The Silent Epidemic: Unveiling Herpetic Uveitis in the Elderly

In aging societies, uveitis-a leading cause of vision loss due to ocular inflammation-is increasingly prevalent, especially among older people. This study aimed to determine the trends and contributing factors of herpetic uveitis in older people, reflecting the broader impact of demographic shifts on ocular health. A retrospective study at the Institute of Science Tokyo reviewed uveitis cases in patients aged ≥ 65 years between 2012 and 2022. Among the 1095 older patients diagnosed with uveitis, 65 (5.9%) had herpesvirus uveitis, predominantly manifesting as unilateral anterior uveitis, with cytomegalovirus as the most common virus. Male predominance in herpetic uveitis cases was identified. The study also noted a significantly higher incidence of unilateral onset in herpetic cases compared to non-herpetic ones (p < 0.05). There was a trend toward a higher rate of secondary glaucoma in herpetic cases. Post-2020, an upsurge in herpetic uveitis diagnoses was recorded, potentially linked to the immunosuppressive effects of the coronavirus disease 2019 pandemic. Additionally, rare and severe acute retinal necrosis was identified in the study cohort. These findings highlight the growing trend of herpetic uveitis in older people in Japan and emphasize the necessity for advanced monitoring, diagnostic accuracy, and treatment strategies for herpes uveitis in aging populations globally.