Adjuvant Role of Amniotic Membrane Transplantation in Acute Ocular Stevens–Johnson Syndrome

Sharma, Namrata; Thenarasun, S.A.; Kaur, Manpreet; Pushker, Neelam; Khanna, Neena; Agarwal, Tushar; Vajpayee, Rasik B

doi:10.1016/j.ophtha.2015.10.027

Cited by 99 publications

(51 citation statements)

References 20 publications

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“…Our prevalence could then be underestimated, probably owing to little knowledge of chronic ocular complications of SJS/TEN in the past and the retrospective design of the study. The proportion of patients with severe visual impairment in the chronic phase was comparable with that of previous reports [10, 17, 26]. Corneal neovascularization was significantly associated with severe visual impairment similar to the prior study [17].…”

Section: Discussionsupporting

confidence: 90%

Factors Contributing to Long-Term Severe Visual Impairment in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Jongkhajornpong

Lekhanont

Siriyotha

et al. 2017

Journal of Ophthalmology

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Purpose. To study the correlation between demographics and clinical variables and long-term severe visual impairment in patients with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). Methods. A retrospective chart review of SJS/TEN patients between 2004 and 2014 was conducted. Demographics, causative agents, ocular manifestations, and visual outcomes were collected. The data were analyzed using a multivariate logistic regression model. Results. Of the 89 patients including SJS (65, 73.03%), TEN (15, 16.85%), and SJS-TEN overlap (9, 10.11%), 55 were female. The mean age was 41.58 ± 19.17 years. The most common identified agents were medications. Among these groups, antibiotics were the most prevalent (47.19%). Three patients (3.7%) had unknown etiology. Antibiotics and nonpharmaceutical triggers were significantly associated with long-term severe visual impairment (odds ratio 4.32; P = 0.015 and 7.20; P = 0.037, resp.). There was a significant negative relationship between HIV infection and long-term severe visual impairment (P = 0.021). Among all chronic ocular complications, only corneal neovascularization significantly correlated with severe visual impairment (P = 0.001). Conclusions. SJS/TEN patients caused by nonpharmaceutical triggers or antibiotics have an increased risk of developing long-term severe visual impairment from corneal neovascularization. HIV infection might be a protective factor against long-term poor visual outcomes.

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Section: Discussionsupporting

confidence: 90%

Factors Contributing to Long-Term Severe Visual Impairment in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Jongkhajornpong

Lekhanont

Siriyotha

et al. 2017

Journal of Ophthalmology

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“…Among patients undergoing standard treatment, corneal opacity occurred in 44%, corneal vascularisation in 24%, symblepharon in 16%, ankyloblepharon in 4% and ectropion/entropion in 8%. These results clearly indicate the efficacy of amniotic membrane transplantation in the treatment and complications prevention in patients with ocular lesions in the course of SJS/TEN . The same conclusions were drawn by researchers describing a series of 10 cases of patients who underwent amniotic membrane transplantation in the acute stage of SJS or TEN.…”

Section: Amnion In the Treatment Of Ten And Sjssupporting

confidence: 77%

“…These results clearly indicate the efficacy of amniotic membrane transplantation in the treatment and complications prevention in patients with ocular lesions in the course of SJS/TEN. 89 The same conclusions were drawn by researchers describing a series of 10 cases of patients who underwent amniotic membrane transplantation in the acute stage of SJS or TEN. All patients restored very good visual acuity and in all patients, the severity of the dry eye was moderate or low and scarring of the eye surface and eyelids was mild to moderate.…”

Section: The Use Of Human Amnion In Ocular Complications In Patientsupporting

confidence: 54%

Preparation of placental tissue transplants and their application in skin wound healing and chosen skin bullous diseases ‐ Stevens‐Johnson syndrome and toxic epidermal necrolysis treatment

Klama-Baryła¹,

Rojczyk

Kitala³

et al. 2020

International Wound Journal

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Unique properties of amniotic membrane make it a promising source for tissue engineering and a clinically useful alternative for patients suffering from chronic wounds including, for example, ulcers, burns, ocular surface damages and wounds occurring in the course of bullous diseases like stevens‐johnson syndrome and toxic epidermal necrolysis. Its use has many advantages over standard wound care, as it contains pluripotent cells, nutrients, anti‐fibrotic and anti‐inflammatory cytokines, growth factors and extracellular matrix (ECM) proteins. Placental tissues can be prepared as a medical component, an advanced therapy medicinal product or a tissue graft. In addition to basic preparation procedures such as washing, rinsing, cutting, drying and sterilisation, there are many optional steps such as perforation, crosslinking and decellularisation. Finally, transplants should be properly stored—in cryopreserved or dehydrated form. In recent years, many studies including basic science and clinical trials have proven the potential to expand the use of amniotic membrane and amnion‐derived cells to the fields of orthopaedics, dentistry, surgery, urology, vascular tissue engineering and even oncology. In this review, we discuss the role of placental tissues in skin wound healing and in the treatment of various diseases, with particular emphasis on bullous diseases. We also describe some patented procedures for placental tissue grafts preparation.

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“…The NEB has had significant role in manufacture, storage, and distribution of amniotic membranes with help from the stem cell facility at AIIMS. Amniotic membrane grafting (AMG) has wide role in OSR in terms of acute chemical injury,[252627] acute Steven–Johnson syndrome,[28] as a substrate for cultivation of stem cells and limbal epithelial cell transplantation procedures. [2930]…”

Section: Resultsmentioning

confidence: 99%

Upgradation and modernization of eye banking services: Integrating tradition with innovative policies and current best practices

Tandon

Singh

Gupta

et al. 2017

Indian J Ophthalmol

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Purpose:The purpose of this study is to review the history and evolution of the National Eye Bank (NEB) and analyze the impact over the years and report the outcome of the invested resources.Methods:Review of archival material, records, project reports, policy and procedures' manuals, and publications was done. Descriptive and analytical processing of data obtained was undertaken. Parameters evaluated included total collection, transplantation, utilization rates of donor cornea, changing trends over time in terms of numbers and duration of recipients waiting, impactful research translated into changes in standard operating protocols, new facilities, and subsequent effects on numbers or quality assurance measures and overview of major achievements. Periodic situational analysis with contextual relevance and interpretation of outcomes was done pertaining to national goals and international standards.Results:The NEB and cornea services have played a key leadership role in furthering the development of eye banking and corneal transplantation services. The contribution extends beyond routine patient care to education, training, generation of resources, advocacy, and policymaking. In quantifiable terms, the overall performance has steadily increased over the years. Major contributions include training of doctors, eye bank staff and corneal surgeons, introduction of innovative techniques for corneal transplantation, setting of national standards for eye banking and provision of preservation media, customized corneal, and ocular surface cell replacement therapy in collaboration with other departments and institutes.Conclusion:The eye banking and corneal transplantation facilities have evolved with time providing quality services, modernized as appropriate with updated knowledge and incorporating technological advances supported by the systematic evidence-based approach.

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Adjuvant Role of Amniotic Membrane Transplantation in Acute Ocular Stevens–Johnson Syndrome

Cited by 99 publications

References 20 publications

Factors Contributing to Long-Term Severe Visual Impairment in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Factors Contributing to Long-Term Severe Visual Impairment in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Preparation of placental tissue transplants and their application in skin wound healing and chosen skin bullous diseases ‐ Stevens‐Johnson syndrome and toxic epidermal necrolysis treatment

Upgradation and modernization of eye banking services: Integrating tradition with innovative policies and current best practices

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