Herpes Zoster Ophthalmicus—Diagnosis and Management

Rousseau, Antoine; Bourcier, Tristan; Colin, J; Labétoulle, Marc

doi:10.17925/usor.2013.06.02.1

Cited by 13 publications

(24 citation statements)

References 54 publications

(75 reference statements)

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“…New lesions keep emerging for 3-5 days, starts with erythema, macules, papules, and vesicles. In elderly or immunocompromised patients, necrotic skin lesions can be found [8]. Skin lesions in zoster can get into deep dermis so that the scar can last for a long time [6].…”

Section: Hzomentioning

confidence: 99%

Human Vaccines and Herpes Zoster Ophthalmicus: Clinical Manifestation, Treatment, and Prevention

Yuwanda¹

2020

Open Access Maced J Med Sci

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Herpes zoster ophthalmicus (HZO) is a reactivation of HZ virus that is latent in ophthalmic division of trigeminal ganglion. Patients over 50 years old, premature infant, pregnancy woman, receiving immunosuppressive agents, and malignancies are at risk of having HZO. Ocular manifestations of HZ are ectropion, entropion, ectopic eyelash, keratitis, conjunctivitis, symblepharon, hypoesthesia, episcleritis, scleritis, scleral atrophy and thinning, uveitis, iris atrophy, posterior synechiae, acute retinal necrosis, progressive outer retinal necrosis, retinal detachment, retina atrophy, optic neuritis, optic atrophy, and strabismus. Polymerase chain reaction, antigen detection, and antibody detection can help to confirm diagnosis. Pharmacology treatments for HZ ophthalmicus are antiviral drugs, corticosteroids, analgesics, tricyclic antidepressants, and antiepileptic drug. Non-pharmacology therapies are scleral contact lens, phototherapeutic keratectomy, photorefractive keratectomy, and penetrating keratoplasty. There are two kinds of vaccination which can be given to patients: Live-attenuated varicella zoster vaccine and recombinant zoster vaccine. It is recommended by Centers for Disease Control and Prevention and Food and Drugs Administration to use recombinant zoster vaccine by 50 years old.

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Section: Hzomentioning

confidence: 99%

Human Vaccines and Herpes Zoster Ophthalmicus: Clinical Manifestation, Treatment, and Prevention

Yuwanda¹

2020

Open Access Maced J Med Sci

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“…Systemic steroids (oral prednisolone or intravenous methylprednisolone) are reserved for cases of resistant, acute-phase pain, debilitating rash, facial palsy or cranial polyneuritis, and severe inflammatory ocular complications. [31214] In the present patient, the development of optic neuritis and NVG were the indications for intravenous methylprednisolone.…”

Section: Discussionmentioning

confidence: 64%

“…HZO is treated using anti-viral agents such as acyclovir, valacyclovir, and famciclovir. [31114] The present patient was started on oral acyclovir (800 mg, 5 times daily). Despite 3 weeks of treatment, he did not show any signs of resolution.…”

Section: Discussionmentioning

confidence: 99%

Herpes zoster ophthalmicus, central retinal artery occlusion, and neovascular glaucoma in an immunocompetent individual

Ahmad¹,

Suan²,

Alexander³

2019

J Ophthalmic Vis Res

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Purpose: To report the unusual case of an immunocompetent individual with herpes zoster ophthalmicus who developed central retinal artery occlusion and subsequent neovascular glaucoma. Case Report: A 40-year-old, immunocompetent patient was diagnosed with herpes zoster ophthalmicus and central retinal artery occlusion on initial presentation. Subsequently, he developed neovascular glaucoma. Conclusion: There are a few case reports of central retinal artery occlusion developing after varicella zoster virus infection. However, a literature search found no reports of neovascular glaucoma following central retinal artery occlusion secondary to varicella zoster virus infection. The present case report indicates that neovascular glaucoma is a possible complication in such a scenario.

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“…The clinical findings in the chronic phase include persistent corneal epithelial defects and postherpetic neuralgia. 8,[11][12][13] In the current report, we studied the ocular involvement of acute HZO. The age of onset of HZO for our cohort was about 50 years.…”

Section: Discussionmentioning

confidence: 99%

Ocular Manifestations in Acute Herpes Zoster Ophthalmicus

Thamphithak

2019

Smj

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Objective: To determine the prevalence and clinical predictors of ocular involvement in acute herpes zoster ophthalmicus. Methods: A retrospective chart review of 167 patients presenting with acute herpes zoster ophthalmicus at the Outpatient Department of Ophthalmology, Siriraj Hospital, was performed. All skin lesions along the ophthalmic branch of the trigeminal nerve (CN V 1) and ocular inflammatory signs were observed and documented. Results: A total of 160 cases were analyzed. The prevalence of ocular inflammation in acute herpes zoster ophthalmicus was 73.1% (117/160). The types of ocular inflammations included conjunctival injection (99.1%), keratitis (51.3%), and iridocyclitis (21.4%). Nasociliary skin lesions (Hutchinson's sign) were the best predictor of ocular inflammation in acute herpes zoster ophthalmicus (p = 0.006, OR = 3.6, 95% CI: 1.5-9.1). Other factors associated with ocular inflammation were a period of longer than 4 days from the onset of rash to an eye examination (p = 0.007, OR = 3.2, 95% CI: 1.4-7.5), and the initiation of systemic acyclovir treatment after 3 days from rash onset (p = 0.037, OR = 2.3, 95% CI: 1.05-4.96). Conclusion: There is a high prevalence of ocular inflammation in acute herpes zoster ophthalmicus, especially among individuals with Hutchinson's sign and delayed systemic acyclovir treatment. General practitioners should be aware of ocular involvement and refer high-risk patients for a complete ophthalmologic assessment.

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Herpes Zoster Ophthalmicus—Diagnosis and Management

Cited by 13 publications

References 54 publications

Human Vaccines and Herpes Zoster Ophthalmicus: Clinical Manifestation, Treatment, and Prevention

Human Vaccines and Herpes Zoster Ophthalmicus: Clinical Manifestation, Treatment, and Prevention

Herpes zoster ophthalmicus, central retinal artery occlusion, and neovascular glaucoma in an immunocompetent individual

Ocular Manifestations in Acute Herpes Zoster Ophthalmicus

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