目标:虽然通常影响老年人和免疫功能低下的个体,据报道,眼带状疱疹(HZO)在儿童中有不同的表现和并发症。在这次审查中,我们评估文献中报道的儿科HZO病例,并讨论流行病学,危险因素,临床表现,治疗和结果。
方法:在PubMed,Scopus,和WebofScience数据库使用术语“儿童眼带状疱疹”和“儿童眼带状疱疹”进行。“非特定于HZO或儿科人群的出版物被排除在外,以及无法审查或不以英语出版的出版物。
结果:回顾了57例描述HZO或HZO相关并发症的病例报告。儿童HZO的主要危险因素包括宫内暴露于水痘或年轻时的原发性水痘感染;HZO也发生在接受水痘疫苗接种的患者中。健康和免疫功能低下的儿童都受到影响,大多数受影响的儿童具有免疫能力。HZO的诊断主要是临床诊断。如果及时治疗并坚持治疗方案,儿童似乎视力恢复和症状缓解良好,除了与视神经炎等罕见并发症相关的不可逆性视力丧失。
结论:HZO在健康和免疫功能低下的儿童中均有发生。认识到这种可治疗的状况对于减少眼部和全身发病率至关重要。缺乏对成年期健康影响的长期随访和评估。需要更系统的研究来确定儿童HZO的发生率以及适当的诊断和治疗方案,以治疗小儿HZO患者。
OBJECTIVE: While typically affecting older adults and immunocompromised individuals, herpes zoster ophthalmicus (HZO) has been reported with varying manifestations and complications in children. In this
review, we evaluate reported cases of pediatric HZO in the literature and discuss the epidemiology, risk factors, clinical presentation, treatment and outcomes.
METHODS: A literature search on PubMed, Scopus, and Web of Science databases was performed using the terms \"pediatric herpes zoster ophthalmicus\" and \"herpes zoster ophthalmicus children.\" Publications that were not specific to HZO or pediatric populations were excluded, as were publications that were not available to
review or not published in the English language.
RESULTS: Fifty-seven reports describing 130 cases of HZO or HZO-related complications were reviewed. Major risk factors for pediatric HZO included intrauterine exposure to varicella or primary varicella infection at a young age; HZO also occurred in patients who had received varicella vaccination. Both healthy and immunocompromised children were affected, with the majority of affected children being immunocompetent. The diagnosis of HZO is primarily clinical. Children appear to have good vision recovery and resolution of symptoms if they are treated promptly and if they adhere to treatment regimens, except for irreversible vision loss related to uncommon complications such as optic neuritis.
CONCLUSIONS: HZO occurs in both healthy and immunocompromised children. Recognizing this treatable condition is essential for reducing ocular and systemic morbidity. Long-term follow-up and assessments of the impact on health in adulthood are lacking. More systematic study is needed to determine the incidence of HZO in children and appropriate diagnostic and treatment protocols for the care of pediatric patients with HZO.