Having herpes zoster ophthalmicus may increase the risk of developing dementia

An additional risk of dementia is not seen with most forms of herpes zoster virus (HZV) infection, except for herpes zoster ophthalmicus (HZO).

Study design

Published studies have noted that in younger people, having HZO led to a greater risk of cerebrovascular events even after the infection was treated. There is also contradicting evidence for a link between HZV infection and dementia. Therefore, investigators performed a systematic review of articles published before September 2022 that focused on the potential association between HZV infection, including HZO, and dementia or Alzheimer’s disease (AD). Data from 9 randomized controlled trials and controlled observational studies were included in a meta-analysis.

Outcomes

While there were no significant associations between overall HZV infection and incidence of dementia or AD, there was a significant association between HZO and increased incidence of dementia. This was found via generic inverse variance, which weighs larger studies more than smaller studies, therefore limiting the imprecision of the pooled data.

Limitations

Only 9 articles were included in the analysis. Data from high-volume multicenter clinical trials are necessary to validate the results presented in this paper.

Clinical significance

Herpes zoster ophthalmicus has been known to cause serious ocular complications, but it is usually managed by an ophthalmologist rather than a general provider. Because the results from this analysis may indicate long-term neurologic complications with HZO, it is important that patients with HZO discuss their infection with their primary clinician. If the links between HZO and dementia are proven, additional studies could reveal whether differences in systemic treatment could decrease the incidence of dementia.

Financial Disclosures: Dr. Parvathy Pillai discloses no financial relationships.