Treatment Modalities and Clinical Outcomes in Ocular Sequelae of Stevens–Johnson Syndrome Over 25 Years—A Paradigm Shift

Iyer, Geetha; Srinivasan, Bhaskar; Agarwal, Shweta; Pillai, Vinay S.; Ahuja, Ashish

doi:10.1097/ico.0000000000000680

Cited by 35 publications

(23 citation statements)

References 27 publications

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“…In this study, 93% eyes had an improved ocular surface and improved BCVA (best corrected visual acuity) over 6 months of follow-up and patients demonstrated significant improvement in comfort. In another retrospective largest interventional study in SJS over 25 years by Iyer et al; symptomatic improvement was noted in 88% with recurrence of keratinization in 8.4% (10). MMG was found to have a beneficial effect on the ocular surface by reducing the corneal vascularization, haze and punctate keratopathy, thereby aiding in improved vision.…”

Section: Treatment Options Lid Margin Keratinizationmentioning

confidence: 92%

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

et al. 2021

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Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular, with significant mortality rates. The chronic phase is characterized by multi-organ sequelae with increased rates of morbidity and reduced quality of life for patients who have survived the acute phase. Since the primary goal in the acute phase is saving the life of the patient, ocular involvement is often missed and a significant proportion of patients present to an ophthalmologist with the chronic ocular sequelae. In India, chronic ocular sequelae and low vision are observed in two-thirds of patients who present in the chronic phase of SJS/TEN. In the chronic phase of ocular involvement, there are definite windows of opportunity which if targeted with specific interventions such as scleral lenses and mucous membrane grafts can help reduce the incidence of corneal blindness and improve the quality of life for patients with SJS/TEN. Over the last decade, several studies from India have advanced the understanding of the natural course of ocular involvement in SJS/TEN and the outcomes of timely interventions in the chronic phase of the disease. We present an overview of the epidemiology of ocular complications of SJS/TEN in India, the specific challenges faced in the management of ocular complications in the acute stage and recent advances in management of the chronic ocular complications of the disease.

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Section: Treatment Options Lid Margin Keratinizationmentioning

confidence: 92%

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

et al. 2021

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“…Even in the absence of severe ocular involvement in acute SJS-TEN, children may develop progressive disease of the ocular surface and conjunctival inflammation over time 54 . Delayed lid margin keratinization 55 , vision deterioration, and corneal damage can occur after SJS-TEN 56 , emphasizing the importance of close continual follow-up by ophthalmology 55 , 57 .…”

Section: To Treat or Not To Treat That Is The Question… But We Stillmentioning

confidence: 99%

Pediatric SJS-TEN: Where are we now?

Ramien

Goldman

2020

F1000Res

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Stevens–Johnson syndrome and toxic epidermal necrolysis are rare severe blistering skin reactions triggered by medications or infections. Over the last 5 to 10 years, a number of important publications have advanced understanding of these diseases and their response to treatment. Importantly, a subset of patients with disease triggered by infection has been identified as having Mycoplasma pneumoniae–induced rash and mucositis, suggesting a reconsideration of the diagnostic paradigm. We present an update on pediatric Stevens–Johnson syndrome and toxic epidermal necrolysis in the broader context of cutaneous adverse drug reactions and focus on challenges and recent advances in diagnosis, management, and prevention.

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“…[ 20 21 ] Issues specific to eyes with SJS in terms of laminar resorption and its consequences, therefore, have led to outcomes in our country that are suboptimal compared to reported outcomes in the non-SJS category. [ 28 33 ] However, the results with the MOOKP appear to be superior to the Boston Type 2 Kpro at a longer follow-up in a similar SJS population, retaining MOOKP as the procedure of choice in these eyes.…”

Section: Discussionmentioning

confidence: 99%

Keratoprosthesis: Current global scenario and a broad Indian perspective

Iyer

Srinivasan

Agarwal

et al. 2018

Indian J Ophthalmol

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Keratoprosthesis (Kpro) forms the last resort for bilateral end-stage corneal blindness. The Boston Type 1 and 2 Kpros, the modified osteo-odonto Kpro and the osteo-Kpro are the more frequently and commonly performed Kpros, and this review attempts to compile the current data available on these Kpros worldwide from large single-center studies and compare the indications and outcomes with Kpros in the Indian scenario. Although the indications have significantly expanded over the years and the complications have reduced with modifications in design and postoperative regimen, these are procedures that require an exclusive setup, and a commitment toward long-term follow-up and post-Kpro care. The last decade has seen a surge in the number of Kpro procedures performed worldwide as well as in India. There is a growing need in our country among ophthalmologists to be aware of the indications for Kpro to facilitate appropriate referral as well as of the procedure to enable basic evaluation during follow-ups in case the need arises, and among corneal specialists interested to pursue the field of Kpros in understanding the nuances of these surgeries and to make a judicious decision regarding patient and Kpro selection and more importantly deferral.

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Treatment Modalities and Clinical Outcomes in Ocular Sequelae of Stevens–Johnson Syndrome Over 25 Years—A Paradigm Shift

Cited by 35 publications

References 27 publications

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Pediatric SJS-TEN: Where are we now?

Keratoprosthesis: Current global scenario and a broad Indian perspective

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