Hutchinson's sign, anterior uveitis may predict vision loss with herpes zoster ophthalmicus

Clin Experiment Ophthalmol. 2010;38(9):845-850.

Patients with herpes zoster ophthalmicus showed good visual outcomes after receiving antiviral therapy, a study found.

Hutchinson's sign and anterior uveitis were both significantly linked to vision loss in these patients, according to the study.

The prospective, longitudinal, observational study consisted of 64 patients with herpes zoster ophthalmicus who underwent extensive ophthalmological and dermatological examinations within 72 hours of rash onset.

All patients were treated with systemic and topical acyclovir. Best corrected visual acuity was evaluated at 6-month follow-up.

Overall, 56.3% of patients had a visual acuity of 6/6 or better and 34.3% experienced mild vision loss. Moderate loss occurred in 4.7% of patients, and 4.7% experienced severe vision loss due to severe uveitis, neurotrophic keratitis or cataract.

Lack of corneal sensation (P = .01), corneal epithelial lesions (P = .03), older age (P = .04), uveitis (P < .001) and positive Hutchinson's sign (P = .001) were significantly linked to vision loss.

Multivariate analysis determined uveitis to be the best predictor of vision loss in patients with herpes zoster ophthalmicus.