Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2016 Jul;123(7):1469-75.
doi: 10.1016/j.ophtha.2016.03.005. Epub 2016 Apr 8.

Epidemiology of Herpes Zoster Ophthalmicus: Recurrence and Chronicity

Kimberly D Tran  1 , Michelle M Falcone  2 , Daniel S Choi  1 , Raquel Goldhardt  1 , Carol L Karp  2 , Janet L Davis  2 , Anat Galor  3
Affiliations

Epidemiology of Herpes Zoster Ophthalmicus: Recurrence and Chronicity

Kimberly D Tran et al. Ophthalmology. 2016 Jul.

Abstract

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.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Age distribution of patients at first diagnosis of Herpes Zoster Ophthalmicus
Figure 2
Figure 2. Kaplan-Meier survival analysis demonstrating cumulative recurrence-free survival over time
See this image and copyright information in PMC

References

    1. Harpaz R, Ortega-Sanchez IR, Seward JF, (CDC) AColPACfDCaP Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP) MMWR RecoMm Rep. 2008;57(RR-5):1–30. quiz CE32-34. - PubMed
    1. Yawn BP, Saddier P, Wollan PC, St Sauver JL, Kurland MJ, Sy LS. A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clin Proc. 2007;82(11):1341–1349. - PubMed
    1. Insinga RP, Itzler RF, Pellissier JM. Acute/subacute herpes zoster: healthcare resource utilisation and costs in a group of US health plans. Pharmacoeconomics. 2007;25(2):155–169. - PubMed
    1. Jumaan AO, Yu O, Jackson LA, Bohlke K, Galil K, Seward JF. Incidence of herpes zoster, before and after varicella-vaccination-associated decreases in the incidence of varicella, 1992-2002. J Infect Dis. 2005;191(12):2002–2007. - PubMed
    1. Donahue JG, Choo PW, Manson JE, Platt R. The incidence of herpes zoster. Arch Intern Med. 1995;155(15):1605–1609. - PubMed

Publication types

LinkOut - more resources