Ethylenediaminetetraacetic Acid Chelation in Herpes Zoster Ophthalmicus Is Associated With a High Rate of Corneal Melt and Perforation.
Aged
Calcium Chelating Agents
/ adverse effects
Corneal Dystrophies, Hereditary
/ drug therapy
Corneal Perforation
/ chemically induced
Corneal Ulcer
/ chemically induced
Edetic Acid
/ adverse effects
Female
Follow-Up Studies
Herpes Zoster Ophthalmicus
/ complications
Humans
Male
Middle Aged
Retrospective Studies
Risk Factors
Visual Acuity
Journal
Cornea
ISSN: 1536-4798
Titre abrégé: Cornea
Pays: United States
ID NLM: 8216186
Informations de publication
Date de publication:
01 Mar 2021
01 Mar 2021
Historique:
received:
07
03
2020
accepted:
05
10
2020
pubmed:
3
12
2020
medline:
25
9
2021
entrez:
2
12
2020
Statut:
ppublish
Résumé
To examine the rate and risk factors for band keratopathy after herpes zoster ophthalmicus (HZO) and the outcomes of ethylenediaminetetraacetic acid (EDTA) treatment. This is a retrospective review of all subjects with HZO seen at Auckland District Health Board between January 2006 and December 2016. A total of 869 subjects with HZO were included in the study. Median follow-up was 6.3 years (total 5504.4 patient-years). Band keratopathy developed in 13 subjects (1.5%). On multivariate analysis, older age at onset [hazard ratio (HR), 1.092; P = 0.034], intraocular pressure ≥30 mm Hg at presentation (HR, 5.548; P = 0.013), and number of recurrences (HR, 1.849; P < 0.001) were associated with increased risk for band keratopathy. Corneal melt occurred in 22 subjects (2.5%) during the follow-up period. On multivariate analysis, uveitis (HR, 8.618; P = 0.004) and disodium EDTA chelation (HR, 8.666; P < 0.001) were associated with increased risk for corneal melt. EDTA chelation was performed in 8 subjects. Corneal melt occurred after EDTA chelation in 4 subjects, and corneal perforation occurred in 2 subjects. One subject was eviscerated due to severe endophthalmitis after repeated corneal perforation and another required enucleation for recurrent corneal melt and microbial keratitis. Band keratopathy is an uncommon complication of HZO. Treatment with EDTA chelation might be associated with a significant risk for severe complications in these eyes and should be approached with caution.
Identifiants
pubmed: 33264147
pii: 00003226-202103000-00004
doi: 10.1097/ICO.0000000000002619
doi:
Substances chimiques
Calcium Chelating Agents
0
Edetic Acid
9G34HU7RV0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
277-281Informations de copyright
Copyright © 2020 Wolters Kluwer Health, Inc. All rights reserved.
Déclaration de conflit d'intérêts
The authors have no funding or conflicts of interest to disclose.
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