The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study

Prathibha Shanthaveerappa; Remya Joseph Parappallil

doi:doi:10.11648/j.ijovs.20190401.14

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The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study

Prathibha Shanthaveerappa, Remya Joseph Parappallil

Published in International Journal of Ophthalmology & Visual Science (Volume 4, Issue 1)

Received: 28 January 2019 Accepted: 22 March 2019 Published: 18 April 2019

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Abstract

Background: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. Purpose:1. To study the mode of presentation, ocular manifestations and complications of herpes zoster ophthalmicus (HZO) 2. To analyse the predisposing factors for the development of HZO. Materials and Methods: A prospective clinical study was done in 20 patients who were clinically diagnosed with HZO in the outpatient department of ophthalmology over a period of one year. They were subjected to a detailed general and ocular examination and were treated medically with close follow up. Result: Advancing age was the most common risk factor. Acute neuralgia was the commonest presenting symptom (75%). Ocular involvement was seen in 16 patients with no bilaterality. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by haemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen. Conclusion: The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity

Published in	International Journal of Ophthalmology & Visual Science (Volume 4, Issue 1)
DOI	10.11648/j.ijovs.20190401.14
Page(s)	19-23
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2019. Published by Science Publishing Group

Keywords

Herpes Zoster Ophthalmicus (HZO), Acyclovir, Orbital Apex Syndrome, Post Herpetic Neuralgia

References

[1]	Kanski JJ., Cornea, Chapter 5. In: Clinical Ophthalmology. 5th edition., (Edinburgh: Butterworth Heinemann; 2003). p111-114.
[2]	Wilson FI. Varicella and Herpes Zoster ophthalmicus. Chap. 25 In : Tabbara K, Hyndiuk R eds. Infections of the eye 2nd edition. ( Bosten: Little, Brown, 1996):387-400.
[3]	Deborah Pavan-Langston. Herpes Zoster Ophthalmicus. Neurology 1995; 45(suppl 8): S50-S51.
[4]	Ragozzino MW, Melton LJ 3d, Kurland LT, Chu CP, Perry HO. Population-based study of herpes zoster and its sequelae. Medicine. 1982; 61:310–6.
[5]	Liesegang TJ. Herpes Zoster Ophthalmicus. Ophthalmology 2008; 115: S3-S12.
[6]	Thomas Catron, MD and H. Gene Hern, MD, West J Emerg Med. 2008 Aug; 9(3): 174–176.
[7]	Deborah Pavan-Langston. Viral diseases of the ocular anterior segment. Chap 14. In: Foster CS., Azar DT., Dohlman CH.eds. Smolin and Thoft’s. The cornea. Scientific foundations and clinical practice. 4th edn. (Philadelphia: Lippincott Williams and Wilkins 2005); p297-397.
[8]	Thomas SL, Hall AJ. What does epidemiology tell us about risk factors for herpes zoster? Lancet Infect Dis 2004; 4(1):26-33.
[9]	Buchbinder SP, Katz MH, Hessol NA, et al. Herpes zoster and human immunodefciency virus infection. J Infect Dis 1992; 166:1153-1156.
[10]	Evaluation and Management of Herpes Zoster Ophthalmicus - SAAD SHAIKH, M. D., and CHRISTOPHER N. TA, M. D., Stanford University Medical Center, Stanford, California Am Fam Physician. 2002 Nov 1; 66(9):1723-1730.
[11]	Colin J, Prisant O, Cochener B, et al. Comparison of the efficacy and safety of valacyclovir and acyclovir for the treatment of herpes zoster ophthalmicus. Ophthalmology 2000; 107: 1507-1511.
[12]	Harding SP, Lipton JR, Wells JC. Natural history of herpes zoster ophthalmicus: predictors of postherpetic neuralgia and ocular involvement. Br J Ophthalmol. 1987; 71:353–8.
[13]	Christopher E. Starr., Deborah Pavan-Langston. Varicella Zoster virus: Mechanisms of pathogenicity and corneal disease. Ophthalmol Clin N Am. 2002; 15:7-15.
[14]	Jabs DA, Nussenblatt RB, Rosenbaum JT; Standardization of Uveitis Nomenclature (SUN) Working Group (2005) Standardization of uveitis nomenclature for reporting clinical data. Results of the first international workshop. Am J Ophthalmol 140:509–516.
[15]	Ghaznawi N, Virdi A, Dayan A, Hammersmith KM, Rapuano CJ, Laibson PR, Cohen EJ (2011) Herpes zoster ophthalmicus: comparison of disease in patients 60 years and older versus younger than 60 years. Ophthalmology 118:2242–2250.
[16]	Borkar DS, Tham VM, Esterberg E, Ray KJ, Vinoya AC, Parker JV, Uchida A, Acharya NR (2013) Incidence of herpes zoster ophthalmicus: results from the Pacific ocular inflammation study. Ophthalmology 120:451–456.
[17]	Malik LM, Azfar NA, Khan AR, et al. Herpes zoster in children. J Pak Assoc Dermatologists 2013; 23(3):267-271.
[18]	Prabhu S, Sripathi H, Gupta S, et al. Childhood herpes zoster: a clustering of ten cases. Indian J Dematol 2009; 54(1):62-64
[19]	Bayu S, Alemayehu W. Clinical Profile of Herpes zoster ophthalmicus in Ethiopians. Clin Infect Dis. 1997; 24:1256-60.
[20]	Marsh RJ, Cooper M. Acyclovir and steroids in herpes zoster Keratouveitis. Br J Ophthal 1984; 68(12):904-905.
[21]	Womack LW, Liesegang TJ. Complications of herpes zoster ophthalmicus. Arch Ophthalmol. 1983; 101:42–5.
[22]	Wood M J., Shukla S., Fiddian AP., Crooks RJ. Treatment of acute herpes zoster : Effect of early versus late therapy with Acyclovir and Valaciclovir on prolonged pain. J Infect Dis 1998; 178(Suppl 1): s81-s84.

