Ocular clinical manifestations in patients diagnosed with ophthalmic herpes zoster
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Abstract
Objective: To know the ocular clinical manifestations in patients diagnosed with herpes zoster ophthalmicus (HZO) at the Carlos Alberto Seguín Escobedo National Hospital of EsSalud - Arequipa, in 2021. Material and methods: Observational and descriptive study. The population included all patients diagnosed with HZO who underwent a thorough eye examination. The data was processed and analyzed using the statistical program SPSS v24 and presented through tables and descriptive graphs. Results: 16 patients were included in the study. The average age was 73 years. 8 cases had high blood pressure, 6 cases had type II diabetes mellitus, and 2 cases had some type of neoplasm.The mean time between the manifestation of the skin rash and the search for medical help was 6 days. The most described ocular symptom was pain (62.5 %). Hutchinson’s sign was present in 12 patients (75 %), and they reported ocular symptoms in 100 % of them. The maximum difference between both eyes’ intraocular pressure (IOP) was 3 mmHg. Slit lamp examination revealed conjunctival hyperemia in five cases (31.3 %) and epithelial keratitis in five cases (31.3 %). Conclusion: The most affected population is the older adult who presents a condition of immunosuppression. Most presented ocular symptoms and Hutchinson’s sign (+), and most sought medical care over 72 hours after the onset of the rash.
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Salmon J. Kanski Oftalmología Clínica. Editorial Elsevier. 9.a edición. 2019.
Vrcek I, Choudhury E, Durairaj V. Herpes Zos¬ter Ophthalmicus: A Review for the Internist. Am J Med. 2017; 130(1):21-26. http://dx.doi.org/10.1016/j.amjmed.2016.08.039
Liesegang T. Herpes zoster ophthalmicus natu¬ral history, risk factors, clinical presentation, and morbidity. Ophthalmol. 2008; 115(2):S3-S12. https://doi.org/10.1016/j.ophtha.2007.10.009
Schmader K. Herpes Zoster. Clin Geriatr Med. 2016; 32(3):539-553. https://doi.org/10.1016/j.cger.2016.02.011
Le P, Rothberg M. Herpes Zoster infection. Brit Med J. 2019;364(k5095):1-6. https://doi.org/10.1136/bmj.k5095
Opstelten W, Zaal M. Managing ophthal¬mic herpes zoster in primary care. Brit Med J. 2005; 331(7509):147-151. DOI: 10.1136/bmj.331.7509.147
Mendonca F, Machado F, Serapiao M, Dos Santos M. Clinical profile and ophthalmologic manifestations of Herpes Zoster Ophthalmicus. Rev Bras Oftalmol. 2019; 78(3):170-174. DOI: 10.5935/0034-7280.20190122
El-Hamd M, Aboeldahab S. Herpes zoster oph¬thalmicus: clinicodemographic characteristics and outcomes of 64 Egyptian patients. Egypt J Dermatol Venerol. 2019;39(2):49-56. DOI: 10.4103/ejdv.ejdv_1_19
Szeto S, Chan T, Wong R, Ng A, Li E, Jhanji V. Prevalence of Ocular Manifestations and Visual Outcomes in Patients With Herpes Zoster Oph¬thalmicus. Cornea. 2017; 36(3):338-342. DOI: 10.1097/ICO.0000000000001046
Borkar D, Tham V, Esterberg E, Ray K, Vi¬noya A, Parker J, et al. Incidence of herpes zoster ophthalmicus: results from the Paci¬fic Ocular Inflammation Study. Ophthalmol. 2013; 120(3):451-456. DOI: 10.1016/j.oph¬tha.2012.09.007
Gupta N, Sachdev R, Sinha R, Titiyal JS, Tandon R. Herpes zoster ophthalmicus: di¬sease spectrum in young adults. Middle East Afr J Ophthalmol. 2011;18(2):178-82. DOI: 10.4103/0974-9233.80710
Tran K, Falcone M, Choi D, Goldhardt R, Karp C, Davis J, et al. Epidemiology of Herpes Zos¬ter Ophthalmicus: recurrence and Chronicity. Ophthalmol. 2016; 123(7):1469-1475. DOI: 10.1016/j.ophtha.2016.03.005
Mather R, Prabriputaloong T, Gritz D, Wong I. Epidemiology of Herpes Zoster Ophthalmicus in Northern California. Invest Ophthalmol Vis Sci. 2003; 44(13):773-777.
