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
Observational Study
. 2020 Mar;127(3):324-330.
doi: 10.1016/j.ophtha.2019.10.001. Epub 2019 Oct 9.

Incidence Rate of Herpes Zoster Ophthalmicus: A Retrospective Cohort Study from 1994 through 2018

Christina L Kong  1 , Ryan R Thompson  1 , Travis C Porco  2 , Eric Kim  1 , Nisha R Acharya  3
Affiliations
Observational Study

Incidence Rate of Herpes Zoster Ophthalmicus: A Retrospective Cohort Study from 1994 through 2018

Christina L Kong et al. Ophthalmology. 2020 Mar.

Abstract

Purpose: To analyze the incidence rate (IR) of herpes zoster ophthalmicus (HZO) and differences by age, gender, race, and region from 1994 through 2018.

Design: Retrospective, observational cohort study.

Participants: Patients with a new International Classification of Diseases, Ninth or Tenth Edition, codes for herpes zoster (HZ) and HZO from January 1, 1994, through December 31, 2018, in the OptumLabs Data Warehouse (OptumLabs, Cambridge, MA).

Methods: OptumLabs Data Warehouse, a longitudinal, real-world data asset with de-identified administrative claims and electronic health record data, was used to identify enrollees with continuous enrollment in the database for 365 days or more. Patients with no history of HZ or HZO and a new code for HZ and HZO were counted as incident cases. The IR of HZO was calculated by year, 10-year age groups, gender, race, and region.

Main outcome measures: Differences in IR from 1994 through 2018 by 10-year age groups and gender.

Results: From 1994 through 2018, 633 474 cases of HZ were reported, with 49 745 (7.9%) having HZO. The incidence of HZO increased from 1994 through 2018 by an estimated 1.1 cases per 100 000 person-years annually (95% confidence interval [CI], 1.0-1.3; P < 0.001). The estimated relative increase was 3.6% annually (95% CI, 3.0%-4.1%). HZO IR increased in all ages over 10 years until 2007, then began declining in individuals younger than 21 and older than 60, stabilizing in individuals 21 to 30 years old, and increasing more slowly among individuals 31 to 60 years old. Men showed an HZO incidence rate ratio (IRR) of 0.74 compared with women. Compared with white patients, the IRRs were 0.70, 0.75, and 0.64 for Asians, black patients, and Hispanics, respectively.

Conclusions: The incidence of HZO has increased 3.6% per year from 1994 to 2018 in the United States. Since 2008, HZO incidence declined in individuals younger than 21 years and older than 60 years while increasing at a lower rate in middle-aged adults. Given the continued increase, greater efforts should be made to vaccinate eligible adults 50 years of age and older. More research on earlier vaccination is warranted.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: No conflicting relationship exists for any author.

Figures

Figure 1.
Figure 1.
Incidence rate of HZO by ten-year age groups from 1994 to 2018
See this image and copyright information in PMC

Comment in

References

    1. Ragozzino MW, Melton LJ, Kurland LT, Chu CP, Perry HO. Population-based study of herpes zoster and its sequelae. Med. 1982;61(5):310–316. - PubMed
    1. Liesegang TJ. Herpes zoster ophthalmicus: natural history, risk factors, clinical presentation, and morbidity. Ophthalmology. 2008;115(2 suppl.):3–12. - PubMed
    1. Weinberg JM. Herpes zoster: Epidemiology, natural history, and common complications. J Am Acad Dermatol. 2007;57(6 suppl):130–135. - PubMed
    1. Yawn BP, Wollan PC St. Sauver JL, Butterfield LC. Herpes zoster--eye complications: rates and trends. PLoS One. 2013;32(7):736–740. - PMC - PubMed
    1. Nithyanandam S, Stephen J, Joseph M, Dabir S. Factors affecting visual outcome in herpes zoster ophthalmicus: a prospective study. Clin Exp Ophthalmol. 2010;38(9):845–850. - PubMed

Publication types