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APA Style

Prathibha Shanthaveerappa, Remya Joseph Parappallil. (2019). The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. International Journal of Ophthalmology & Visual Science, 4(1), 19-23. https://doi.org/10.11648/j.ijovs.20190401.14

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ACS Style

Prathibha Shanthaveerappa; Remya Joseph Parappallil. The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. Int. J. Ophthalmol. Vis. Sci. 2019, 4(1), 19-23. doi: 10.11648/j.ijovs.20190401.14

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AMA Style

Prathibha Shanthaveerappa, Remya Joseph Parappallil. The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. Int J Ophthalmol Vis Sci. 2019;4(1):19-23. doi: 10.11648/j.ijovs.20190401.14

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@article{10.11648/j.ijovs.20190401.14,
  author = {Prathibha Shanthaveerappa and Remya Joseph Parappallil},
  title = {The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {4},
  number = {1},
  pages = {19-23},
  doi = {10.11648/j.ijovs.20190401.14},
  url = {https://doi.org/10.11648/j.ijovs.20190401.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20190401.14},
  abstract = {Background: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. Purpose:1. To study the mode of presentation, ocular manifestations and complications of herpes zoster ophthalmicus (HZO) 2. To analyse the predisposing factors for the development of HZO. Materials and Methods: A prospective clinical study was done in 20 patients who were clinically diagnosed with HZO in the outpatient department of ophthalmology over a period of one year. They were subjected to a detailed general and ocular examination and were treated medically with close follow up. Result: Advancing age was the most common risk factor. Acute neuralgia was the commonest presenting symptom (75%). Ocular involvement was seen in 16 patients with no bilaterality. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by haemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen. Conclusion: The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity},
 year = {2019}
}

