after receiving the first dose of mRNA 1273 COVID-19 vaccine and was initially diagnosed with episcleritis. Symptoms persisted and 10 days after vaccination, patient noted to have 1+ anterior chamber cell, anterior chamber fibrin, and posterior synechiae. Patient was diagnosed with Anterior Uveitis and treated with topical prednisolone acetate 1%, cyclogyl 1% and subconjunctival Kenalog injection with resolution after 6 weeks. Patient had work up done, of significance was the HLA-B27 and low-titer (1:80) antinuclear antibody positivity. Patient received the second dose of COVID-19 vaccine (brand unspecified) on unknown date and did not develop a uveitis flare. Patient however, had 3 other flares of anterior uveitis all treated with topical steroids, last flare is still ongoing. Re-challenge is unknown since second dose brand was not specified. The benefit-risk relationship of mRNA 1273 vaccine is not affected by this report.