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Aimee R. Edell, Elisabeth Cohen; Herpetic Eye Disease: Spectrum Of Disease At A City Hospital For The Underserved. Invest. Ophthalmol. Vis. Sci. 2012;53(14):6164. doi: https://doi.org/.
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To establish the clinical profile of herpetic eye disease among patients at a large city hospital for the underserved, and to further define the spectrum of disease among patients with herpes zoster ophthalmicus (HZO).
Retrospective chart review of 48 patients presenting to Bellevue Hospital Emergency Department for management of herpetic eye disease for which an ophthalmologic consultation was obtained from January 1, 2006 to December 31, 2011.
More patients were diagnosed with herpes zoster than herpes simplex (62.5%, n = 30 vs. 37.5%, n = 18, respectively). Of those with HZO, patients were more often male (22 male vs. 8 female), with a mean patient age of 52 years (median 55 years). The most common decade of onset of HZO was 50-59 years. Recurrent herpes zoster was seen in 13.3% of cases (n = 4). Of these, 50% were immunocompromised (n = 2). Forty percent of patients presented within 72 hours of onset of cutaneous symptoms (n = 10), and 96% presented within 1 week (n = 24, data available for 25 patients). Visual acuity was 20/30 or better in the affected eye in 76.7% of cases (n = 23). HZO with ocular involvement was found in 93% of cases (n = 28), with the eyelids, conjunctiva, and corneal epithelium most commonly affected (86.7%, n = 26, 66.7%, n = 20, 50%, n = 15, respectively). Intraocular pressure in the affected eye versus the unaffected eye was not significantly different (16.1 mmHg vs. 15.2 mmHg, p = 0.34, respectively). Three patients with HZO were immunocompromised, with those younger than 60 years attributable to HIV (n = 2), and older than 60 years attributable to ongoing chemotherapy (n = 1). The average duration of follow up for the acute episode was 5 days after onset of cutaneous symptoms. None of the patients in this series received the vaccine against herpes zoster.
Acute herpes zoster ophthalmicus was seen more commonly than ocular herpes simplex in patients presenting to the emergency room. Patients were more likely to be male, aged 50-59 years, and to present 4 to 7 days after the onset of cutaneous symptoms.
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