Herpes Zoster Ophthalmicus Clinical Presentation and Risk Factors for Loss of Vision - 13/07/21
, Jay J. Meyer, Kevin Liu, Helen V. Danesh-MeyerHighlights |
• | This was a retrospective study of 869 subjects with herpes zoster ophthalmicus. |
• | Ocular involvement occurred in 84.8%. |
• | A total of 51.2% had corneal involvement and 47.6% uveitis. |
• | Permanent vision loss (≤20/50) occurred in 9.6%. |
• | Vision loss was associated with older age, immunosuppression, and uveitis. |
Résumé |
Purpose |
To determine the rate of moderate and severe vision loss following herpes zoster ophthalmicus (HZO) and to identify associated factors.
Design |
Retrospective cohort study.
Methods |
All subjects with acute HZO seen at a single center from 2006 to 2016 were included in the study. The primary outcome measure was the proportion of individuals with moderate and/or severe loss of vision following an acute episode of HZO. Secondary outcome measures included causes and factors associated with permanent loss of vision owing to HZO.
Results |
A total of 869 patients with acute HZO were identified with a median follow-up time of 6.3 years (interquartile range 3.7-8.9 years). Ocular involvement of HZO was diagnosed at or within the first month of presentation in 737 individuals (84.8%). The most common sites of ocular involvement were conjunctivitis (76.1%), followed by keratitis (51.2%) and uveitis (47.6%). Moderate vision loss (≤20/50) secondary to HZO occurred in 83 eyes (9.6%) while severe vision loss (≤20/200) occurred in 31 eyes (3.6%). Causes of loss of vision included corneal scarring (94.0%), corneal perforation (4.8%), and secondary glaucoma (1.2%). Severe vision loss was associated with older age (hazard ratio [HR] 1.059, P = .001), immunosuppression (HR 3.125, P = .028), poor presenting visual acuity (HR 2.821, P = .002), and uveitis (HR 4.777, P = .004) on multivariate analysis.
Conclusions |
Among individuals with HZO, approximately 1 in 10 individuals may develop moderate or severe vision loss, primarily owing to corneal scarring. Older age, immunosuppression, and uveitis are associated with severe permanent loss of vision secondary to HZO.
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Vol 226
P. 83-89 - juin 2021 Retour au numéro
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