Lee Chia-Yi, Chang Yuh-Shin, Ho Chung-Han, Wang Jhi-Joung, Jan Han-Yi, Lee Po-Han, Jan Ren-Long
Department of Ophthalmology, Chi Mei Medical Centre, Tainan, Taiwan.
School of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
Front Med (Lausanne). 2025 Mar 6;12:1532366. doi: 10.3389/fmed.2025.1532366. eCollection 2025.
Herpes zoster ophthalmicus (HZO) occurs due to the reactivation of latent varicella-zoster virus (VZV) and is characterized by the involvement of the ophthalmic branch of the trigeminal nerve. While this pathophysiology is well-established, the precise mechanisms driving VZV reactivation remain incompletely understood. Furthermore, it is unclear whether individuals with common comorbidities that compromise immune function face an elevated risk of developing HZO. Investigating potential links between HZO and chronic systemic conditions holds significant importance from public health, medical, and scientific perspectives. To address these gaps, we conducted a study to examine the association between HZO development, sociodemographic factors, and systemic comorbidities.
This nationwide, population-based, retrospective, matched case-controlled study included 52,112 patients with HZO (identified by the International Classification of Diseases, Ninth Revision, Clinical Modification code 053.2 for herpes zoster with ophthalmic complications) from the Taiwan National Health Insurance Research Database. The age-, sex-, and index date-matched control group included 52,112 non-HZO individuals from the Taiwan Longitudinal Health Insurance Database 2000. Sociodemographic factors and associated systemic diseases were examined using univariate logistic regression analyses, and continuous variables were analysed using paired -tests. The odds ratios (ORs) for developing HZO were compared using adjusted logistic regression analysis.
Patients with systemic diseases (hypertension, diabetes, hyperlipidaemia, etc.) had significantly higher ORs for HZO development. Patients whose monthly income was >NT$ 30,000 and patients residing in southern Taiwan had increased odds of developing HZO; however, patients residing in northern Taiwan, metropolitans, or satellite cities, and being public servants (military, civil, teaching staff, etc.) had decreased odds of developing HZO.
HZO is strongly associated with hypertension, diabetes mellitus, hyperlipidaemia, coronary artery disease, chronic renal disease, and human immunodeficiency virus infection. These findings emphasise the role of systemic health in HZO risk.
眼部带状疱疹（HZO）是由潜伏的水痘-带状疱疹病毒（VZV）再激活引起的，其特征是三叉神经眼支受累。虽然这种病理生理学已得到充分证实，但驱动VZV再激活的确切机制仍未完全了解。此外，尚不清楚免疫功能受损的常见合并症患者发生HZO的风险是否升高。从公共卫生、医学和科学角度来看，研究HZO与慢性全身性疾病之间的潜在联系具有重要意义。为填补这些空白，我们开展了一项研究，以检验HZO发生、社会人口学因素和全身性合并症之间的关联。
这项基于全国人口的回顾性配对病例对照研究纳入了来自台湾国民健康保险研究数据库的52112例HZO患者（根据国际疾病分类第九版临床修订本代码053.2确定为伴有眼部并发症的带状疱疹）。年龄、性别和索引日期匹配的对照组包括来自2000年台湾纵向健康保险数据库的52112例非HZO个体。使用单因素逻辑回归分析检查社会人口学因素和相关的全身性疾病，使用配对t检验分析连续变量。使用调整后的逻辑回归分析比较发生HZO的比值比（OR）。
患有全身性疾病（高血压、糖尿病、高脂血症等）的患者发生HZO的OR显著更高。月收入超过30000新台币的患者和居住在台湾南部的患者发生HZO的几率增加；然而，居住在台湾北部、大城市或卫星城市的患者以及公务员（军事、文职、教职员工等）发生HZO的几率降低。
HZO与高血压、糖尿病、高脂血症、冠状动脉疾病、慢性肾病和人类免疫缺陷病毒感染密切相关。这些发现强调了全身健康在HZO风险中的作用。
