Abstract
Purpose :
The incidence of ocular herpetic pathologies, in particular Herpes Zoster Ophthalmicus (HZO), has seemingly been on a rise over the past years, especially among the elderly and immunocompromised. The nature of this rise is likely multifactorial ranging from access to Shingles vaccination programmes, potential increase in immunocompromised individuals, social factors and most recently, Covid-19 infection. The relationship between Covid-19 and ocular herpetic pathologies has anecdotal basis. Certain studies have hypothesized T-cell dysfunction as a mechanism of Varicella Zoster virus reactivation in patients affected by Covid-19. This retrospective, observational study analyses the pattern of incidence of ocular herpetic pathologies in a secondary care centre, United Kingdom (UK).
Methods :
This study was set in an eye casualty clinic in Queens Hospital, Burton-on-Trent (University Hospitals Derby & Burton NHS, UK). Diagnoses of each patient was recorded in the Eye Casualty Patient Register. Data was extracted from three time periods – i. Pre-covid pandemic (July -December 2019), ii. Pandemic (July - December 2021) and iii. Post coronavirus vaccine introduction, UK (April and May 2021). Extracted data was pooled into the following groups – Herpes Simplex Keratits (HSK)/ HZO/ Shingles/Herpetic Kertatouveitis/ Herpes Zoster/Herpes Simplex/Herpes simplex endothelitis.
Results :
The data between pre-pandemic and post-pandemic periods highlighted an increasing incidence of certain ocular herpetic conditions. Highest number of diagnoses were recorded as HSK and HZO. HSK accounted for the highest incidence across all time periods - 41% (pandemic), 34% (pre-pandemic) and 37.5% (after vaccine introduction). On the other hand, similar incidence is noted with HZO diagnoses - 32.9% (pandemic), 32.7% (pre-pandemic) and 37.5% (after vaccine introduction).
Conclusions :
Overall, a gradual increase in incidence of ocular herpetic pathologies was observed from 2019 - 2021 at this centre. Multiple factors could be responsible for this rise, with Covid-19 infection as a potential factor. However, there is insufficient data to draw up a definitive association between the increasing incidence of such conditions and Covid-19, especially as the immune response to the infection and vaccinations are poorly understood. Larger, multi-centre studies would be required to assess the burden of incidence in the UK.
This abstract was presented at the 2022 ARVO Annual Meeting, held in Denver, CO, May 1-4, 2022, and virtually.