Abstract
Purpose :
Several studies have shown that zoster become more common, and can present with more severe manifestations as old, immunocompromised patients increase. In addition, herpes zoster ophthalmicus (HZO) shows divers ocular signs, disease severity and duration. We analyze types and frequency of ocular complications of HZO and evaluate risk factors of chronic and recurrent HZO in South Korea.
Methods :
Retrospective, hospital-based cohort study was performed of 131 patients who were diagnosed with HZO clinically from July 26, 2009, through May 31, 2016 seen in the Samsung Medical center (SMC).
A total of 1,875 herpes zoster patients and 131 clinically characterized HZO were recruited.
Assessment of the HZO patient’s clinical course was defined by the following: an acute episode of HZO was defined as quiescence of disease within 90 days of initial presentation, HZO recurrence was defined as any recurrent eye disease after quiescence of disease and medical treatment, and chronic HZO was defined as active disease persisting more than 90 days from initial presentation.
Potential risk factors for recurrent and chronic disease such as demographics, immune status, types of ocular complications were evaluated with logistic regression methodology.
Results :
One hundred and thirty one patients with HZO were included in the study. Overall, the male/female (M/F) ratio was 67/64, mean age at incident episode of HZO was 54.83 ± 18.03 years (range, 10~89 years). Most patient were immune competent (89.3%). Patients were followed for a mean of 1.93 ± 4.69 months (range, 0~41.57 months). There are 24 chronic HZO patients and 12 patients of recurrent HZO. The overall 1-, 3-, and 5-year recurrence rates for either recurrent eye disease were 5.9%, 12.4%, and 15.1%, respectively. Young age (odds ratio [OR] = 0.962, confidence interval [CI] =0.930-0.995, p=0.024), epithelial keratitis (OR=6.793, CI=1.907-24.193, p=0.003) and uveitis (OR=10.896, CI=2.393-49.617, p=0.002) increased the risk of chronic disease. Epithelial keratitis (OR=5.009, CI=1.366-18.376, p=0.015) and uveitis (OR=7.083, CI=1.780-28.184, p=0.005) increased the risk of recurrent disease.
Conclusions :
This study reports newer data indicating that quite a number of patients experience recurrent and chronic HZO. Futher study is needed to guide preventative and therapeutic approaches to recurrent and chronic HZO.
This is an abstract that was submitted for the 2017 ARVO Annual Meeting, held in Baltimore, MD, May 7-11, 2017.