Atopic Disease and Herpes Simplex Eye Disease: A Population-Based Case-Control Study

Purpose: To determine whether atopy is associated with herpes simplex virus (HSV) ocular disease. Design: Retrospective, population-based, case-control study. Methods: setting: Large, regional health maintenance organization (Northern California Kaiser Permanente). study Population: 1,042,351 people over a one-year period. observation Procedures: Electronic database search for HSV ocular disease and subsequent chart review determined study eligibility. Two age-matched control groups (one population-based and one clinic-based) were randomly chosen. Medical record review determined the presence of atopy. Severe atopic disease was defined by diagnostic code or illness requiring an emergency room visit, hospitalization, or treatment with a systemic corticosteroid. main Outcome Measures: Presence of HSV eye disease, presence of atopy, and characterization of atopy severity. Results: HSV eye disease was found in 172 patients. HSV cases had a greater prevalence of atopy (34%, 58/172) than the clinic-based (25%, 43/172) or the population-based controls (21%, 36/172, odds ratio (OR) 1.5, 95% confidence interval (CI) 0.9 to 2.6 and OR 1.9, 95%, CI 1.1 to 3.3, respectively). The association of HSV ocular disease with severe atopy was even greater, with a history of severe atopic disease in 13% (22/172) of patients with HSV ocular disease as compared with 6% (11/172) of patients in the clinic control group and 3% (5/172) of patients in the population control group (OR 2.0, 95% CI 0.7 to 5.9 and OR 4.8, 95% CI 1.6 to 19.2, respectively). Conclusions: Patients with HSV ocular disease are more likely to have a history of atopic disease, especially severe atopic disease, than age-matched controls.