Long-Term Effect of a Treatment Protocol for Acute Ocular Involvement in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis

Overview

Journal Am J Ophthalmol

Specialty Ophthalmology

Date 2019 Jul 22

PMID 31326519

Citations 24

Authors

Swapna S Shanbhag

Ramy Rashad

James Chodosh

Hajirah N Saeed

Affiliations

Soon will be listed here.

Abstract

Purpose: To describe the long-term effect of a treatment protocol for ocular involvement in acute Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN), including focused ocular examination and pathology-appropriate use of lubrication, topical corticosteroids, topical antibiotics, and amniotic membrane transplantation (AMT).

Design: Retrospective, comparative case series.

Methods: A total of 48 patients (96 eyes) were included in this study. Nine of 48 patients (18 eyes) had acute SJS/TEN from 2000 to 2007 and did not receive protocol care (Group I). Thirty-nine of 48 patients (78 eyes) had acute SJS/TEN from 2008 to 2017 and received protocol care (Group II). The main outcome measures were best-corrected visual acuity (BCVA) at final follow-up visit and incidence of complications in the chronic phase.

Results: No eyes in Group I received AMT for SJS/TEN, compared to 87% of qualifying eyes in Group II (P < .0001) There was a significant difference in the proportion of eyes with BCVA ≥20/40 at last follow-up between Group I and Group II (33% vs 92%, P < .001). The proportion of eyes with vision-threatening complications in the chronic phase was significantly higher in Group I versus Group II (67% vs 17%, P = .002), with most complications occurring in the first 2 years after disease onset in both groups.

Conclusions: A specific protocol for acute ocular care in SJS/TEN, including aggressive use of AMT, was highly successful in reducing corneal blindness and severe vision-threatening complications of the disorder.

Citing Articles

Early Recognition and Management of Ocular Manifestations of Toxic Epidermal Necrolysis in a Pediatric Patient: A Case Report.

Abulfateh F, AlHaqbani Y, Albuainain A Cureus. 2024; 16(9):e70323.

PMID: 39469382 PMC: 11513214. DOI: 10.7759/cureus.70323.

Acute and chronic ocular outcomes in SJS/TEN patients treated with oral ciclosporin vs intravenous immunoglobulin.

Foo V, Yueh L, Mehta J, Ong H Front Med (Lausanne). 2024; 11:1398506.

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The outcomes of corneal sight rehabilitating surgery in Stevens-Johnson syndrome: case series.

Peng R, Chi M, Xiao G, Qu H, Shen Z, Zhao Y BMC Ophthalmol. 2024; 24(1):205.

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Updates in SJS/TEN: collaboration, innovation, and community.

Marks M, Botta R, Abe R, Beachkofsky T, Boothman I, Carleton B Front Med (Lausanne). 2023; 10:1213889.

PMID: 37901413 PMC: 10600400. DOI: 10.3389/fmed.2023.1213889.

Marsupialization of conjunctival inclusion cyst in Stevens-Johnson syndrome.

Li J, Huang Y Adv Ophthalmol Pract Res. 2023; 3(1):1-5.

PMID: 37846432 PMC: 10577827. DOI: 10.1016/j.aopr.2022.10.004.

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