Epidemiology of Herpes Zoster Ophthalmicus Recurrence and Chronicity
Epidemiology of Herpes Zoster Ophthalmicus Recurrence and Chronicity
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DOI：
10.1016/j.ophtha.2016.03.005
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发表时间：
2016-07-01
期刊：
影响因子：
13.7
通讯作者：
Galor, Anat
中科院分区：
文献类型：
--
作者：
Tran, Kimberly D.;Falcone, Michelle M.;Galor, Anat
目的：以医院为基础的流行病学研究，描述眼部带状疱疹（HZO）的患病率和复发性和慢性疾病的危险因素。设计：回顾性、以医院为基础的队列研究。参与者：在研究期间在布劳沃德和迈阿密退伍军人管理局医疗保健系统（MIAVHS）评估的所有患者。方法：回顾性分析2010年1月1日至2014年12月31日在MIAVHS就诊的临床诊断为HZO的患者的病历。对患者临床病程的评估定义如下：HZO急性发作定义为疾病在初次发病后90天内静止，HZO复发定义为疾病在停止治疗后90天或更长时间内复发眼病或皮疹，慢性HZO定义为自初次发病后持续90天以上的活动性疾病。主要结局指标：主要结局指标包括伴有和不伴有眼部受累的HZO发生频率、HZO复发率以及复发性或慢性HZO的危险因素。结果：90例HZO患者纳入研究。HZO发病的平均年龄为68±13.8岁（范围27 ~ 95岁）。大多数患者是白人（73%），有免疫能力（79%），在随访期间没有接种带状疱疹疫苗（82%）。患者的平均随访时间为3.9±5.9年（范围0-33年）。所有皮肤区HZ的周期患病率为1.1%，HZ累及V1 （HZO）的频率为0.07%，累及眼睛的HZO的频率为0.05%。复发性眼病或皮疹的1、3和5年复发率分别为8%、17%和25%。高眼压（风险比[HR]， 4.6； 95%可信区间[CI]， 1.3-16.5；优势比[OR]， 6.7; 95% CI, 1.5-31.2）和葡萄膜炎（HR, 5.7; 95% CI, 1.7-19.0； OR, 6.7; 95% CI, 1.5-31.2）增加了复发和慢性疾病的风险。结论：该研究支持最新数据，表明相当比例的患者经历复发性和慢性HZO。需要进一步的研究来指导复发性和慢性HZO的预防和治疗方法。(C) 2016年由Elsevier代表美国眼科学会出版。
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. (C) 2016 Published by Elsevier on behalf of the American Academy of Ophthalmology.