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R. Mather, T. Prabriputaloong, D.C. Gritz, I.G. Wong; Epidemiology of Herpes Zoster Ophthalmicus in Northern California . Invest. Ophthalmol. Vis. Sci. 2003;44(13):773.
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Purpose: To determine the epidemiology including the incidence and prevalence of herpes zoster ophthalmicus (HZO) in Northern California through a population-based cross-sectional study. Methods: Medical records of all people, from two target communities, diagnosed with ocular herpes virus infection between July 1, 1998 and June 30, 1999 were reviewed retrospectively. The incidence rates were calculated using a dynamic population model. Twelve-month period prevalence ratios were calculated based on the mid-period population. Different ethnic group incidence rates were compared using Poisson maximum-likelihood regression analysis. Results: The mid-period target population was 240,419. Of the 101 patients coded as ocular herpes, 63 were cases of herpes simplex infection and 29 cases were coded as herpes zoster ophthalmicus- 24 with ocular involvement, 3 cases without ocular involvement and 2 cases of keratitis due to chicken pox. Of the HZO group with ocular involvement, there were 11 new onset cases, and 13 cases beginning prior to the target period. The overall incidence was 4.6 cases per 100,000 person-years while the prevalence ratio was 10.4 cases/ 100,000. The overall male to female ratio was 0.92. The mean age at time of diagnosis was 53.9 years (range: 30-92 yrs). The highest incidence rate occurred among those aged 85 or older, with a rate of 81.5 per 100,000 person-years. The clinical features of HZO included: blepharitis 12%, conjunctivitis 17%, epithelial keratitis 25%, stromal keratitis 29%, with stromal infiltrate in 12% of cases, and iritis 17%. No cases of retinitis were reported. The prevalence ratios (per 100,000 persons) related to race were as follows: Whites 11.9, Blacks 1.2, Asians 22.9, Hispanics 7.4 and Other 12.1. The incidence rates (per 100,000 person-years) also differed with race: Whites 4.9, Blacks 1.2, Asians 17.1, Hispanics 3.7 and Other 6.0. Black patients had a 0.100 (p=0.02) prevalence rate ratio when compared to non-Blacks. Asians compared to non-Asians had a prevalence rate ratio of 3.04 (p=0.046). Conclusions: The incidence of new cases of ocular herpes zoster infection in our study was 4.6 per 100,000 person-years. This study confirms the previously reported lower prevalence of HZO in Blacks compared to non-Blacks. Furthermore, to our knowledge, the higher rate in Asian patients when compared with non-Asian patients has not been reported by others.
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