50세 미만과 50세 이후에서 발생하는 안부 대상포진의 비교
Herpes Zoster Ophthalmicus in Patients Younger than 50 Years Versus 50 Years and Older
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목적: 안부 대상포진환자의 나이에 따른 위험인자, 임상양상 및 예후에 대해 알아보고자 하였다. 대상과 방법: 2008년 1월 1일부터 2010년 12월 31일까지 이화여자대학교 목동병원 안과에서 안부 대상포진을 진단받은 환자들을 대상으로 의무기록을 후향적으로 조사하였으며 50세를 기준으로 나이에 따른 전신질환, 안과적 합병증, 치료 및 예후를 비교 분석하였다. 결과: 총 102명(102안)의 안부 대상포진 환자가 포함되었다. 평균 나이는 50.6 ± 21.8(범위, 3-89)세였으며 젊은 환자군과 노인 환자군의 수는 비슷하였다(43.1% vs. 56.9%). 50세에서 59세 사이에 가장 높은 발생률을 보였으며 성별에 따른 차이는 없었다(p=0.06). 두군간의 안과적 합병증을 비교하였을 때 젊은 군에서 앞 포도막염의 발생률이 높았다(p=0.04). 또한 젊은 환자일수록 기저질환으로면역억제제를 사용 중인 빈도가 높았다(p=0.01). 결론: 안부 대상포진은 50세 미만과 50세 이후의 환자에서 비슷한 발생률을 보였다. 안과적 합병증은 두 군에서 비슷하였으나 젊은환자에서 앞 포도막염의 발생률이 유의하게 높았다. 기저 질환으로 인해 면역억제제를 복용하는 빈도가 젊은 군에서 유의하게 많았다.
Abstract
Purpose: To study the clinical course of herpes zoster ophthalmicus (HZO) and to compare the demographics, treatments,and outcomes in patients under 50 years of age versus patients 50 years of age or older at the time of diagnosis. Methods: A retrospective chart review was performed of 102 patients who were diagnosed with HZO between January 1,2008 and December 31, 2010. Baseline demographics and clinical characteristics between patients with an onset of HZO under the age of 50 years and patients with an onset of HZO at the age of 50 years or older were compared. Results: Similar numbers of patients were affected with HZO in the younger and older age groups (n = 44, 43.1%, vs. n =58, 56.9%). The mean ± SD of age was 50.6 ± 21.8 years (range, 3-89 years) and the most common decade of HZO onset was between 50 and 59 years. Gender and disease laterality were not statistically different between the 2 groups. No significant difference was found regarding the presence of any ocular manifestation between the groups; however, anterior uveitis was more frequent in the younger patients (p = 0.04). The number of patients with immunosuppressive therapy was higher in the younger age group (p = 0.01). Conclusions: HZO-affected patients under the age of 50 years and older than 50 years were equally distributed, with the most common decade of onset between the age of 50 and 59 years. Younger patients had a higher incidence of anterior uveitis and immunosuppressive therapy due to underlying systemic diseases.
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