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

ABSTRACT

Purpose@#To determine the efficacy of tear varicella zoster virus polymerase chain reaction (VZV PCR) results for the occurrenceof ocular symptoms in patients diagnosed with herpes zoster ophthalmicus (HZO), as compared to Hutchinson’s sign, and to determinethe 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 February2015 to June 2018. We investigated whether Hutchinson’s sign and VZV PCR results were correlated with the occurrence of ocularsymptoms 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 commonocular symptom. There were correlations between Hutchinson’s sign and the occurrence of ocular symptoms, and betweenVZV PCR and the occurrence of ocular symptoms (p = 0.047 and p = 0.005, respectively). The receiver operating characteristiccurve of Hutchinson’s sign and VZV PCR in ocular involvement of the area under the curve of the tear VZV PCR was larger thanHutchinson’s sign (VZV PCR = 0.72; Hutchinson’s sign = 0.63). Only keratouveitis was identified as a risk factor for recurrenceof 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.