Chronic Ocular Sequelae of Stevens-Johnson Syndrome in Children: Long-term Impact of Appropriate Therapy on Natural History of Disease
Chronic Ocular Sequelae of Stevens-Johnson Syndrome in Children: Long-term Impact of Appropriate Therapy on Natural History of Disease
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DOI：
10.1016/j.ajo.2018.01.028
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发表时间：
2018-05-01
影响因子：
4.2
通讯作者：
Sangwan, Virender S.
中科院分区：
文献类型：
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作者：
Basu, Sayan;Shanbhag, Swapna S.;Sangwan, Virender S.
目得：描述Stevens-Johnson综合征（SJS）慢性后遗症儿童的长期眼部和视力发病率以及各种管理策略的视力结局。设计：回顾性比较病例系列。方法：本研究包括1990年至2015年期间284例SJS儿童的568只眼。患眼接受保守治疗（n = 440）或确定性治疗（n = 128），包括眼睑边缘粘膜移植（MMG）、眼表生态系统（PROSE）角膜接触镜假体置换术、同种异体角膜缘移植或基于干燥严重程度和角膜损伤的原因和程度使用算法方法的人工角膜。主要结果指标为最佳矫正视力（BCVA）。结果：三分之二的患者在急性SJS后超过一年，99%的患者没有进行羊膜移植，60%的患者视力低下或失明。8岁以下儿童的眼部和视力发病率显著更高（P
PURPOSE: To describe the long-term ocular and visual morbidity in children with chronic sequelae of Stevens-Johnson syndrome (SJS) and visual outcomes of various management strategies.DESIGN: Retrospective comparative case series.METHODS: This study included 568 eyes of 284 children with SJS who presented between 1990 and 2015. Affected eyes received either conservative therapy (n = 440) or definitive management (n = 128), including lid margin mucous membrane grafting (MMG), prosthetic replacement of the ocular surface ecosystem (PROSE) contact lenses, allogeneic limbal transplantation, or keratoprosthesis using an algorithmic approach based on the severity of dryness and cause and extent of corneal damage. The primary outcome measure was best-corrected visual acuity (BCVA).RESULTS: Two thirds of patients presented more than a year after acute SJS, 99% without prior amniotic membrane grafting, with low vision or blindness in 60% of eyes. Children 8 years or younger in age had significantly worse ocular and visual morbidity (P