Herpes zoster ophthalmicus at a tertiary health facility, South-western Nigeria: Clinical presentations and outcome

  • O Fasina
  • SJ Hughes
Keywords: Herpes Simplex, Herpes Zoster Ophthalmicus, Human Immunodeficiency Virus, Postherpetic Neuralgia

Abstract

Herpes zoster ophthalmicus is a neurocutaneous disease caused by the human alpha herpes virus Type 3 and it is characterized by reactivation of dormant varicella-zoster virus lying within the trigeminal ganglia. The objective of this study was to describe the clinical presentation and management outcome of patients with herpes zoster ophthalmicus in a tertiary health facility. This was a retrospective study of patients with herpes zoster ophthalmicus managed at the Eye Clinic of a tertiary health facility in the South-western part of Nigeria over eight years. There were 17 patients, comprising five males and the mean age at presentation was 54.9±13.7 years. Seven (41.2%) patients were seropositive for the Human Immunodeficiency Virus (HIV) while nine (52.9%) patients had corneal involvement. Fifteen (88.2%) patients had involvement of the first branch of the trigeminal nerve (V1), and one (5.9%) patient each had involvement of the second branch of the trigeminal nerve (V2) and the first two branches of the trigeminal nerve (V1 and V2). All the patients were managed with oral and topical antiviral medications. Ten patients (58.8%) developed postherpetic neuralgia. In conclusion, Herpes zoster ophthalmicus is strongly associated with HIV seropositivity and older age and a significant proportion of patients develop post-herpetic neuralgia necessitating long term management.

References

Wiafe B. Herpes Zoster Ophthalmicus in HIV/AIDS. J Comm Eye Health 2003; 16: 35-36.

Liesegang TJ. Herpes Zoster Ophthalmicus natural history, risk factors, clinical presentation and morbidity. Ophthalmology 2008; 115: 3-12.

Umeh RE. Herpes zoster ophthalmicus and HIV infection in Nigeria. Int J STD AIDS 1998; 9: 476-479.

Owoeye JFA, Ademola-Popoola DS. Herpes zoster infection and HIV seropositivity among eye patients – University of Ilorin Teaching Hospital experience. West Afr J Med 2003; 22: 136-138.

Dawodu OA, Osahon AI, Alikah AA, Bakare C. Herpes zoster ophthalmicus. South Afr Med J 2005; 95: 30-31.

Akinsola FB, Okanny CC, Majekodunmi AA, Akinsete I. Ocular manifestations of HIV infections in Lagos: Lagos University Teaching Hospital experience. Niger Postgrad Med J 1997; 4: 84-87.

Nwosu SNN, Anyiwo CE, Nwosu MC. Herpes zoster ophthalmicus associated with HIV infections. A report of two cases. Niger Med J 1995; 281: 27-29.

Adio AO, Fiebai B. Herpes zoster ophthalmicus and HIV seropositivity in South-south Nigeria. Niger J Med 2010; 19: 162-164.

Saka ES, Olatunj FO, Monsudi KF, Balarabe AH, Qudus BA, Isa A. Herpes zoster ophthalmicus infection among eye patients- Federal Medical Centre Birni Kebbi, Kebbi state experience. J Med Res Clin Sci 2014; 2: 3293-3298.

Hodge WG, Seiff SR, Margolis TP. Ocular opportunistic infection incidences among patients who are HIV positive compared to patients who are HIV negative. Ophthalmology 1998; 105: 895-900.

Magadi MA. Understanding the gender disparity in HIV infection across countries in sub-Saharan Africa: evidence from the Demographic and Health Surveys. Soc Health Illness 2011; 33: 522–539.

Fasina O, Ubah JN. Pattern of pre-hospital consultation among ophthalmic patients seen in a tertiary hospital in south-west Nigeria. Afr J Med Med Sci 2009; 38: 173-177.

Gupta N, Sachdev R, Sinha R, Titiyal JS, Tandon R. Herpes zoster ophthalmicus: disease spectrum in young adults. Middle East Afr J Ophthalmol 2011; 18: 178–182.

Kahloun R, Attia S, Jelliti B, Attia A Z, Khochtali S, Yahia SB, et al. Ocular involvement and visual outcome of herpes zoster ophthalmicus: a review of 45 patients from Tunisia, North Africa. J Ophthal Inflamm Infect 2014; 4: 25.

Van Dyk M, Meyer D. Hutchinson’s sign as a marker of ocular involvement in HIV-positive patients with herpes zoster ophthalmicus. South Afr Med J 2010; 100: 172-174.

Zaal MJ, Völker-Dieben HJ, D'Amaro J. Prognostic value of Hutchinson’s sign in acute herpes zoster ophthalmicus. Graefes Arch Clin Exp Ophthalmol 2003; 241: 187-191.

Severson EA, Baratz KH, Hodge DO, Burke JP. Herpes zoster ophthalmicus in Olmsted county, Minnesota: have systemic antivirals made a difference? Arch Ophthalmol 2003; 121: 386–390.

Published
2020-08-22
Section
Case Report