Ocular and facial thermography in herpes zoster ophthalmicus and post-herpetic neuralgia

A.B. Tullo, G. Cardona, P.B. Morgan, N. Efron

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Abstract

Purpose. Herpes Zoster may lead to a chronic stage of persistent and intense pain known as post-herpetic neuralgia (PHN) in 15% of cases. How damage to somatic and possibly autonomic nerves leads to PHN is not yet understood. This study was designed to investigate temperature changes in Herpes Zoster Ophthalmicus (HZO) with PHN. Methods. A non-contact infrared detector was used to measure temperature of the ocular surface and facial skin in patients with HZO in the acute and chronic stages. Pain quantity and quality and corneal sensitivity were recorded. Data was analyzed by comparing the readings from the affected part of the face with those from the contralateral side. Results. Patients with HZO in the acute stage showed high inter-ocular temperature differences (ITD), with the affected side being warmer than the other side. Thermography in a group of 17 patients showed that the affected side was, on average, over half a degree warmer than the other side, with temperatures tending to equate after approximately 4 weeks. ITD in patients with established PHN however, revealed the eye affected as being much colder than the fellow eye. Analysis of a group of 12 patients with PHN revealed a statistically significant ITD of 1.08+/-0.83 degrees C (Mean+/-SD), p<0.01. Corneal sensitivity tended to be markedly reduced on the affected side. In ophthalmic PHN therefore a profound vascular disturbance persists long after the acute stage which may originate from local vasculitis, from an up-regulation of the vasoconstrictive activity of the sympathetic nervous system or from a combination of factors. Conclusions. Ocular thermography may contribute to elucidating the pathogenesis of PHN in HZO.
Original languageUndefined
Pages (from-to)S49
JournalInvestigative Ophthalmology and Visual Science
Volume37
Issue number3
Publication statusPublished - 1996

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