A cross-sectional comparative study on chronic ocular manifestations of Stevens–Johnson syndrome and toxic epidermal necrolysis in Chinese eyes: a 15-year case series

Chow, Loraine L. W.; Ng, Alex; Chow, Sharon S W; Choy, Bonnie Nga Kwan; Shih, Kendrick Co; Wong, Ian Y.; Chan, Johnny C. Y.; Lai, Jimmy S. M.

doi:10.1007/s10792-017-0576-5

Cited by 3 publications

(6 citation statements)

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“…Like China (54.5%) [ 9 ], India (55.0%) [ 8 , 12 ], Japan (63.6%) [ 10 ], Thailand (61.8%) [ 7 ] and the UK (61.9%) [ 15 ], our sample (58.3%) showed a female predominance in people with SJS/TEN. This may be explained by the fact that autoimmune diseases appear with a higher incidence among women than among men, and SJS/TEN is thought to be associated with changes in the innate immune system.…”

Section: Discussionmentioning

confidence: 89%

“…In addition, as a result of differences in methodologies, comparisons between the results of different surveys are not easy. Chow et al (China) [ 9 ], Rashad et al (USA) [ 16 ] and Yoshikawa et al (Japan) [ 10 ] used solely Sotozono’s grading system [ 29 ], and Ganekal and Nagarajappa (India) [ 8 ] used a modified Sotozono’s classification system. In contrast, Basu et al (India) [ 30 ], Iyer et al (India) [ 31 ], Jabbour et al (UK) [ 11 ] and Jongkhajornpong et al (Thailand) [ 7 ] processed their data in four different grading systems.…”

Section: Discussionmentioning

confidence: 99%

“…The main causative agents of SJS/TEN are systemic medications, infections and vaccines, with patterns that vary worldwide [1,5]. As a result of the rarity of SJS/TEN, only a few studies are available on the causes and ocular complications of SJS/TEN [6][7][8][9][10][11][12][13][14][15][16].…”

Section: Introductionmentioning

confidence: 99%

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Clinical Characteristics and Treatment of Ophthalmic Sequelae of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis at a Tertiary Eyecare Centre in Hungary

Tóth,

Lukács,

Stachon

et al. 2024

Ophthalmol Ther

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Introduction This study analysed the causative factors and clinical characteristics of acute and chronic ocular sequelae of Stevens–Johnson syndrome and toxic epidermal necrolysis (SJS/TEN) treated at a large third-referral centre in a developed country (Hungary) over a 15-year period. Methods This was a retrospective review of patients with acute and/or chronic SJS/TEN who were managed between 2006 and 2020 at the Department of Ophthalmology of Semmelweis University in Budapest, Hungary. For each subject, clinical data, including patient demographics, clinical history, causative agents of SJS/TEN, and conservative and surgical treatment details, were reviewed. Results Ninety-six eyes of 48 patients were included (28 female; 58.3%); the age at disease onset was 32.1 ± 22.4 years. The most common causative factors were medicines ( n = 36; 75.0%). Among these drugs, 29.2% were nonsteroidal anti-inflammatory drugs (NSAIDs) ( n = 14), 20.8% were antibiotics ( n = 10) and 14.6% were antiepileptic drugs ( n = 7). In patients with chronic SJS/TEN, the most commonly found ocular sequelae were conjunctival hyperaemia in 45 (56.3%) eyes, symblepharon in 38 (47.5%) eyes, trichiasis/distichiasis in 37 (46.3%) eyes, corneal neovascularization in 31 (38.8%) eyes and corneal scarring in 29 (36.3%) eyes. In patients with chronic SJS/TEN, the most frequently used topical conservative treatment included antibiotics in 53 (66.3%) eyes, preservative-free artificial tears in 50 (62.5%) eyes and topical corticosteroids in 42 (52.5%) eyes of 40 patients. The most frequently performed ocular surgeries for managing chronic ocular sequelae in patients with SJS/TEN were epilation for trichiasis ( n = 27; 33.8%), cataract surgery ( n = 14; 17.5%), entropion surgery ( n = 12; 15.0%), penetrating keratoplasty (PK) ( n = 11; 13.8%) and amniotic membrane transplantation ( n = 4; 5.0%). Conclusion Our results suggest that NSAIDs, antibiotics and antiepileptic drugs are the most common causative factors for SJS/TEN in Hungary. Like in other countries, in Hungary, the ocular management of patients with acute and chronic SJS/TEN is heterogeneous, and most cases do not follow modern therapeutic guidelines. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-024-00924-z.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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Clinical Characteristics and Treatment of Ophthalmic Sequelae of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis at a Tertiary Eyecare Centre in Hungary

