{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T10:22:21Z","timestamp":1786962141816,"version":"build-2736575974"},"reference-count":102,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T00:00:00Z","timestamp":1757030400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"JSPS KAKENHI","award":["JP 20K09824"],"award-info":[{"award-number":["JP 20K09824"]}]},{"name":"JSPS KAKENHI","award":["25K02864"],"award-info":[{"award-number":["25K02864"]}]},{"name":"JSPS KAKENHI","award":["22FC0201"],"award-info":[{"award-number":["22FC0201"]}]},{"name":"JSPS KAKENHI","award":["23fk0108671h0001"],"award-info":[{"award-number":["23fk0108671h0001"]}]},{"name":"JSPS KAKENHI","award":["23fk0108672h0001"],"award-info":[{"award-number":["23fk0108672h0001"]}]},{"name":"JSPS KAKENHI","award":["FY2023"],"award-info":[{"award-number":["FY2023"]}]},{"name":"Ministry of Health, Labour, and Welfare of Japan","award":["JP 20K09824"],"award-info":[{"award-number":["JP 20K09824"]}]},{"name":"Ministry of Health, Labour, and Welfare of Japan","award":["25K02864"],"award-info":[{"award-number":["25K02864"]}]},{"name":"Ministry of Health, Labour, and Welfare of Japan","award":["22FC0201"],"award-info":[{"award-number":["22FC0201"]}]},{"name":"Ministry of Health, Labour, and Welfare of Japan","award":["23fk0108671h0001"],"award-info":[{"award-number":["23fk0108671h0001"]}]},{"name":"Ministry of Health, Labour, and Welfare of Japan","award":["23fk0108672h0001"],"award-info":[{"award-number":["23fk0108672h0001"]}]},{"name":"Ministry of Health, Labour, and Welfare of Japan","award":["FY2023"],"award-info":[{"award-number":["FY2023"]}]},{"name":"Japan Agency for Medical Research and Development, AMED","award":["JP 20K09824"],"award-info":[{"award-number":["JP 20K09824"]}]},{"name":"Japan Agency for Medical Research and Development, AMED","award":["25K02864"],"award-info":[{"award-number":["25K02864"]}]},{"name":"Japan Agency for Medical Research and Development, AMED","award":["22FC0201"],"award-info":[{"award-number":["22FC0201"]}]},{"name":"Japan Agency for Medical Research and Development, AMED","award":["23fk0108671h0001"],"award-info":[{"award-number":["23fk0108671h0001"]}]},{"name":"Japan Agency for Medical Research and Development, AMED","award":["23fk0108672h0001"],"award-info":[{"award-number":["23fk0108672h0001"]}]},{"name":"Japan Agency for Medical Research and Development, AMED","award":["FY2023"],"award-info":[{"award-number":["FY2023"]}]},{"name":"Takeda Science Foundation","award":["JP 20K09824"],"award-info":[{"award-number":["JP 20K09824"]}]},{"name":"Takeda Science Foundation","award":["25K02864"],"award-info":[{"award-number":["25K02864"]}]},{"name":"Takeda Science Foundation","award":["22FC0201"],"award-info":[{"award-number":["22FC0201"]}]},{"name":"Takeda Science Foundation","award":["23fk0108671h0001"],"award-info":[{"award-number":["23fk0108671h0001"]}]},{"name":"Takeda Science Foundation","award":["23fk0108672h0001"],"award-info":[{"award-number":["23fk0108672h0001"]}]},{"name":"Takeda Science Foundation","award":["FY2023"],"award-info":[{"award-number":["FY2023"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Vaccines"],"abstract":"<jats:p>This comprehensive review examines the multifaceted interactions between influenza viruses and the ocular system, integrating viral pathogenesis, clinical manifestations, and vaccine-related considerations. Influenza A subtypes (H7, H1N1, H5N1) and influenza B viruses induce a spectrum of ocular complications, from mild conjunctivitis\u2014predominantly associated with H7 avian strains\u2014to sight-threatening disorders like uveal effusion syndrome, acute macular neuroretinopathy, and optic neuritis. Experimental evidence confirms viral replication in human corneal and retinal cells, with H7N7 demonstrating unique tropism for ocular tissues via NF-\u03baB-mediated inflammatory pathways. Clinical cases highlight direct viral invasion and immune-mediated mechanisms, such as Vogt\u2013Koyanagi\u2013Harada disease exacerbation and retinal vasculitis. Rarely, influenza vaccination has been linked to oculorespiratory syndrome, uveitis, and demyelinating events, though large-scale epidemiological studies (e.g., WHO safety reports) confirm vaccines\u2019 favorable risk\u2013benefit profile, distinguishing true adverse events from temporal associations. This synthesis emphasizes the need for ophthalmologists to prioritize surveillance during influenza seasons, integrating diagnostic tools like conjunctival RT-PCR and optical coherence tomography. Future research should focus on defining viral receptor-binding mechanisms in ocular tissues and developing targeted therapies for severe retinopathies, while reinforcing vaccination as a cornerstone of public health despite rare ocular risks.<\/jats:p>","DOI":"10.3390\/vaccines13090950","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T09:51:21Z","timestamp":1757065881000},"page":"950","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Influenza-Associated Ocular Complications: A Comprehensive Review of Viral Subtypes, Clinical Presentations, and Vaccination Risks"],"prefix":"10.3390","volume":"13","author":[{"given":"Yuan","family":"Zong","sequence":"first","affiliation":[{"name":"Department of Ophthalmology, Zhongshan Torch Development Zone People\u2019s Hospital, Zhongshan 528436, China"},{"name":"Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan"},{"name":"International Ocular Surface Research Center, Institute of Ophthalmology, and Key Laboratory for Regenerative Medicine, Jinan University Medical School, Guangzhou 510632, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuang","family":"Qiu","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology, Zhongshan Torch Development Zone People\u2019s Hospital, Zhongshan 528436, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3124-1101","authenticated-orcid":false,"given":"Jing","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mingming","family":"Yang","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1359-8198","authenticated-orcid":false,"given":"Yaru","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingheng","family":"Du","sequence":"additional","affiliation":[{"name":"International Ocular Surface Research Center, Institute of Ophthalmology, and Key Laboratory for Regenerative Medicine, Jinan University Medical School, Guangzhou 510632, China"},{"name":"Department of Ophthalmology, The First Affiliated Hospital of Jinan University, Guangzhou 510630, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyoko","family":"Ohno-Matsui","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Koju","family":"Kamoi","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Institute of Science Tokyo, Tokyo 113-8510, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,9,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1016\/S0140-6736(17)33293-2","article-title":"Estimates of global seasonal influenza-associated respiratory mortality: A modelling study","volume":"391","author":"Iuliano","year":"2018","journal-title":"Lancet"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"797","DOI":"10.1016\/j.mpmed.2021.09.015","article-title":"Influenza: Epidemiology and hospital management","volume":"49","author":"Tyrrell","year":"2021","journal-title":"Medicine"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Nuwarda, R.F., Alharbi, A.A., and Kayser, V. 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