Purpose

: To examine risk factors associated with cerebrovascular accident (CVA) following herpes zoster ophthalmicus (HZO).

Design

: Retrospective cohort study

Methods

: Review of medical records of all subjects with HZO seen at the department of Ophthalmology, Auckland District Health Board, New Zealand, between 1^st January 2006 and 31^st December 2016. Main outcome measures: Cerebrovascular accident within 12 months of diagnosis.

Results

: 869 patients diagnosed with HZO were included in the study. The median age at onset of HZO was 65.5 (Interquartile range, IQR 52.9 – 75.4) and 52.5% (n=456) were male. Antiviral therapy was started in 765 participants (88.0%), not utilised in 95 (10.9%) and not documented in 9 participants (1.0%). Four hundred sixty-eight participants (54.9%) received prompt oral antiviral therapy (≤72 hours of rash onset). A CVA occurred in the 12 months following HZO in 14 subjects (1.6%) and was most common in older subjects, occurring in 2.5% aged ≥65 years, 0.7% aged 40-65 years and 0.9% aged <40 years. Hazard of CVA was highest immediately following HZO, with median time to CVA of 2.3 months (IQR 0.8 – 5.9 months). Subjects that received prompt acyclovir had a 76.2% lower hazard of CVA (0.9% vs 2.6%, p=0.022) on multivariate analysis.

Conclusions

: Cerebrovascular accident occurs in a low proportion of individuals within one year following HZO. Antiviral treatment for HZO may reduce the risk of subsequent CVA when given within 72 hours of rash onset.

中文翻译：

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及时抗病毒治疗与眼带状疱疹后脑血管意外风险降低相关

目的

: 检查与眼带状疱疹 (HZO) 后脑血管意外 (CVA) 相关的危险因素。

设计

: 回顾性队列研究

方法

^{: 审查 2006 年 1 月 1日}至 2016 年 12 月31 日期间在新西兰奥克兰区卫生局眼科看到的所有 HZO 受试者的医疗记录^。主要结果测量：诊断后 12 个月内发生脑血管意外。

结果

: 869 名诊断为 HZO 的患者被纳入研究。HZO 发病的中位年龄为 65.5 岁（四分位距，IQR 52.9 – 75.4），52.5%（n=456）为男性。765 名参与者 (88.0%) 开始了抗病毒治疗，95 名 (10.9%) 未使用，9 名参与者 (1.0%) 未记录。468 名参与者 (54.9%) 接受了及时的口服抗病毒治疗（皮疹发病时间≤72 小时）。14 名受试者 (1.6%) 在 HZO 后的 12 个月内发生 CVA，并且在老年受试者中最常见，2.5% 的年龄≥65 岁、0.7% 的年龄在 40-65 岁和 0.9% 的年龄 <40 岁。在 HZO 之后，CVA 的风险最高，达到 CVA 的中位时间为 2.3 个月（IQR 0.8 - 5.9 个月）。在多变量分析中，接受即时阿昔洛韦治疗的受试者的 CVA 风险降低了 76.2%（0.9% 对 2.6%，p=0.022）。

结论

：HZO 后一年内发生脑血管意外的个体比例很低。在皮疹发作后 72 小时内给予 HZO 抗病毒治疗可降低随后发生 CVA 的风险。