Stevens -Johnson syndrome (SJS) has manifestation through the exfoliation of epidermis and mucosaltissue. Ocular surface is usually affected in acute and chronic stage. The patients are usually suffered from chronic ocular sequelae including symblepharon, limbal stem cell deficiency, etc. Furthermore, ocular microbiome may also be altered in SJS. This is prospective, age and sex matched analytical study which including 20 chronic SJS patients and 20 healthy subjects for specimen collection from inferior conjunctiva for microbiome analysis by conventional cultures and next-Generation Sequencing (nGS) methods. Significant higher proportion of positive-cultured specimen was demonstrated in SJS group (SJS group 60%, healthy 10%, p-value = 0.001). In addition, NGS which providing high-throughput sequencing has demonstrated the greater diversity of microbial species. the higher proportion of pathogenic microorganisms including Pseudomonas spp., Staphylococcus spp., Streptococcus spp., Acinetobacter spp. was shown in SJS group. ocular surface in SJS is usually occupied by more diverse microorganisms with increased proportion of pathogenic species. This condition may affect chronic inflammation and opportunistic infections in SJS group. In order to prevent and treat infection in these patients, appropriate antibiotics based on bacterial examination should be considered as the first-line treatment in the SJS patients.Stevens -Johnson syndrome (SJS) is an abnormal immune-mediated responses stimulated by medications such as sulfonamides, allopurinol, cold medicines including paracetamol 1 and systemic infections caused by virus and mycoplasma. Incidence of SJS is 1.2-6 out of 1,000,000 persons per year 2 . Although the incidence of diseases is low, the mortality rate is high ranging from 1% to 5% 2 . Patients usually present with severe, acute blistering disorders that affect the skin and mucous membranes involving oral mucosa and ocular surface 3 . Ocular involvement has been reported in 25-75% of SJS patients 2 . In the acute phase, patients usually develop conjunctivitis, corneal abrasion, and pseudo-membrane formation. While chronic ocular sequelae develop in 35% of cases, including eyelid irregularity, symblepharon formation, limbal stem cell deficiency (LSCD), and keratinization, leading to poor vision 2 .Recent interests are focused in the change of ocular microbiomes in this devastating disease. Several studies reported alteration of the ocular microbiomes in SJS patients, compared to healthy subjects. In healthy eyes, the most common microorganisms are Staphylococcus coagulase negative, Corynebacterium, and Propionibacterium 4,5 which are mainly gram-positive bacteria colonized in the ocular surface. In SJS, more pathogenic species are found including gram-negative bacteria. Frizon, et al. reported different compositions of microorganisms in SJS patients consisting of 55% of gram-positive cocci, 19% of gram-positive bacilli, and 25% of gram-negative bacilli 4 . They also found that these pathogenic organisms showed...

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Purpose To evaluate the association between symptoms and signs of dry eye diseases (DED) with corneal biomechanical parameters. Methods This cross-sectional study enrolled 81 participants without history of ocular hypertension, glaucoma, keratoconus, corneal edema, contact lens use, diabetes, and ocular surgery. All participants were evaluated for symptoms and signs of DED using OSDI questionnaire, tear film break-up time (TBUT), conjunctival and corneal staining (NEI grading) and Schirmer test. Corneal biomechanical parameters were obtained using Corvis ST. Mixed-effects linear regression analysis was used to determine the association between symptoms and signs of DED with corneal biomechanical parameters. Difference in corneal biomechanical parameter between participants with low (Schirmer value ≤10 mm; LT group) and normal (Schirmer value >10mm; NT group) tear production was analyzed using ANCOVA test. Results The median OSDI scores, TBUT, conjunctival and corneal staining scores as well as Schirmer test were 13±16.5 (range; 0–77), 5.3±4.2 seconds (range; 1.3–11), 0±1 (range; 0–4), 0±2 (ranges; 0–9) and 16±14 mm (range; 0–45) respectively. Regression analysis adjusted with participants’ refraction, intraocular pressure, and central corneal thickness showed that OSDI had a negative association with highest concavity radius (P = 0.02). The association between DED signs and corneal biomechanical parameters were found between conjunctival staining scores with second applanation velocity (A2V, P = 0.04), corneal staining scores with second applanation length (A2L, P = 0.01), Schirmer test with first applanation time (A1T, P = 0.04) and first applanation velocity (P = 0.01). In subgroup analysis, there was no difference in corneal biomechanical parameters between participants with low and normal tear production (P>0.05). The associations were found between OSDI with time to highest concavity (P<0.01) and highest displacement of corneal apex (HC-DA, P = 0.04), conjunctival staining scores with A2L (P = 0.01) and A2V (P<0.01) in LT group, and Schirmer test with A1T (P = 0.02) and HC-DA (P = 0.03), corneal staining scores with A2L (P<0.01) in NT group. Conclusions According to in vivo observation with Corvis ST, patients with DED showed more compliant corneas. The increase in dry eye severity was associated with the worsening of corneal biomechanics in both patients with low and normal tear production.