Risk Factors Associated with Comorbidities and Complications in Patients with Herpes Zoster Ophthalmicus: A Retrospective Analysis

Abstract

Aim: The incidence of herpes zoster ophthalmicus (HZO) has been increasing in recent years. Although HZO is a self-limiting disease with an excellent response to treatment, it may cause significant neurological and ocular complications. We aim to identify the demographic and clinical characteristics of patients with HZO and determine the risk factors for ocular involvement and postherpetic neuralgia (PHN). Additionally, we investigate how these risk factors might inform early diagnostic and therapeutic interventions, ultimately guiding strategies to prevent HZO-related complications. Materials and Methods: Eighty-six patients diagnosed with HZO and hospitalized at our institution were evaluated. All patients underwent inpatient follow-up to monitor for potential ocular complications. PHN was defined as either the documented persistent pain or use of analgesic medications three months post-HZO onset. Results: A total of 86 patients were included, with a mean age of 67.2 +/- 13.0 years and a male-to-female ratio of 0.91. Ocular involvement was observed in 57.0% of cases. No significant associations regarding age, sex, immunosuppression status, or Hutchinson's sign were found between patients with and without ocular involvement. However, patients with maxillary or combined maxillary-mandibular branch involvement had a significantly lower risk of ocular complications (P < 0.001). PHN occurred in 46.5% of patients and was significantly linked to greater clinical severity (P = 0.026) and neurologic symptoms (P = 0.005). Conclusion: Whereas Hutchinson's sign did not predict ocular involvement, involvement of the maxillary and mandibular branches was linked to a reduced risk of ocular complications. Clinical severity was positively correlated with PHN.