J Korean Ophthalmol Soc.  2020 Apr;61(4):334-340. 10.3341/jkos.2020.61.4.334.

Effectiveness of the Tear Varicella Zoster Virus Polymerase Chain Reaction inHerpes Zoster Ophthalmicus

• Park HJ
• Paik HJ
• Kim DH

• KMID: 2500097
• DOI: http://doi.org/10.3341/jkos.2020.61.4.334

Abstract

Purpose
To determine the efficacy of tear varicella zoster virus polymerase chain reaction (VZV PCR) results for the occurrence of ocular symptoms in patients diagnosed with herpes zoster ophthalmicus (HZO), as compared to Hutchinson’s sign, and to determine the relationship between recurrence of HZO and VZV PCR results.
Methods
We conducted a retrospective analysis using medical records from 69 patients diagnosed with HZO from February 2015 to June 2018. We investigated whether Hutchinson’s sign and VZV PCR results were correlated with the occurrence of ocular symptoms and recurrence of HZO.
Results
Of the 69 patients, 51 patients (73%) had ocular symptoms and 45 patients (65.2%) had conjunctivitis as the most common ocular symptom. There were correlations between Hutchinson’s sign and the occurrence of ocular symptoms, and between VZV PCR and the occurrence of ocular symptoms (p = 0.047 and p = 0.005, respectively). The receiver operating characteristic curve of Hutchinson’s sign and VZV PCR in ocular involvement of the area under the curve of the tear VZV PCR was larger than Hutchinson’s sign (VZV PCR = 0.72; Hutchinson’s sign = 0.63). Only keratouveitis was identified as a risk factor for recurrence of HZO (odds ratio = 30.53; p = 0.033). There was no correlation between keratouveitis and recurrence of HZO (p > 0.05).
Conclusions
In patients with HZO, the tear VZV PCR may be as effective a predictor of ocular involvement as Hutchinson’s sign, and keratouveitis diagnosed at the initial visit was associated with the recurrence of HZO.

Keyword

Herpes zoster ophthalmicus; Hutchinson’s sign; Keratouveitis; Polymerase chain reaction; Varicella zoster virus