Abstract：
OBJECTIVE: To examine the frequency of recurrences, risk factors, and long-term clinical outcomes in subjects with herpes zoster ophthalmicus (HZO).
METHODS: Retrospective cohort study.
METHODS: All subjects with acute HZO seen at a single center from 2006 to 2016 were included in the study. The primary outcome measure was eye disease recurrence. The secondary outcome measure was moderate vision loss (≤20/50).
RESULTS: A total of 869 patients with acute HZO were identified, with a median follow-up time of 6.3 years (interquartile range 3.7-8.9 years). In all, 551 recurrences were observed, and at least 1 recurrence was seen in 200 subjects (23.0%), with uveitis (34.8%) being the most common. The median time to first recurrence was 3.5 months. Predictors of disease recurrence included immunosuppression (P = .026), higher presenting intraocular pressure (P = .001), corneal involvement (P = .001), and uveitis (P < .001) on multivariate analysis. Topical steroids were initiated in the first month of presentation in 437 subjects, and recurrence was observed in 184 (42.1%) of these subjects. Following cessation of topical steroid treatment, recurrence occurred after a median of 1.4 months (90% within 7 months). Moderate vision loss (≤20/50) occurred in 15.5%, 28.6%, 31.4%, 50.0%, and 57.4% of eyes with 0, 1, 2, 3, and 4 or more recurrences.
CONCLUSIONS: Recurrence of HZO eye disease is common, with an increased risk of vision loss with more recurrences. These findings indicate the need for close monitoring for potential recurrences, especially after cessation of topical steroid treatment, and in individuals with identified risk factors for recurrence.
METHODS: Retrospective cohort study.
METHODS: All subjects with acute HZO seen at a single center from 2006 to 2016 were included in the study. The primary outcome measure was eye disease recurrence. The secondary outcome measure was moderate vision loss (≤20/50).
RESULTS: A total of 869 patients with acute HZO were identified, with a median follow-up time of 6.3 years (interquartile range 3.7-8.9 years). In all, 551 recurrences were observed, and at least 1 recurrence was seen in 200 subjects (23.0%), with uveitis (34.8%) being the most common. The median time to first recurrence was 3.5 months. Predictors of disease recurrence included immunosuppression (P = .026), higher presenting intraocular pressure (P = .001), corneal involvement (P = .001), and uveitis (P < .001) on multivariate analysis. Topical steroids were initiated in the first month of presentation in 437 subjects, and recurrence was observed in 184 (42.1%) of these subjects. Following cessation of topical steroid treatment, recurrence occurred after a median of 1.4 months (90% within 7 months). Moderate vision loss (≤20/50) occurred in 15.5%, 28.6%, 31.4%, 50.0%, and 57.4% of eyes with 0, 1, 2, 3, and 4 or more recurrences.
CONCLUSIONS: Recurrence of HZO eye disease is common, with an increased risk of vision loss with more recurrences. These findings indicate the need for close monitoring for potential recurrences, especially after cessation of topical steroid treatment, and in individuals with identified risk factors for recurrence.
摘要：
目的：为了检查复发的频率，眼带状疱疹（HZO）患者的危险因素和长期临床结局。
方法：回顾性队列研究。
方法：从2006年至2016年在单个中心观察到的所有急性HZO受试者均纳入研究。主要结果指标是眼部疾病复发。次要结果指标为中度视力下降（≤20/50）。
结果：共869例急性HZO患者，中位随访时间为6.3年（四分位距3.7-8.9年）。观察到551例复发，在200名受试者中至少有一次复发（23.0％），葡萄膜炎（34.8％）是最常见的。首次复发的中位时间为3.5个月。疾病复发的预测因素包括免疫抑制（p=0.026），高眼压（p=0.001），角膜受累（p=0.001），和葡萄膜炎（p<0.001）的多变量分析。437名受试者在就诊的第一个月开始外用类固醇，其中184例(42.1%)患者出现复发.停止局部类固醇治疗后，中位时间1.4个月后复发(90%在7个月内).中度视力丧失（≤20/50）占15.5%，28.6%,31.4%,50.0%和57.4%的眼睛为零，一,两个,三,和四次或更多次复发。
结论：HZO眼病的复发很常见，视力丧失的风险增加，复发更多。这些发现表明需要密切监测潜在的复发，特别是在停止局部类固醇治疗后，以及那些有复发风险因素的患者。
方法：回顾性队列研究。
方法：从2006年至2016年在单个中心观察到的所有急性HZO受试者均纳入研究。主要结果指标是眼部疾病复发。次要结果指标为中度视力下降（≤20/50）。
结果：共869例急性HZO患者，中位随访时间为6.3年（四分位距3.7-8.9年）。观察到551例复发，在200名受试者中至少有一次复发（23.0％），葡萄膜炎（34.8％）是最常见的。首次复发的中位时间为3.5个月。疾病复发的预测因素包括免疫抑制（p=0.026），高眼压（p=0.001），角膜受累（p=0.001），和葡萄膜炎（p<0.001）的多变量分析。437名受试者在就诊的第一个月开始外用类固醇，其中184例(42.1%)患者出现复发.停止局部类固醇治疗后，中位时间1.4个月后复发(90%在7个月内).中度视力丧失（≤20/50）占15.5%，28.6%,31.4%,50.0%和57.4%的眼睛为零，一,两个,三,和四次或更多次复发。
结论：HZO眼病的复发很常见，视力丧失的风险增加，复发更多。这些发现表明需要密切监测潜在的复发，特别是在停止局部类固醇治疗后，以及那些有复发风险因素的患者。
