Ocular Manifestations according to Duration of Treatment in Herpes Zoster Ophthalmicus

Lee, Bo Ram; Han, Kyung Eun; Jun, Roo Min

Original Article

Annals of Optometry and Contact Lens 2016;15(3):97-102.
Published online September 25, 2016.

Ocular Manifestations according to Duration of Treatment in Herpes Zoster Ophthalmicus

Bo Ram Lee, Kyung Eun Han, Roo Min Jun

Department of Ophthalmology, Ewha Womans University Mokdong Hospital, Seoul, Korea

Received: 25 July 2016 • Revised: 18 August 2016 • Accepted: 18 August 2016

Abstract

Purpose: To compare the clinical characteristics and risk factors of patients with herpes zoster ophthalmicus (HZO) according to the duration of treatment.
Methods: A retrospective chart review was performed of 58 patients who were diagnosed with HZO between January 1, 2010 and December 31, 2014. Baseline demographics, clinical characteristics and treatment between patients who received treatment within 4 weeks and patients who received treatment more than 4 weeks were compared.
Results: Among a total of 58 patients, 31 patients (53.4%) were received treatment within 4 weeks and 27 patients (46.6%) were received treatment more than 4 weeks. The number of male was higher in the patients received treatment more than 4 weeks group (p=0.017). The age and disease laterality were not statistically different between the 2 groups. Diabetes mellitus, hypertension, interval between first symptom and antiviral treatment tend to be higher in the patients received long treatment group. Punctate epithelial keratitis (77.8% vs. 41.9%, p=0.006), anterior uveitis (70.4% vs. 9.7%, p<0.001) stromal keratitis (40.7% vs. 3.2%, p=0.02), neurotrophic keratopathy (14.8% vs. 0%, p=0.041), were more frequent in the patients who received treatment more than 4 weeks (p=0.04). The number of patients received topical steroid therapy (p<0.001) and systemic steroid therapy (p<0.001) were higher in the same group.
Conclusions: Herpes zoster ophthalmicus shows different clinical characteristics according to duration of treatment. Patients who present punctate epithelial keratitis, stromal keratitis, neurotrophic keratopathy and anterior uveitis should be warned about the possibility of long term treatment duration and should be treated aggressively enough.

Key Words: Herpes zoster ophthalmicus; Ocular complication; Treatment duration