TY - JOUR
T1 - Epidemiology of Herpes Zoster Ophthalmicus Recurrence and Chronicity
AU - Tran, Kimberly D.
AU - Falcone, Michelle M.
AU - Choi, Daniel S.
AU - Goldhardt, Raquel
AU - Karp, Carol L.
AU - Davis, Janet L.
AU - Galor, Anat
N1 - Funding Information:
Supported by the Department of Veterans Affairs, Veterans Health Administration, Office of Research and Development, Clinical Sciences Research EPID-006-15S (A.G.), the National Institutes of Health, Bethesda, Maryland (Center Core Grant no.: P30EY014801; Research to Prevent Blindness, Inc, New York, New York (unrestricted grant); The Ronald and Alicia Lepke Grant (C.L.K.); The Lee and Claire Hager Grant (C.L.K.); The Jimmy and Gaye Bryan Grant (C.L.K.); The Gordon Charitable Trust (C.L.K.); and the Richard Azar Family Grant (C.L.K.).
Publisher Copyright:
© 2016 Published by Elsevier on behalf of the American Academy of Ophthalmology.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - 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.
AB - 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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U2 - 10.1016/j.ophtha.2016.03.005
DO - 10.1016/j.ophtha.2016.03.005
M3 - Article
C2 - 27067924
AN - SCOPUS:84975270492
VL - 123
SP - 1469
EP - 1475
JO - Ophthalmology
JF - Ophthalmology
SN - 0161-6420
IS - 7
ER -