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John A. Gonzales, Durga Borkar, Vivien Tham, Aleli Vinova, Elizabeth Esterberg, Nisha Acharya; Association between Atopy and Herpetic Eye Disease in a Hawaiian population. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6162. doi: https://doi.org/.
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To determine whether atopy is associated with herpetic ocular disease.
A retrospective, population-based, case-control study was conducted. Electronic medical records from Kaiser Permanente Hawaii were reviewed to identify patients with herpes simplex (HSV) or herpes zoster (HZV) eye disease (blepharitis, conjunctivitis, dermatitis, keratitis, and uveitis) and were then analyzed for history of atopic diseases (atopic dermatitis, allergic rhinitis, and asthma) during a 2-year period (January 1, 2006 to December 31, 2007). Two control groups were selected from the Kaiser Hawaii population: 1) a randomly selected group from the entire Kaiser membership 2) an age and gender-matched control group for all cases of herpetic eye disease in patients 18 years of age and older. Correlations were assessed using STATA 11.0 software (StataCorp LP, College Station, TX) and P-values were calculated via Fisher’s exact test.
There were 127 patients with HSV eye disease (114 patients were 18 years of age and older) and 141 patients with HZV eye disease (137 patients 18 years of age and older). Compared to the general Kaiser control group, having a diagnosis of 3 atopic diseases was highly associated with having HSV ocular disease (OR 3.5, P=0.03). Additionally, atopic dermatitis was associated with HSV eye disease (OR 2.7, P=0.005). Compared to the age and gender matched control group of patients 18 years of age or older, patients with HSV eye disease were again more likely to have all 3 atopic diseases (OR 6.9, P=0.01), as well as atopic dermatitis (OR 2.5, P=0.01). No statistically significant associations between atopy and HZV eye disease were found.
Patients with HSV eye disease are more likely to have atopic dermatitis as well as all 3 atopic diseases, unlike HZV eye disease in which no relationship was found. A dysregulation in cell-mediated immunity, which is present in atopic conditions, may predispose patients to developing HSV ocular disease.
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