Abstract
BackgroundOcular complications of herpes zoster ophthalmicus (HZO) may lead to substantial visual impairment. The purpose of this study was to characterize and analyze ocular involvement and visual outcome of HZO in patients from Tunisia, North Africa. This study is a retrospective chart review of 51 eyes of 45 patients with HZO.ResultsMean age was 44.5 years. Thirty patients (66.7%) were aged over 50 years. Twenty-four patients (53.3%) were male and 21 patients were female (46.7%). There was no statistically significant difference in gender distribution. Initial mean best corrected visual acuity (BCVA) was 20/50. Ocular manifestations included adnexal involvement (58.8%), keratitis (31.4%), keratouveitis (31.4%), isolated anterior uveitis (AU) (29.4%), intraocular pressure elevation (23.5%), oculomotor nerve palsy (5.8%), and optic neuritis (1.9%). Isolated AU (p < 0.001), isolated keratitis (p = 0.001), and intraocular pressure elevation (p = 0.013) were more likely to be concomitant to HZO active skin disease, while keratouveitis occurred more likely more than 1 month after HZO eruption (p < 0.001). AU and keratouveitis were more likely to be associated with age ≥ 50 years (p = 0.001 and p = 0.02, respectively). Ocular complications included neurotrophic keratopathy (1.9%), corneal opacity (5.9%), secondary glaucoma (7.8%), optic atrophy (1.9%), and postherpetic neuralgia (13.3%). Mean follow-up was 12 months. Mean final BCVA was 20/32; it was ≥ 20/40 in 78.4% of the eyes.ConclusionsOur study provided epidemiologic and clinical data of HZO in a Tunisian population. AU and keratitis were the most common ocular complications. Neurotrophic keratopathy was scarce. The overall visual outcome is good, with about three quarters of the treated patients maintaining VA of 20/40 or better.
Highlights
Ocular complications of herpes zoster ophthalmicus (HZO) may lead to substantial visual impairment
The charts of 45 consecutive patients (51 eyes) with HZO managed at the Department of Ophthalmology at Fattouma Bourguiba University Hospital of Monastir, Tunisia, from 1 January 2000 to 31 January 2012 were reviewed
Patients were questioned concerning the history of the present illness, compromised immune status, medication use including immunosuppressive drug and topical or systemic antiviral therapy at presentation, renal failure, moderate or severe hypertension, diabetes mellitus, and previous relevant eye diseases such as chronic uveitis, keratitis, cataract, and glaucoma
Summary
Ocular complications of herpes zoster ophthalmicus (HZO) may lead to substantial visual impairment. The purpose of this study was to characterize and analyze ocular involvement and visual outcome of HZO in patients from Tunisia, North Africa. Herpes zoster affects 20% to 30% of the population at some point in their lifetime, and approximately 10% to 20% of these individuals will have HZO [1]. Ocular involvement occurs in approximately 50% of HZO patients in the absence of prompt preventive antiviral therapy [1]. HZO is often associated with a chronic course characterized by significant ocular morbidity and may lead to significant visual impairment in the absence of prompt and adequate treatment. The purpose of the present study was to characterize and analyze ocular involvement and visual outcome of HZO in patients from Tunisia, North Africa
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