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Herpes zoster eye complications: rates and trends.
- Source :
-
Mayo Clinic proceedings [Mayo Clin Proc] 2013 Jun; Vol. 88 (6), pp. 562-70. Date of Electronic Publication: 2013 May 09. - Publication Year :
- 2013
-
Abstract
- Purpose: To provide population-based data on the risk, types, and outcomes of eye involvement in herpes zoster (HZ).<br />Methods: A cohort study based on review of the medical records of patients in whom HZ was diagnosed between January 1, 1980, and December 31, 2007, was performed. Herpes zoster was confirmed by the presence of the typical rash and symptoms or by laboratory testing, and eye involvement was confirmed by ophthalmologists' evaluation. Information was collected on all eye diagnoses and on HZ eye-related visits, treatments, procedures, and outcomes.<br />Results: Of the 2035 individuals with HZ in any dermatome, 184 (9.0%) had eye involvement. The mean age of the 184 was 62.6 years, and 5 cases occurred in patients younger than 21. Overall, 6.5% (12) were immunosuppressed at the time of the eye complications. The rate of increase in HZ eye involvement was 23% by decade from 1980 to 2007. Common eye complications were keratitis (n=144, 76.2%), uveitis/iritis (n=88, 46.6%), and conjunctivitis (n=67, 35.4%). Recurrent keratitis and recurrent iritis/uveitis occurred in 6.9% (13) and 7.4% (14), respectively. Outcomes included 6 patients (3.3%) with new vision decrements to 20/200 or worse. Two individuals had successful corneal transplants. Another 6 individuals (3.3%) had lid ptosis that affected vision, including 1 elderly woman with permanent unilateral tarsorrhaphy. Severe HZ eye pain was reported to be directly responsible for 1 unsuccessful suicide attempt. Acute retinal necrosis did not develop in any individual. A mean of 10.8 eye visits per patient with HZ and eye involvement was reported to continue for a mean of 308 days.<br />Conclusion: Eye complications are common and result in considerable health care use and permanent vision decrement in about 6.6% (6) of individuals with HZ eye involvement. Most health care use and long-term adverse outcomes occurred in patients in whom prevention of HZ with the zoster vaccine would be possible.<br /> (Copyright © 2013 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adolescent
Adult
Aged
Aged, 80 and over
Cohort Studies
Conjunctivitis, Viral therapy
Female
Herpes Zoster Ophthalmicus complications
Herpes Zoster Ophthalmicus therapy
Humans
Incidence
Keratitis therapy
Keratitis virology
Male
Middle Aged
Minnesota epidemiology
Retrospective Studies
Risk Factors
Uveitis therapy
Uveitis virology
Vision Disorders therapy
Vision Disorders virology
Young Adult
Conjunctivitis, Viral epidemiology
Herpes Zoster Ophthalmicus epidemiology
Keratitis epidemiology
Uveitis epidemiology
Vision Disorders epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1942-5546
- Volume :
- 88
- Issue :
- 6
- Database :
- MEDLINE
- Journal :
- Mayo Clinic proceedings
- Publication Type :
- Academic Journal
- Accession number :
- 23664666
- Full Text :
- https://doi.org/10.1016/j.mayocp.2013.03.014