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Risk Factors for the Development of Ocular Complications in Herpes Zoster Ophthalmicus

thesis
posted on 01.05.2020, 00:00 by Ann-Marie Lobo-Chan
Purpose: The purpose of this study is to report the incidence of herpes zoster (HZ) and herpes zoster ophthalmicus (HZO) in a large urban hospital system and to determine risk factors that are associated with the development of ocular complications in HZO. A secondary objective is to report the frequency of shingles vaccination and any episodes of HZ reactivation following shingles vaccination in this population. Methods: A retrospective cohort study was performed on patients seen at the University of Illinois Hospital system from 2010-2015 with HZ and HZO identified by diagnosis code. Medical chart review of HZO patients seen within 1 year of diagnosis of disease was performed. Patients with any ocular complication at 6 months and 1 year time points were compared to patients without ocular complications. Multivariable logistic regression analysis was performed to determine factors associated with the development of ocular complications in HZO. Results: During the study period, 1365 patients had HZ with an incidence of 332 per 100,000; the mean age of onset was 52 years, 60% of patients were female and 38% were black. HZO with confirmed ocular involvement was seen in 122 (8.9%) patients. Of 93 patients with HZO included in the analysis, the mean age was 57.8 years, and patients were predominantly female (55.9%) and Caucasian (39.8%). Ocular complications developed in 25 (27%) patients; the most common complication was corneal scarring (24.7%). Female gender (8.9, 95%CI 2.27, 35.1) and stromal keratitis (9.69, 95% CI 2.66, 35.4) were associated with a higher odds of development of ocular complications. Shingles vaccination rates were low (0.4%) in this population during the study period, but only 4 (0.5%) patients developed reactivation of HZ following vaccination. Conclusions: HZ and HZO represent major public health issues. In HZO, female gender and stromal keratitis are strongly associated with development of ocular complications. Understanding risk factors for HZ/HZO can help to target populations for vaccination to prevent disease and long-term antiviral and anti-inflammatory therapy in those with disease.

History

Advisor

Mehta, Supriya

Chair

Mehta, Supriya

Department

Public Health Sciences

Degree Grantor

University of Illinois at Chicago

Degree Level

Masters

Degree name

MS, Master of Science

Committee Member

Konda, Sreenivas Shukla, Deepak

Submitted date

May 2020

Thesis type

application/pdf

Language

en

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