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Jonathan Powell, Marianna Atiya, David Poulsen, Ethan K Sobol, Jose Diaz, David C Gritz; Herpes zoster ophthalmicus and associations with ocular complications: Bronx Epidemiology of HIV Eye Studies (BEHIVES). Invest. Ophthalmol. Vis. Sci. 2015;56(7 ):5756.
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© ARVO (1962-2015); The Authors (2016-present)
Herpes zoster ophthalmicus (HZO) has potentially serious ocular complications. There is little data published on the strength of association of risk factors for developing ocular complications. We explored several risk factors potentially associated with the development of iritis, keratitis, blepharoconjunctivitis, and postherpetic neuralgia (PHN) for individuals with HZO.
A comparative, retrospective investigation among HZO patients in the Bronx was performed. Cases of HZO from June 1, 2006 through May 31, 2014 were identified using Montefiore’s Clinical Looking Glass software (CLG), which compiles medical information for all individuals within the hospital outpatient system. The inclusion criteria consisted of a clinical diagnosis of HZO and Bronx residency. Relevant demographic and clinical information was extracted from the CLG database and confirmed through chart review. Potential associations evaluated included age, gender, HIV status, diagnosis of diabetes and atopy, and presence of the Hutchinson’s sign. Firth logistic regression modeling was used to determine any significant associations between HIV status and other potential risk factors for each outcome of interest. Odds ratios (OR) and 95% confidence intervals (95% CI) were calculated to estimate relative risk.
The study group included 155 patients with HZO. While controlling for confounders, HIV status was significantly associated with the development of iritis (p=0.0275) and keratitis (p = 0.0013). The adjusted OR estimates for iritis and keratitis manifestations among HIV cases were 3.163 (95% CI: 1.146 to 8.648) and 5.230 (95% CI: 1.963 to 14.389) respectively. Also, HIV infection had an estimated OR of 4.067 (95% CI: 1.469 to 12.910) for the development of at least one of the four ocular complications while adjusting for Hutchinson’s sign and age.
The presence of HIV was correlated with an increased risk of developing various ocular complications for individuals with HZO. To our knowledge, this study represents the first time the strength of association has been measured between HIV status and the onset of iritis, keratitis, blepharoconjunctivitis, and PHN among HZO cases.
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