Kong C, Thompson R, Porco T, Kim E, Achar¬ya N. Incidence Rate of Herpes Zoster Oph¬thalmicus: A Retrospective Cohort Study from 1994 through 2018. Ophthalmol. 2020; 127(3):324-330. https://doi.org/10.1016/j.oph¬tha.2019.10.001
Ghaznawi N, Virdi A, Dayan A, Hammersmith K, Rapuano C, Laibson P, et al. Herpes zoster ophthalmicus: comparison of disease in patients 60 years and older versus younger than 60 years. Ophthalmol. 2011; 118:2242-2250. DOI: 10.1016/j.ophtha.2011.04.002
Miserocchi E, Fogliato G, Bianchi I, Bande¬llo F, Modorati G. Clinical features of ocular herpetic infection in an italian referral center. Cornea. 2014; 33:565-570. DOI: 10.1097/ICO.0000000000000129
Lionakis N, Mendrinos D, Sanidas E, Favatas G, Georgopoulou M. Hypertension in the elder¬ly. World J Cardiol. 2012; 4(5):135-147. DOI: 10.4330/wjc.v4.i5.135
Delgado S. Frecuencia de infección retroviral en pacientes con herpes zoster atendidos en el Departamento de Enfermedades Infecciosas, Tropicales y Dermatológicas del Hospital Nacio¬nal Cayetano Heredia [Tesis de pregrado]. Lima: Universidad Peruana Cayetano Heredia; 2006. Recuperado a partir de: http://repositorio.upch.edu.pe/bitstream/handle/upch/3712/Frecuencia_DelgadoMalaga_Sandra.pdf?sequence=3&isAllowed=y.
Geerlings S, Hoepelman A. Immune dysfunction in patients with diabetes mellitus (DM). Immu¬nol Med Microbiol. 1999; 26(3):259-265. DOI: 10.1111/j.1574-695X.1999.tb01397.x
Fashner J, Bell AL. Herpes zoster and posther¬petic neuralgia: prevention and management. Am Fam Physician. 2011; 83(12):1432-1437. PMID: 21671543
Wood M, Kay R, Dworkin R, Soong S, Whit¬ley R. Oral acyclovir therapy accelerates pain resolution in patients with herpes zoster: a meta-analysis of placebo-controlled trials. Clin Infect Dis. 1996; 22(2):341-347. DOI: 10.1093/clinids/22.2.341
Severson E, Baratz K, Hodge D, Burke J. Herpes zoster ophthalmicus in olmsted county, Minnesota: have systemic antivirals made a difference? Arch Ophthalmol. 2003; 121(3):386-390. DOI: 10.1001/archopht.121.3.386
Takase H, Kubono R, Terada Y, Imai A, Fukuda S, Tomita M, et al. Comparison of the ocular characteristics of anterior uveitis caused by herpes simplex virus, varicella-zoster virus, and cytomegalovirus. Jpn J Ophthalmol. 2014; 58(6):473-482. DOI: 10.1007/s10384-014-0340-6
Johnson J, Amzat R, Martin N. Herpes zos¬ter ophthalmicus. Prim Care Clin Office Pract. 2015; 42:285-303. https://doi.org/10.1016/j.pop.2015.05.007
Butsch F, Greger D, Butsch C, Von Stebut E. Prognostic value of Hutchinson’s sign for ocular involvement in herpes zoster ophthalmicus. J Dtsch Dermatol Ges. 2017; 15(5):563-564. DOI: 10.1111/ddg.13227
Zaal M, Volker H, D’Amaro J. Prognostic value of Hutchinson’s sign in acute herpes zoster ophthalmicus. Arch Klin Exp Ophthalmol. 2003; 241(3):187-191. DOI: 10.1007/s00417-002-0609-1
Kalogeropoulos C, Bassukas I, Moschos M, Ta¬bbara K. Eye and Periocular Skin Involvement in Herpes Zoster Infection. Med Hypothesis Discov Innov Ophthalmol. 2015; 4(4):142-156. PMID: 27800502
Zajdenweber M, Muccioli C. Treatment of acute retinal necrosis: systematic review. Arq Bras Oftalmol. 2005; 68(4):463-469. DOI: 10.1590/s0004-27492005000400009