Herpes Zoster Ophthalmicus Elevates Stroke Risk

Herpes zoster ophthalmicus increases the risk of stroke, even after controlling for both medical comorbidities and social factors, according to research published in Eye.

Investigators used an administrative medical claims database to validate the association between herpes zoster ophthalmicus and stroke while rigorously controlling for both medical comorbidities and social factors. The team took a 2-step approach, first conducting a retrospective case-control study assessing the hazard for stroke and then a self-controlled case series comparing the incidence of stroke prior to and after diagnosing the disorder.

The case-control study included 25,720 individuals with herpes zoster ophthalmicus (average age, 71.7 years; 59.9% women) and 75,924 age- and sex-matched control group participants (average age, 71.8 years; 60% women). During the 1-year follow-up period, 6.7% of patients with herpes zoster ophthalmicus and 6.0% of control group participants had a stroke diagnosis. Individuals in the case group experienced an 18% higher risk of stroke compared with individuals in the control group during this period (hazard ratio [HR], 1.18; 95% CI, 1.12-1.25; P <.001), the report shows. 

The self-controlled case series analysis included 20,149 patients (average age, 71.6; 60.2% women) who were diagnosed with herpes zoster ophthalmicus. Among these participants, the risk of stroke was highest within the first month of diagnosis (relative risk [RR], 1.58; P<.001) and persisted for at least a year (RR, 1.33; 95% CI, 1.07–1.65; P=.009).

“Confirming this link between [herpes zoster ophthalmicus] and subsequent stroke has important implications for both treatment of the reactivated viral illness and prevention of stroke,” according to the study authors. “These results suggest that timely management is crucial, but begs the question as to what interventions work best to reduce morbidity and mortality from stroke in these patients.”

Study limitations include a retrospective nature and the use of an insurance-based data set, which may limit generalizability to uninsured populations.

Disclosure: Some study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.  

This article originally appeared on Optometry Advisor