一个大型城市医疗系统中带状疱疹眼炎眼部并发症发生的风险因素和带状疱疹疫苗的使用情况。

IF 4.1 1区医学 Q1 OPHTHALMOLOGY

American Journal of Ophthalmology Pub Date : 2024-10-01 DOI:10.1016/j.ajo.2024.09.028

Ann-Marie Lobo-Chan, Amy Song, Arya Kadakia, Supriya D. Mehta

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引用次数: 0

摘要

目的：描述城市医院系统中带状疱疹（HZ）和带状疱疹性眼炎（HZO）的流行病学特征，并确定与带状疱疹性眼炎眼部并发症相关的风险因素。报告该人群接种带状疱疹疫苗的频率以及接种带状疱疹疫苗后HZ再活化的情况：方法：对 2010 年 1 月 1 日至 2021 年 12 月 1 日期间在伊利诺伊大学医院系统就诊的 HZ 和 HZO 患者进行回顾性队列研究。研究人员摘录了确诊后一年内就诊的 HZO 患者的病历。多变量逻辑回归分析确定了与 HZO 眼部并发症发生相关的因素：研究期间共有 3283 名 HZO 患者，平均发病年龄为 52.3 岁，61.6% 为女性，37% 为黑人。110例（3.4%）HZO患者的眼部受累。40例（36.4%）患者出现眼部并发症；最常见的并发症是角膜瘢痕（70%）。年龄（几率比 [OR] 1.04，95%CI 1.0-1.1）、女性性别（OR 2.86，95%CI 1.0-8.1）、初诊时使用类固醇（4.46，95%CI 1.4-14.6）和基质角膜炎（OR 3.45，95%CI 1.2-9.8）与眼部并发症的发生有关。在符合条件的人群中，5333 人（1.5%）接种了带状疱疹疫苗；43 名患者在接种疫苗后出现 HZ 再激活：结论：在 HZO 患者中，年龄、女性性别、初诊时使用类固醇激素以及基质性角膜炎与眼部并发症的发生密切相关。本研究人群中带状疱疹疫苗接种率较低。了解 HZ/HZO 并发症的可能性和疫苗接种率有助于识别高危人群，预防疾病。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Risk Factors for the Development of Ocular Complications in Herpes Zoster Ophthalmicus and Zoster Vaccine Utilization in a Large, Urban Health System

Purpose

To characterize the epidemiology of herpes zoster (HZ) and herpes zoster ophthalmicus (HZO) in an urban hospital system and determine risk factors associated with developing ocular complications in HZO. To report the frequency of shingles vaccination and HZ reactivation following shingles vaccination in this population.

Methods

A retrospective cohort study was conducted on patients seen at the University of Illinois Hospital system from January 1, 2010 to December 1, 2021 with HZ and HZO identified by diagnosis code. Charts of HZO patients seen within 1 year of diagnosis were abstracted. Multivariable logistic regression analysis identified factors associated with the development of ocular complications in HZO.

Results

During the study period, 3283 patients had HZ; mean age of onset was 52.3 years, 61.6% were female, and 37% were Black. HZO with ocular involvement was seen in 110 (3.4%) patients. Ocular complications developed in 40 (36.4%) patients; the most common complication was corneal scarring (70%). Age (odds ratio [OR] 1.04, 95%CI 1.0-1.1), female gender (OR 2.86, 95%CI 1.0-8.1), steroids at initial visit (4.46, 95%CI 1.4-14.6), and stromal keratitis (OR 3.45, 95% CI 1.2, 9.8) were associated with developing ocular complications. Of eligible populations, 5333 (1.5%) received shingles vaccination; 43 patients developed reactivation of HZ following vaccination.

Conclusions

In HZO, age, female gender, steroids at initial visit, and stromal keratitis are strongly associated with developing ocular complications. Shingles vaccination rates were low in this study population. Understanding potential for complications in HZ/HZO and vaccination uptake can help identify at risk populations to prevent disease. NOTE: Publication of this article is sponsored by the American Ophthalmological Society.

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来源期刊

American Journal of Ophthalmology 医学-眼科学

CiteScore

9.20

自引率

7.10%

发文量

406

审稿时长

36 days

期刊介绍： The American Journal of Ophthalmology is a peer-reviewed, scientific publication that welcomes the submission of original, previously unpublished manuscripts directed to ophthalmologists and visual science specialists describing clinical investigations, clinical observations, and clinically relevant laboratory investigations. Published monthly since 1884, the full text of the American Journal of Ophthalmology and supplementary material are also presented online at www.AJO.com and on ScienceDirect. The American Journal of Ophthalmology publishes Full-Length Articles, Perspectives, Editorials, Correspondences, Books Reports and Announcements. Brief Reports and Case Reports are no longer published. We recommend submitting Brief Reports and Case Reports to our companion publication, the American Journal of Ophthalmology Case Reports. Manuscripts are accepted with the understanding that they have not been and will not be published elsewhere substantially in any format, and that there are no ethical problems with the content or data collection. Authors may be requested to produce the data upon which the manuscript is based and to answer expeditiously any questions about the manuscript or its authors.