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TY - JOUR
T1 - The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study
AU - Prathibha Shanthaveerappa
AU - Remya Joseph Parappallil
Y1 - 2019/04/18
PY - 2019
N1 - https://doi.org/10.11648/j.ijovs.20190401.14
DO - 10.11648/j.ijovs.20190401.14
T2 - International Journal of Ophthalmology & Visual Science
JF - International Journal of Ophthalmology & Visual Science
JO - International Journal of Ophthalmology & Visual Science
SP - 19
EP - 23
PB - Science Publishing Group
SN - 2637-3858
UR - https://doi.org/10.11648/j.ijovs.20190401.14
AB - Background: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. Purpose:1. To study the mode of presentation, ocular manifestations and complications of herpes zoster ophthalmicus (HZO) 2. To analyse the predisposing factors for the development of HZO. Materials and Methods: A prospective clinical study was done in 20 patients who were clinically diagnosed with HZO in the outpatient department of ophthalmology over a period of one year. They were subjected to a detailed general and ocular examination and were treated medically with close follow up. Result: Advancing age was the most common risk factor. Acute neuralgia was the commonest presenting symptom (75%). Ocular involvement was seen in 16 patients with no bilaterality. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by haemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen. Conclusion: The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity
VL - 4
IS - 1
ER -

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Author Information

Prathibha Shanthaveerappa

Department of Ophthalmology, Rajarajeswari Medical College and Hospital, Rajiv Gandhi University of Health And Sciences, Bangalore, India
Remya Joseph Parappallil

Department of Ophthalmology, Rajarajeswari Medical College and Hospital, Rajiv Gandhi University of Health And Sciences, Bangalore, India

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APA Style

Prathibha Shanthaveerappa, Remya Joseph Parappallil. (2019). The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. International Journal of Ophthalmology & Visual Science, 4(1), 19-23. https://doi.org/10.11648/j.ijovs.20190401.14

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ACS Style

Prathibha Shanthaveerappa; Remya Joseph Parappallil. The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. Int. J. Ophthalmol. Vis. Sci. 2019, 4(1), 19-23. doi: 10.11648/j.ijovs.20190401.14

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AMA Style

Prathibha Shanthaveerappa, Remya Joseph Parappallil. The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study. Int J Ophthalmol Vis Sci. 2019;4(1):19-23. doi: 10.11648/j.ijovs.20190401.14

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@article{10.11648/j.ijovs.20190401.14,
  author = {Prathibha Shanthaveerappa and Remya Joseph Parappallil},
  title = {The Clinical Profile and Ocular Manifestations of Herpes Zoster Ophthalmicus- A Hospital Based Study},
  journal = {International Journal of Ophthalmology & Visual Science},
  volume = {4},
  number = {1},
  pages = {19-23},
  doi = {10.11648/j.ijovs.20190401.14},
  url = {https://doi.org/10.11648/j.ijovs.20190401.14},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ijovs.20190401.14},
  abstract = {Background: Herpes Zoster Ophthalmicus (HZO) occurs due to reactivation of latent varicella zoster virus within the gasserian ganglion involving the ophthalmic division of the trigeminal nerve. HZO often has a chronic course with significant ocular morbidity as eye is considered potentially serious of all sites of herpes zoster owing to its delicate nature. Purpose:1. To study the mode of presentation, ocular manifestations and complications of herpes zoster ophthalmicus (HZO) 2. To analyse the predisposing factors for the development of HZO. Materials and Methods: A prospective clinical study was done in 20 patients who were clinically diagnosed with HZO in the outpatient department of ophthalmology over a period of one year. They were subjected to a detailed general and ocular examination and were treated medically with close follow up. Result: Advancing age was the most common risk factor. Acute neuralgia was the commonest presenting symptom (75%). Ocular involvement was seen in 16 patients with no bilaterality. Conjunctiva (60%) was the most common ocular structure involved followed by Cornea (45%). Anterior uveitis (20%) was complicated by haemorrhagic uveitis and orbital apex syndrome with total external ophthalmoplegia. Post herpetic neuralgia was the commonest complication seen. Conclusion: The potential manifestations of HZO are myriad. Development of serious inflammatory complications was associated with delay in therapy. Hence timely diagnosis and management are critical in limiting ocular morbidity},
 year = {2019}
}

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