{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T19:36:46Z","timestamp":1786649806744,"version":"build-2736575974"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"5","license":[{"start":{"date-parts":[[2023,5,1]],"date-time":"2023-05-01T00:00:00Z","timestamp":1682899200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2023,5]]},"abstract":"<jats:p>The aim of this study is to report the clinical features, imaging findings including confocal imaging, corneal nerve fiber analysis, and management outcomes in a series of three cases of varicella zoster virus (VZV) reactivation following one dose of coronavirus disease 2019 (COVID-19) vaccination. This was a retrospective and observational study. All the patients who developed uveitis post-vaccination were pooled together. Patients who had VZV reactivation were included. Two cases had polymerase chain reaction positive for VZV from aqueous humor. At the time of presentation, IgG and IgM spike protein antibodies for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were tested. Out of this pool, three patients with classical features to describe pole-to-pole manifestations were chosen. A 36-year-old lady with post-vaccination sclerokeratouveitis associated with reactivation of herpes zoster ophthalmicus, a 56-year-old lady with post-vaccination acute anterior uveitis associated with herpes zoster ophthalmicus, and a 43-year-old gentleman with post-vaccination acute retinal necrosis were included. We present a possible link between anti-SARS-CoV-2 virus vaccination and varicella zoster reactivation in these patients and also describe the clinical features, imaging findings including confocal imaging, corneal nerve fiber analysis, and management with detailed discussion.<\/jats:p>","DOI":"10.4103\/ijo.ijo_2942_22","type":"journal-article","created":{"date-parts":[[2023,5,17]],"date-time":"2023-05-17T03:02:38Z","timestamp":1684292558000},"page":"2001-2007","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":4,"title":["Pole-to-pole involvement of varicella zoster virus reactivation following COVID-19 vaccination"],"prefix":"10.4103","volume":"71","author":[{"given":"Padmamalini","family":"Mahendradas","sequence":"first","affiliation":[{"name":"Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yash","family":"Parmar","sequence":"additional","affiliation":[{"name":"Department of Retina, Narayana Nethralaya, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sai Bhakti","family":"Mishra","sequence":"additional","affiliation":[{"name":"Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Patil","sequence":"additional","affiliation":[{"name":"Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ankush","family":"Kawali","sequence":"additional","affiliation":[{"name":"Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Srinivasan","family":"Sanjay","sequence":"additional","affiliation":[{"name":"Department of Uveitis and Ocular Immunology, Narayana Nethralaya, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhujang","family":"Shetty","sequence":"additional","affiliation":[{"name":"Cataract and Refractive Surgery, Narayana Nethralaya, Bengaluru, Karnataka, India"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2023,5,17]]},"reference":[{"key":"R1-20251006","doi-asserted-by":"crossref","first-page":"389","DOI":"10.1136\/postgradmedj-2021-140654","article-title":"Review of COVID-19 vaccine subtypes, efficacy and geographical distributions","volume":"98","author":"Francis","year":"2022","journal-title":"Postgrad Med J"},{"key":"R2-20251006","doi-asserted-by":"crossref","first-page":"944","DOI":"10.3390\/vaccines9090944","article-title":"Cutaneous adverse reactions to COVID-19 vaccines: Insights from an immuno-dermatological perspective","volume":"9","author":"Niebel","year":"2021","journal-title":"Vaccines (Basel)"},{"key":"R3-20251006","doi-asserted-by":"crossref","first-page":"3398","DOI":"10.4103\/ijo.IJO_2824_21","article-title":"After the storm: Ophthalmic manifestations of COVID-19 vaccines","volume":"69","author":"Sen","year":"2021","journal-title":"Indian J Ophthalmol"},{"key":"R4-20251006","doi-asserted-by":"crossref","first-page":"2427","DOI":"10.1056\/NEJMoa2028436","article-title":"Safety and immunogenicity of SARS-CoV-2 mRNA-1273 vaccine in older adults","volume":"383","author":"Anderson","year":"2020","journal-title":"N Engl J Med"},{"key":"R5-20251006","article-title":"BNT162b2 induces SARS-CoV-2 neutralizing antibodies and T cells in humans","author":"Sahin","year":"2020","journal-title":"medRxiv"},{"key":"R6-20251006","doi-asserted-by":"crossref","first-page":"291","DOI":"10.1136\/bjo.2010.185983","article-title":"Reactivation of acute retinal necrosis after flu H1N1 vaccination","volume":"95","author":"Rothova","year":"2011","journal-title":"Br J Ophtalmol"},{"key":"R7-20251006","doi-asserted-by":"crossref","first-page":"810","DOI":"10.1016\/S0140-6736(99)00623-6","article-title":"Reactivation of herpesvirus infections after vaccinations?","volume":"353","author":"Walter","year":"1999","journal-title":"Lancet"},{"key":"R8-20251006","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1111\/j.1708-8305.2006.00098.x","article-title":"Herpes Zoster after yellow fever vaccination","volume":"14","author":"Bayas","year":"2007","journal-title":"J Travel Med"},{"key":"R9-20251006","first-page":"e16725","article-title":"Ipsilateral zoster ophthalmicus post COVID-19 vaccine in healthy young adults","volume":"13","author":"Thimmanagari","year":"2021","journal-title":"Cureus"},{"key":"R10-20251006","doi-asserted-by":"crossref","first-page":"439","DOI":"10.1007\/s11940-013-0246-5","article-title":"Complications of varicella zoster virus reactivation","volume":"15","author":"Nagel","year":"2013","journal-title":"Curr Treat Options Neurol"},{"key":"R11-20251006","doi-asserted-by":"crossref","first-page":"572","DOI":"10.3390\/vaccines9060572","article-title":"Reactivation of varicella zoster virus after vaccination for SARS-CoV-2","volume":"9","author":"Psichogiou","year":"2021","journal-title":"Vaccines (Basel)"},{"key":"R12-20251006","doi-asserted-by":"crossref","first-page":"1339","DOI":"10.1097\/00007890-199505150-00020","article-title":"Decreased alloreactivity after vaccination against hepatitis B","volume":"59","author":"Ruder","year":"1995","journal-title":"Transplantation"},{"key":"R13-20251006","doi-asserted-by":"crossref","first-page":"1566","DOI":"10.1111\/jocd.14035","article-title":"Herpes zoster following inactivated COVID-19 vaccine: A coexistence or coincidence?","volume":"20","author":"Bostan","year":"2021","journal-title":"J Cosmet Dermatol"},{"key":"R14-20251006","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.jdcr.2021.04.014","article-title":"Varicella-zoster virus reactivation after SARS-CoV-2 BNT162b2 mRNA vaccination: Report of 5 cases","volume":"12","author":"Rodr\u00edguez-Jim\u00e9nez","year":"2021","journal-title":"JAAD Case Rep"},{"key":"R15-20251006","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1186\/s12348-021-00260-4","article-title":"Varicella-zoster virus reactivation causing herpes zoster ophthalmicus (HZO) after SARS-CoV-2 vaccination-Report of three cases","volume":"11","author":"Papasavvas","year":"2021","journal-title":"J Ophthalmic Inflamm Infect"},{"key":"R16-20251006","doi-asserted-by":"crossref","first-page":"e6","DOI":"10.1111\/jdv.17646","article-title":"Varicella-zoster and herpes simplex virus reactivation post-COVID-19 vaccination: A review of 40 cases in an International Dermatology