June 2023
Volume 64, Issue 8
Open Access
ARVO Annual Meeting Abstract  |   June 2023
Characteristics of Herpetic Eye Diseases Associated with Cognitive Impairment
Author Affiliations & Notes
  • Rebecca Zeng
    Ophthalmology, Boston Medical Center, Boston, Massachusetts, United States
  • Manju L Subramanian
    Ophthalmology, Boston Medical Center, Boston, Massachusetts, United States
  • Footnotes
    Commercial Relationships   Rebecca Zeng None; Manju Subramanian None
  • Footnotes
    Support  None
Investigative Ophthalmology & Visual Science June 2023, Vol.64, 1174. doi:
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      Rebecca Zeng, Manju L Subramanian; Characteristics of Herpetic Eye Diseases Associated with Cognitive Impairment. Invest. Ophthalmol. Vis. Sci. 2023;64(8):1174.

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Abstract

Purpose : Multiple population-based studies have elucidated a link between systemic herpesviruses, including those with ocular manifestations, and dementia. In this retrospective, case-control study, we aim to investigate presentations of herpetic eye diseases which may incur an increased risk for the development of cognitive impairment (CI).

Methods : Records were searched by ICD-9 and ICD-10 codes to identify patients with a history of herpesviral and zoster ocular diseases seen by the Ophthalmology department at Boston Medical Center between 6/1/2015 and 9/1/2022. Subjects were excluded based on a history of psychotic disorders, substance use, or congenital cognitive impairment. Demographics, ocular history, and medical history were collected in addition to the onset, laterality, exam findings and treatment of herpetic eye diseases. The main outcome measure was the presence of CI. Data on the onset and presentation of CI, including results of Mini-Mental Status Exam and Montreal Cognitive Assessment were also recorded. Student’s t-tests and Pearson chi-square tests were performed to evaluate the differences in characteristics of herpetic eye diseases in subjects who developed CI in comparison to those who did not.

Results : A total of 154 patients were included in this study, of which 79 (51.3%) patients carried a diagnosis of herpes zoster ophthalmicus (VZV) and 75 (48.7%) patients carried a diagnosis of herpes simplex ocular disease (HSV). 16 patients with VZV and 2 patients with HSV developed CI. The age of onset for HSV was older in patients who developed CI, but not VZV (HSV: 87.5 ± 2.1 vs. 44.9 ± 24.3 years, p = .04; VZV: 77.1 ± 11.3 vs. 55.84 ± 16.8 years, p = .11). No differences in sex or racial distribution were found (p = .31, p = .44). The development of CI was associated with a presentation of dermatitis (77.8% who developed CI vs. 46.3% who did not develop CI, p < .01), cranial nerve palsy (11.1% vs. 0%, p <.001), and VA worse than or equal to 20/50 (55.6% vs. 18.4%, p <.01). However, a VA worse than 20/200 was not associated with the development of CI (16.6% vs. 11.0%, p =.71)

Conclusions : We build upon the findings of existing population-based studies and characterize the presentations of herpetic eye diseases that are associated with the development of CI. These results may be valuable in understanding the pathophysiology regarding the link between herpesviruses and dementia.

This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.

 

 

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