Wang Tsung-Jen, Hu Chao-Chien, Lin Herng-Ching
Department of Ophthalmology, Taipei Medical University Hospital, Taipei, Taiwan.
Arch Ophthalmol. 2012 Apr;130(4):451-5. doi: 10.1001/archophthalmol.2011.357.
To investigate the relationship between herpes zoster (HZ) and the subsequent risk of anterior uveitis during the year following an HZ diagnosis, using a nationwide population-based data set.
This study used the Taiwan National Health Insurance Research Database. The study cohort consisted of 314,405 patients who received a diagnosis of HZ. The comparison cohort comprised 943,215 randomly selected patients. We tracked each patient for a 1-year period from their index ambulatory care visit to identify those who subsequently received a diagnosis of anterior uveitis. Stratified Cox proportional hazard regressions were performed to compute the adjusted 1-year uveitis-free survival rate, after adjusting for patient's age, sex, and geographic region and the presence of rheumatoid arthritis, psoriasis, mumps, systemic lupus erythematosus, tuberculosis, ankylosing spondylitis, and human immunodeficiency syndrome/AIDS.
During the 1-year follow-up period, 2515 (0.2%) of 1,257,620 sampled patients were diagnosed with anterior uveitis: 908 from the study cohort (0.3% of the patients with HZ) and 1607 from the comparison cohort (0.2% of patients without HZ). After adjusting for potential confounders, the hazard ratio of anterior uveitis during the 1-year follow-up period was 1.67 for patients with HZ (P < .001) compared with the comparison cohort. In addition, the hazard ratio of anterior uveitis for patients with HZ ophthalmicus was 13.06 (P < .001) when compared with patients without HZ.
The risk of anterior uveitis increased in the year following a diagnosis of HZ. We suggest that patient eye condition be evaluated following diagnosis with HZ.
利用全国性基于人群的数据集,调查带状疱疹(HZ)与HZ诊断后一年内前葡萄膜炎后续风险之间的关系。
本研究使用了台湾国民健康保险研究数据库。研究队列包括314405例诊断为HZ的患者。对照队列由943215例随机选择的患者组成。我们从每位患者的首次门诊就诊开始跟踪1年,以确定那些随后被诊断为前葡萄膜炎的患者。在调整患者的年龄、性别、地理区域以及类风湿性关节炎、银屑病、腮腺炎、系统性红斑狼疮、结核病、强直性脊柱炎和人类免疫缺陷病毒/艾滋病的存在后,进行分层Cox比例风险回归以计算调整后的1年无葡萄膜炎生存率。
在1年的随访期内,1257620例抽样患者中有2515例(0.2%)被诊断为前葡萄膜炎:研究队列中有908例(HZ患者的0.3%),对照队列中有1607例(无HZ患者的0.2%)。在调整潜在混杂因素后,与对照队列相比,HZ患者在1年随访期内前葡萄膜炎的风险比为1.67(P <.001)。此外,与无HZ患者相比,眼带状疱疹患者前葡萄膜炎的风险比为13.06(P <.001)。
HZ诊断后一年内前葡萄膜炎的风险增加。我们建议在诊断HZ后对患者的眼部状况进行评估。