Registry","volume":"36","author":"Fathy","year":"2022","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"R17-20251006","doi-asserted-by":"crossref","first-page":"100381","DOI":"10.1016\/j.bbih.2021.100381","article-title":"The Pfizer-BNT162b2 mRNA-based vaccine against SARS-CoV-2 may be responsible for awakening the latency of herpes varicella-zoster virus","volume":"18","author":"Maldonado","year":"2021","journal-title":"Brain Behav Immun Health"},{"key":"R18-20251006","doi-asserted-by":"crossref","first-page":"1310","DOI":"10.1002\/jmv.21506","article-title":"A real-time PCR assay to identify and discriminate among wild-type and vaccine strains of varicella-zoster virus and herpes simplex virus in clinical specimens, and comparison with the clinical diagnoses","volume":"81","author":"Harbecke","year":"2009","journal-title":"J Med Virol"},{"issue":"suppl 1","key":"R19-20251006","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1093\/ofid\/ofw172.110","article-title":"The clinical and laboratory diagnosis of Herpes Zoster: How good is it?","volume":"3","author":"Dooling","year":"2016","journal-title":"Open Forum Infect Dis"},{"key":"R20-20251006","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s12348-021-00262-2","article-title":"Effect of SARS-CoV-2 mRNA vaccination on ocular herpes simplex and varicella-zoster virus reactivation: Should preventive antiviral treatment be given in known herpes patients","volume":"11","author":"Herbort","year":"2021","journal-title":"J Ophthalmic Inflamm Infect"},{"key":"R21-20251006","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1016\/S1473-3099(03)00857-0","article-title":"What does epidemiology tell us about risk factors for herpes zoster?","volume":"4","author":"Thomas","year":"2004","journal-title":"Lancet Infect Dis"},{"key":"R22-20251006","doi-asserted-by":"crossref","first-page":"ofw205","DOI":"10.1093\/ofid\/ofw205","article-title":"Risk of Herpes Zoster in individuals on biologics, disease-modifying antirheumatic drugs, and\/or corticosteroids for autoimmune diseases: A systematic review and meta-analysis","volume":"3","author":"Marra","year":"2016","journal-title":"Open Forum Infect Dis"},{"key":"R23-20251006","doi-asserted-by":"crossref","first-page":"SI90","DOI":"10.1093\/rheumatology\/keab345","article-title":"Herpes Zoster following BNT162b2 mRNA COVID-19 vaccination in patients with autoimmune inflammatory rheumatic diseases: A case series","volume":"60","author":"Furer","year":"2021","journal-title":"Rheumatology (Oxford)"},{"key":"R24-20251006","doi-asserted-by":"crossref","first-page":"NP32","DOI":"10.1177\/11206721211046485","article-title":"Reactivation of varicella zoster infection presenting as acute retinal necrosis post COVID 19 vaccination in an Asian Indian male","volume":"33","author":"Mishra","year":"2023","journal-title":"European Journal of Ophthalmology"},{"key":"R25-20251006","doi-asserted-by":"crossref","first-page":"5231","DOI":"10.1002\/jmv.27036","article-title":"Herpes Zoster emergence following MRNA COVID-19 vaccine","volume":"93","author":"Eid","year":"2021","journal-title":"J Med Virol"},{"key":"R26-20251006","doi-asserted-by":"crossref","first-page":"169","DOI":"10.1016\/j.ijid.2021.08.048","article-title":"Herpes Zoster after COVID vaccination","volume":"111","author":"van Dam","year":"2021","journal-title":"Int J Infect Dis"},{"key":"R27-20251006","doi-asserted-by":"crossref","first-page":"3389","DOI":"10.1111\/jocd.14268","article-title":"Herpes Zoster after inactivated COVID-19 vaccine: A cutaneous adverse effect of the vaccine","volume":"20","author":"Arora","year":"2021","journal-title":"J Cosmet Dermatol"},{"key":"R28-20251006","doi-asserted-by":"crossref","first-page":"1960","DOI":"10.1111\/jocd.14210","article-title":"20 Post-COVID-19 vaccine-related shingles cases seen at the Las Vegas Dermatology Clinic and sent to Us via Social