Tóth,

Lukács,

Stachon

et al. 2024

Ophthalmol Ther

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“…The mean age in our study was 27.5 years (SD 18.8), while many other studies showed a higher mean age of 41–52 years. [ 3 11 ] This dissimilarity may be because we included all the patients with ages ranging from 1 to 74 years. We saw a female preponderance with a female to male ratio of 1.37:1.…”

Section: Discussionmentioning

confidence: 99%

“…A study by Chow et al revealed that the ocular manifestation amongst the cases of SJS/TEN is 53%. [ 11 ] Based on the study's findings with an absolute precision of 20% and desired confidence interval of 95%, it was estimated that 24 patients need to be enrolled in this study. On review of the medical records, we found that over 7 years, the number of patients admitted with the diagnosis of SJS/TEN was 45, and we included all of them as it was a retrospective study and we expected some data to be missing in some patients.…”

Section: Methodsmentioning

confidence: 99%

Ocular manifestations in acute stage Stevens-Johnson syndrome/toxic epidermal necrolysis - A retrospective study in a tertiary hospital in South India

Shetti

Pradeep

2022

Taiwan Journal of Ophthalmology

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PURPOSE: To describe the ocular manifestations in the acute stage of Stevens-Johnson syndrome/ toxic epidermal necrolysis. MATERIALS AND METHODS: We reviewed all the medical records of patients diagnosed with Stevens-Johnson syndrome/ toxic epidermal necrolysis and erythema multiforme between 2012 and 2019. Demographics, ophthalmic manifestations, and the treatment given systemically and locally were reviewed and analyzed. RESULTS: We had forty-five patients admitted to our hospital between Jan 2012 to Dec 2019 with SJS/TEN as a diagnosis.Twenty-six (57.5%) of them were females, and 19(42.2%) were males. The mean age was 27.5 years.Forty (88.9%) of our cases were diagnosed as Stevens-Johnson syndrome, and five (11.9%) as toxic epidermal necrolysis. We found antiepileptics as a triggering agent in thirteen cases (28.8%). Fever (84.4%) and mucosal lesions (86.7%) were the most common presenting symptom. We found ocular symptoms in only 22 (48.9%) patients. The treating physicians referred only thirty-one cases to the ophthalmologist, out of which 22 cases were referred within three days of admission. The most common ocular involvement was conjunctival congestion (69%). Ocular grading showed that mild grade included 42.9%, moderate grade 28.6%, and severe grade 28.6% of the cases. The ocular treatment involved medical management with lubricating drops (100%), topical steroids (58.6%), and topical antibiotics (68.9%). Five individuals with a severe grade of ocular involvement underwent amniotic membrane transplantation. CONCLUSION: Ocular examination and grading are essential in the acute stage of SJS/TEN. It helps the ophthalmologist recognize the sentinel findings and institute appropriate treatment in the acute stage as early as possible.

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Ocular Disease in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Saeed

Rashad

2019

Foundations of Corneal Disease

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A cross-sectional comparative study on chronic ocular manifestations of Stevens–Johnson syndrome and toxic epidermal necrolysis in Chinese eyes: a 15-year case series

Abstract: The average total Sotozono score was higher in the TEN group than in the SJS group, but the difference was not statistically significant. Nevertheless, the score correlated with the visual acuity which was statistically worse in the TEN group.

Cited by 3 publications

References 26 publications

Clinical Characteristics and Treatment of Ophthalmic Sequelae of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis at a Tertiary Eyecare Centre in Hungary

Clinical Characteristics and Treatment of Ophthalmic Sequelae of Stevens–Johnson Syndrome and Toxic Epidermal Necrolysis at a Tertiary Eyecare Centre in Hungary

Ocular manifestations in acute stage Stevens-Johnson syndrome/toxic epidermal necrolysis - A retrospective study in a tertiary hospital in South India

Ocular Disease in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

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