Long-Term Effect of a Treatment Protocol for Acute Ocular Involvement in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.
Long-Term Effect of a Treatment Protocol for Acute Ocular Involvement in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis.
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史蒂文斯-约翰逊综合征/中毒性表皮坏死松解症急性眼部受累治疗方案的长期效果。
DOI：
10.1016/j.ajo.2019.07.006
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发表时间：
2019-12
影响因子：
4.2
通讯作者：
Saeed HN
中科院分区：
文献类型：
--
作者：
Shanbhag SS;Rashad R;Chodosh J;Saeed HN
PurposeTo描述一种治疗方案对急性Stevens-Johnson综合征/中毒性表皮坏死松解症（SJS/TEN）眼部受累的长期效果，包括重点眼部检查和病理学适当使用润滑剂、局部皮质类固醇、局部抗生素和羊膜移植（AMT）。2000年至2007年，48例患者中有9例（18只眼）患有急性SJS/TEN，未接受方案治疗（第I组）。2008年至2017年，48例患者中的39例（78只眼）患有急性SJS/TEN，并接受了方案护理（第II组）。主要结果指标为最后随访时的最佳矫正视力（BCVA）和慢性期并发症的发生率。相比之下，第二组中87%的合格眼睛末次随访时BCVA ≥20/40的患眼比例I组与II组差异有统计学意义（P <.0001）（33%对92%，P < .001）。I组慢性期出现威胁视力并发症的患眼比例显著高于II组（67%vs17%，P = 0.002），大多数并发症发生在发病后的前2年，两组均为如此。结论SJS/TEN患者的急性眼部护理的特定方案，包括积极使用AMT，在减少角膜失明和严重的视力威胁并发症方面非常成功。
PurposeTo 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).DesignRetrospective, comparative case series.MethodsA 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.ResultsNo 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.ConclusionsA 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.
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影响因子：
4.2
作者：
Vazirani, Jayesh;Nair, Dhanyasree;Sangwan, Virender
通讯作者：
Sangwan, Virender
影响因子：
6.4
作者：
Shanbhag, Swapna S.;Chodosh, James;Saeed, Hajirah N.
通讯作者：
Saeed, Hajirah N.
影响因子：
4.2
作者：
Sotozono, Chie;Ueta, Mayumi;Hashimoto, Koji
通讯作者：
Hashimoto, Koji
影响因子：
5.1
作者：
Shay, Elizabeth;Kheirkhah, Ahmad;Liang, Lingyi;Sheha, Hossam;Gregory, Darren G.;Tseng, Scheffer C. G.
通讯作者：
Tseng, Scheffer C. G.
影响因子：
4.2
作者：
Basu, Sayan;Shanbhag, Swapna S.;Sangwan, Virender S.
通讯作者：
Sangwan, Virender S.