Prospective multicenter observational study to assess the burden of herpes zoster ophthalmicus: Baseline results

Abstract

Purpose : This longitudinal cohort study aimed to describe symptoms, healthcare utilization, and quality of life (QoL) burden among patients with herpes zoster ophthalmicus (HZO).

Methods : Patients ≥18 years old with active HZO, English/Spanish speaking, willing and able to respond to study assessments, and not enrolled in a concurrent interventional HZO trial were recruited after evaluation for initial or recurrent HZO episode by 6 US ophthalmologic practices in 2019-23. Data were collected via 1) clinical assessment form completed by the practice and 2) baseline patient questionnaires (at study enrollment) on symptoms, healthcare utilization, and patient-reported outcomes (National Eye Institute 25-item Visual Function Questionnaire [NEI-VFQ-25] for vision-related QoL, eight-item Patient Health Questionnaire [PHQ-8] for depressive symptoms, Zoster Brief Pain Inventory [ZBPI] for pain, and Work Productivity and Activity Impairment – Specific Health Problem questionnaire [WPAI-SHP]). Descriptive statistics are reported.

Results : Clinical information was completed for 113 patients (mean age: 64 years). Herpes zoster iridocyclitis (20%), keratitis (15%), and conjunctivitis (4%) were the most common HZO diagnoses. Baseline survey was completed by 103 patients (67% white; 59% female; 73 initial and 30 recurrent HZO episodes; Table 1). The most common patient-reported symptoms were sensitivity to light (64%), dryness (58%), and ptosis (56%) (Table 2). In the 3 months prior to enrollment, emergency room (ER) or urgent care was sought by 31% of patients, with shingles or eye problems reported as the major reasons for the visit. Mean NEI-VFQ-25 score (standard deviation [SD]) was 82 (16), while mean PHQ-8 and ZBPI scores (SD) were 5 (5) and 1 (2), reflecting mild depression and mild pain, respectively (Table 2). Mean work productivity loss (SD) was 17% (24%) (Table 2).

Conclusions : HZO causes a significant burden on adults, with some common and impactful patient symptoms often requiring ER or urgent care use. QoL and work productivity decrements are similar to other major ocular diseases. These findings highlight the imperative need for preventive measures for herpes zoster.

This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.

 

Table 1. Descriptive summary of participants at baseline by HZO status

 

Table 2. Patient-reported symptoms and quality of life at baseline by HZO status