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2016 ; 123
(7
): 1469-75
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Epidemiology of Herpes Zoster Ophthalmicus: Recurrence and Chronicity
#MMPMID27067924
Tran KD
; Falcone MM
; Choi DS
; Goldhardt R
; Karp CL
; Davis JL
; Galor A
Ophthalmology
2016[Jul]; 123
(7
): 1469-75
PMID27067924
show ga
PURPOSE: A hospital-based epidemiology study to describe herpes zoster
ophthalmicus (HZO) prevalence and risk factors for recurrent and chronic disease.
DESIGN: Retrospective, hospital-based cohort study. PARTICIPANTS: All patients
evaluated in the Broward and Miami Veterans Administration Healthcare System
(MIAVHS) during the study period. METHODS: Retrospective medical record review of
patients seen in the MIAVHS from January 1, 2010, through December 31, 2014, with
a HZO clinical diagnosis. Assessment of the patient's clinical course was defined
by the following: an acute episode of HZO was defined as quiescence of disease
within 90 days of initial presentation, HZO recurrence was defined as any
recurrent eye disease or rash 90 days or more after quiescence of disease was
noted off therapy, and chronic HZO was defined as active disease persisting more
than 90 days from initial presentation. MAIN OUTCOME MEASURES: Main outcome
measures included the frequency of HZO with and without eye involvement, HZO
recurrence rates, and risk factors for recurrent or chronic HZO. RESULTS: Ninety
patients with HZO were included in the study. The mean age at incident episode of
HZO was 68±13.8 years (range, 27-95 years). Most patients were white (73%),
immune competent (79%), and did not receive zoster vaccination at any point
during the follow-up (82%). Patients were followed for a mean of 3.9±5.9 years
(range, 0-33 years). The period prevalence of HZ in any dermatome was 1.1%, the
frequency of HZ involving V1 (HZO) was 0.07%, and the frequency of HZO with eye
involvement was 0.05%. The overall 1-, 3-, and 5-year recurrence rates for either
recurrent eye disease or rash were 8%, 17%, and 25%, respectively. Ocular
hypertension (hazard ratio [HR], 4.6; 95% confidence interval [CI], 1.3-16.5;
odds ratio [OR], 6.7; 95% CI, 1.5-31.2) and uveitis (HR, 5.7; 95% CI, 1.7-19.0;
OR, 6.7; 95% CI, 1.5-31.2) increased the risk of recurrent and chronic disease.
CONCLUSIONS: This study supports newer data indicating that a significant
proportion of patients experience recurrent and chronic HZO. Further study is
needed to guide preventative and therapeutic approaches to recurrent and chronic
HZO.
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