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Dana Darwish, Joel Sugar, Elmer Tu, Jose de la Cruz, Ann-Marie Lobo; Ocular complications in herpes zoster ophthalmicus. Invest. Ophthalmol. Vis. Sci. 2019;60(9):6701.
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© ARVO (1962-2015); The Authors (2016-present)
To determine the presence of ocular involvement and development of ocular complications in patients who present with herpes zoster ophthalmicus (HZO) to a tertiary care center.
A retrospective chart review of patients diagnosed with HZO based on ICD-9 diagnosis code (053.2) at University of Illinois Hospital systems from 2010-2015 was performed. Demographic information, medications, co-morbidities, visual acuity (VA), exam findings, and ocular complications were recorded.
Of 250 adult patients with ICD-9 code 053.2 during the study period, 130 patients had HZO, 48 patients had HZV dermatitis only, and 72 were incorrectly coded.Of 130 HZO patients, 82% were over age 50, 57% were female, and 43% Caucasian. 47% of patients received antivirals within 72 hours, with a mean of 4.8 days between symptom onset to treatment.Of 130 HZO patients, 42 developed ocular complications within 1 year of diagnosis. 95% of patients were over age 50, 67% were female, and 55% were Caucasian. 57% of patients received antivirals within 72 hours, with a mean of 4.5 days between symptom onset to treatment. Ocular complications included corneal scarring (65%), new onset or chronic keratitis (47%), reduced corneal sensation (21%), uveitis (7%), glaucoma (5%), corneal neovascularization (2%), and ischemic optic neuropathy (2%). 4 patients needed surgery for corneal scarring (10%). Visual acuity within 1 year improved for 19 patients (45%), worsened for 7 patients (17%), remained unchanged for 9 patients (21%), and was unavailable for 7 patients.A significant number of the 42 patients with ocular complications were older (p=0.005), Caucasian (p=0.05), and were placed on antivirals for greater than 6 months (p=0.007) when compared to the 88 patients without complications. There was no difference between those with and without complications in receiving antivirals within 72 hours (p=0.184). Of the 12 HZO patients who remained on antivirals for greater than 6 months, 11 had ocular complications requiring long-term antiviral therapy, specifically corneal scarring (72%).
One third of HZO patients with ocular involvement developed ocular complications within 1 year of diagnosis. Ocular complications developed in spite of receiving antivirals within 72 hours, and the majority remaining on treatment for greater than 6 months had HZO induced complications. Further study is needed to determine risk factors for development of ocular complications.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.
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