Department of Research, Olmsted Medical Center, Rochester, MN 55904, USA.
Mayo Clin Proc. 2013 Jun;88(6):562-70. doi: 10.1016/j.mayocp.2013.03.014. Epub 2013 May 9.
To provide population-based data on the risk, types, and outcomes of eye involvement in herpes zoster (HZ).
A cohort study based on review of the medical records of patients in whom HZ was diagnosed between January 1, 1980, and December 31, 2007, was performed. Herpes zoster was confirmed by the presence of the typical rash and symptoms or by laboratory testing, and eye involvement was confirmed by ophthalmologists' evaluation. Information was collected on all eye diagnoses and on HZ eye-related visits, treatments, procedures, and outcomes.
Of the 2035 individuals with HZ in any dermatome, 184 (9.0%) had eye involvement. The mean age of the 184 was 62.6 years, and 5 cases occurred in patients younger than 21. Overall, 6.5% (12) were immunosuppressed at the time of the eye complications. The rate of increase in HZ eye involvement was 23% by decade from 1980 to 2007. Common eye complications were keratitis (n=144, 76.2%), uveitis/iritis (n=88, 46.6%), and conjunctivitis (n=67, 35.4%). Recurrent keratitis and recurrent iritis/uveitis occurred in 6.9% (13) and 7.4% (14), respectively. Outcomes included 6 patients (3.3%) with new vision decrements to 20/200 or worse. Two individuals had successful corneal transplants. Another 6 individuals (3.3%) had lid ptosis that affected vision, including 1 elderly woman with permanent unilateral tarsorrhaphy. Severe HZ eye pain was reported to be directly responsible for 1 unsuccessful suicide attempt. Acute retinal necrosis did not develop in any individual. A mean of 10.8 eye visits per patient with HZ and eye involvement was reported to continue for a mean of 308 days.
Eye complications are common and result in considerable health care use and permanent vision decrement in about 6.6% (6) of individuals with HZ eye involvement. Most health care use and long-term adverse outcomes occurred in patients in whom prevention of HZ with the zoster vaccine would be possible.
提供基于人群的带状疱疹（HZ）眼部受累风险、类型和结局的数据。
对 1980 年 1 月 1 日至 2007 年 12 月 31 日期间诊断为 HZ 的患者的病历进行了基于回顾的队列研究。HZ 通过典型皮疹和症状或实验室检测结果确认，眼部受累通过眼科医生评估确认。收集了所有眼部诊断以及与 HZ 眼部相关的就诊、治疗、程序和结局信息。
在任何皮节出现 HZ 的 2035 人中，有 184 人（9.0%）眼部受累。184 例患者的平均年龄为 62.6 岁，有 5 例患者年龄小于 21 岁。总体而言，12 例（6.5%）在眼部并发症发生时存在免疫抑制。1980 年至 2007 年，每十年 HZ 眼部受累的发生率增加 23%。常见的眼部并发症包括角膜炎（n=144，76.2%）、葡萄膜炎/虹膜炎（n=88，46.6%）和结膜炎（n=67，35.4%）。复发性角膜炎和复发性虹膜炎/葡萄膜炎分别发生在 6.9%（13 例）和 7.4%（14 例）患者中。结局包括 6 例（3.3%）患者新出现视力下降至 20/200 或更差。2 例患者接受了成功的角膜移植。另有 6 例（3.3%）患者出现影响视力的眼睑下垂，其中包括 1 例因永久性单侧睑裂缝合而视力永久受损的老年女性。1 例因严重的 HZ 眼部疼痛而企图自杀未遂。任何患者均未出现急性视网膜坏死。HZ 伴眼部受累患者的平均眼部就诊次数为 10.8 次/例，平均持续 308 天。
眼部并发症很常见，导致约 6.6%（6 例）HZ 眼部受累患者出现大量的医疗保健使用和永久性视力下降。大多数医疗保健使用和长期不良结局发生在可通过带状疱疹疫苗预防 HZ 的患者中。