Media","volume":"20","author":"Lee","year":"2021","journal-title":"J Cosmet Dermatol"},{"key":"R29-20251006","doi-asserted-by":"crossref","first-page":"198","DOI":"10.7774\/cevr.2021.10.2.198","article-title":"A rare case of shingles after COVID-19 vaccine: Is it a possible adverse effect?","volume":"10","author":"Aksu","year":"2021","journal-title":"Clin Exp Vaccine Res"},{"key":"R30-20251006","doi-asserted-by":"crossref","first-page":"216","DOI":"10.4103\/injr.injr_137_21","article-title":"Herpes zoster reactivation after COVID-19 vaccination in patients with autoimmune diseases","volume":"17","author":"Sanjay","year":"2022","journal-title":"Indian J Rheumatol"},{"key":"R31-20251006","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1097\/ICO.0000000000002999","article-title":"Recurrence of varicella-zoster virus keratitis after SARS-CoV-2 vaccination","volume":"41","author":"Ryu","year":"2022","journal-title":"Cornea"},{"key":"R32-20251006","doi-asserted-by":"crossref","first-page":"928","DOI":"10.1136\/bjo.2007.133967","article-title":"Use of multiplex PCR and real-time PCR to detect human herpes virus genome in ocular fluids of patients with uveitis","volume":"92","author":"Sugita","year":"2008","journal-title":"Br J Ophthalmol"},{"key":"R33-20251006","doi-asserted-by":"crossref","first-page":"2160","DOI":"10.1128\/JCM.00294-13","article-title":"Time profile of viral DNA in aqueous humor samples of patients treated for varicella-zoster virus acute retinal necrosis by use of quantitative real-time PCR","volume":"51","author":"Bernheim","year":"2013","journal-title":"J Clin Microbiol"},{"key":"R34-20251006","doi-asserted-by":"crossref","first-page":"781","DOI":"10.1016\/j.ajo.2007.06.034","article-title":"Infectious uveitis in immunocompromised patients and the diagnostic value of polymerase chain reaction and Goldmann-Witmer coefficient in aqueous analysis","volume":"144","author":"Westeneng","year":"2007","journal-title":"Am J Ophthalmol"},{"key":"R35-20251006","doi-asserted-by":"crossref","first-page":"313","DOI":"10.1016\/j.ajo.2005.09.017","article-title":"Polymerase chain reaction and Goldmann-Witmer coefficient analysis are complimentary for the diagnosis of infectious uveitis","volume":"141","author":"De Groot-Mijnes","year":"2006","journal-title":"Am J Ophthalmol"},{"key":"R36-20251006","doi-asserted-by":"crossref","first-page":"686427","DOI":"10.3389\/fmed.2021.686427","article-title":"Antiviral therapy for varicella zoster virus (VZV) and Herpes simplex virus (HSV)-induced anterior uveitis: A systematic review and meta-analysis","volume":"8","author":"Testi","year":"2021","journal-title":"Front Med (Lausanne)"},{"key":"R37-20251006","first-page":"133","article-title":"Combination systemic and intravitreal antiviral therapy in the management of acute retinal necrosis syndrome (an American Ophthalmological Society thesis)","volume":"111","author":"Flaxel","year":"2013","journal-title":"Trans Am Ophthalmol Soc"}],"container-title":["Indian Journal of Ophthalmology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2942_22","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,13]],"date-time":"2026-08-13T18:58:39Z","timestamp":1786647519000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ovid.com\/10.4103\/IJO.IJO_2942_22"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,5]]},"references-count":37,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2023]]}},"URL":"https:\/\/doi.org\/10.4103\/ijo.ijo_2942_22","relation":{},"ISSN":["0301-4738","1998-3689"],"issn-type":[{"value":"0301-4738","type":"print"},{"value":"1998-3689","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,5]]},"assertion":[{"value":"2022-11-04","name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-01-13","name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}}]}}