Herpes Zoster Ophthalmicus: Comparison of Disease in Patients 60 Years and Older Versus Younger than 60 Years

Studying Physician Knowledge, Attitudes, and Practices Regarding the Herpes Zoster Vaccine to Address Perceived Barriers to Vaccination

“…2,[15][16][17][18] One third of all people in the United States will get HZ with numbers highest in people aged 50 to 70 years. 2,16 Because HZ incidence is related to T-cell varicella zoster-specific immunity, decreased cell-mediated immunity because of age, immunocompromise, and/or decreased exposure have contributed to the rise in HZ.…”

“…2,16 Because HZ incidence is related to T-cell varicella zoster-specific immunity, decreased cell-mediated immunity because of age, immunocompromise, and/or decreased exposure have contributed to the rise in HZ. 6,17,19 Despite FDA approval of the vaccine with evidence of its safety and efficacy, significant barriers to utilization remain for immunocompetent patients aged 60 years and older. [6][7][8][20][21][22] These baseline survey results confirm the recent literature that from a physician perspective, high cost to patients, difficulties with ordering, administering and storing the HZ vaccine, and lack of strong physician recommendation are major barriers to increasing HZ vaccination.…”

Treatment of Pseudodendrites in Herpes Zoster Ophthalmicus With Topical Ganciclovir 0.15% Gel

“…14 In a series of 20 patients with these delayed corneal lesions, a cumulative recurrence rate of 45.6% per 100 personyears of follow-up was identified. 6 Ghaznawi et al 15 reported that delayed pseudodendrites occurred more frequently (36%) in patients who had an initial HZO onset at a younger age (,60 years) compared with development after 60 years of age (16.7%). As with systemic recurrences, the corneal lesions can also occur in both immunocompromised and immunocompetent states.…”

Herpes Simplex and Herpes Zoster Eye Disease

“…3,8 The vaccine against HZ (Zostavax; Merck Sharp & Dohme, Corp, Whitehouse Station, NJ) is recommended by the CDC for the prevention of HZ in immunocompetent individuals of 60 years and older and is approved by the FDA for individuals of 50 years and older. [13][14][15] The Shingles Prevention Study demonstrated a 51% decrease in HZ incidence with the use of Zostavax among immunocompetent individuals of 60 years and older.…”

“…4,5 It is believed that the vaccines currently available against VZV and HZ may change the epidemiology of HZ and HZO as a result of altered immunity within the community; however, recent population-based analyses show a steady increase in the rate of new HZ cases that seems to be independent of VZV vaccination. 1,2,[6][7][8][9] This is a subject of immense public health interest and warrants further investigation. Underuse of the vaccine against HZ is also a major concern, with only 14.4% of eligible patients receiving it as of 2010.…”