Herpes zoster ophthalmicus and the risk of stroke: a population-based follow-up study.
OBJECTIVE
To investigate the risk of stroke development following a diagnosis of herpes zoster ophthalmicus (HZO).


METHODS
Data were retrospectively collected from the Taiwan National Health Insurance Research Database. The study cohort comprised all patients with a diagnosis of HZO (ICD-9-CM code 053.2) in 2003 and 2004 (n = 658). The comparison cohort was comprised of randomly selected patients (3 for every HZO patient, n = 1974) matched with the study group in terms of age and gender. Patients were tracked from their index visits for 1 year. The Kaplan-Meier method was utilized to compute the 1-year stroke-free survival rate. Cox proportional hazard regressions were carried out to compute the adjusted 1-year stroke-free survival rate after adjusting for possible confounding factors.


RESULTS
Stroke developed in 8.1% of patients with HZO and 1.7% of patients in the comparison cohort during the 1-year follow-up period. HZO patients had significantly lower 1-year stroke-free survival rates than patients in the comparison cohort. After adjusting for patients' demographic characteristics, selected comorbidities, and medication habits, HZO patients were found to have a 4.52-fold (95% confidence interval 2.45-8.33) higher risk of stroke than the matched comparison cohort. There was no significant difference in the rate of stroke development between patients who had received systemic antiviral treatment and those who had not.


CONCLUSIONS
Herpes zoster ophthalmicus may represent a marker of increased risk of stroke development during the 1-year follow-up period.
Lin
Herng-Ching
HC
Department of Ophthalmology, Taipei Medical University Hospital, 252 Wu-Hsing Street, Taipei 110, Taiwan.
Chien
Ching-Wen
CW
Ho
Jau-Der
JD
D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D018672:Community Health Planning; D005260:Female; D006563:Herpes Zoster Ophthalmicus / Q000150:complications* / Q000453:epidemiology; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011159:Population Surveillance; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012720:Severity of Illness Index; D020521:Stroke / Q000453:epidemiology* / Q000209:etiology* / Q000821:virology; D013624:Taiwan; D013997:Time Factors