Amniotic Membrane Transplantation in Acute Toxic Epidermal Necrolysis: Histopathologic Changes and Ocular Surface Features after 1-Year follow-up

López-García, José Santiago; Rivas, Luís; García-Lozano, I; Conesa, Eduardo; Elosua, Isabel; Murube, Juan

doi:10.5301/ejo.5000434

Cited by 7 publications

(6 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…These diseases are characterized by serious conjunctival damage, with particular harm to the goblet cell population. 25,29 However, patients 16 (Lyell syndrome) and 19 (Stevens-Johnson syndrome), who presented milder conjunctival involvement, showed a significant downregulation of gene expression, thereby corroborating the hypothesis that increased expression of this mucin after treatment is more related to the degree of conjunctival involvement than to the etiology of the disease. In those eyes in which corneal alterations predominated, such as patients with aniridia or with idiopathic limbal deficiency, we did not find significant changes in mucin expression after the treatment with autologous serum eye drops.…”

Section: Discussionmentioning

confidence: 54%

Effects of Autologous Serum Eye Drops on Conjunctival Expression of MUC5AC in Patients With Ocular Surface Disorders

López-García¹,

García-Lozano

Rivas³

et al. 2016

Cornea

Self Cite

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 54%

Effects of Autologous Serum Eye Drops on Conjunctival Expression of MUC5AC in Patients With Ocular Surface Disorders

López-García¹,

García-Lozano

Rivas³

et al. 2016

Cornea

Self Cite

View full text Add to dashboard Cite

show abstract

“…Most recently, a prospective case series by Lopez-Garcia et al on AMT for moderate and severe ocular involvement of TEN showed that the observed clinical improvement in ocular surface condition and visual acuity corresponded with a reduction in squamous metaplasia in corneal and conjunctival cells and increase in goblet cell density over 1 year [13]. This is the first study to demonstrate the beneficial effects of AMT were linked to histological improvements of the ocular surface.…”

Section: Discussionmentioning

confidence: 71%

“…More promising is a paradigm shift towards disease modulation during the acute inflammatory stage. Recent literature reports have shown that early intervention with AMT in the acute phase of SJS/TEN can minimize ocular surface damage [5][6][7][8][9][10][11][12][13].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Early Bilateral Amniotic Membrane Transplantation in the Management of Severe Ocular Involvement from Acute Toxic Epidermal Necrolysis in a Chinese Pediatric Patient

Shih¹

2014

J Clin Exp Ophthalmol

View full text Add to dashboard Cite

Introduction: Toxic Epidermal Necrolysis (TEN) is a rare but potentially life-threatening muco-cutaneous condition associated with idiosyncratic hypersensitivity to certain drugs. Ophthalmic involvement is common, typically affecting the ocular surface and eyelids. Survivors often suffer from resulting bilateral blindness and ocular dryness or pain.Objective: To report the successful management of severe ocular surface disease during the acute stage of toxic epidermal necrolysis using early amniotic membrane transplantation on both eyes in a Chinese paediatric patient. Design: Interventional case reportCase report: A 15 year-old Chinese girl was transferred to the intensive care unit of Queen Mary Hospital, Hong Kong with TEN after taking oral cefuroxime and diclofenac. She developed bilateral keratoconjunctivitis, diffuse corneal epithelial defects (80-90% of cornea surface) and later bilateral symblephara. After initial treatment with daily rodding, topical lubricants, steroids and antibiotics, there was no improvement in her condition. Bilateral amniotic membrane transplantation (AMT) was performed over the cornea, fornix, tarsal and bulbar conjunctiva on day 10 of illness.On discharge from the hospital (post-operative week 7), the patient had pinhole visual acuity of 6/7.5 in the right eye and 6/6 the left eye. She was eventually weaned off all topical medication Visual acuity eventually recovered to 6/6 in both eyes by week 20 after surgery. There was mild residual forniceal symblepharon and eyelid margin keratinization. She continues to require regular lubricants for her chronic ocular surface condition. Conclusion:Early use of AMT minimized ocular damage and prevented severe vision loss in a Chinese pediatric patient with severe bilateral ocular surface inflammation secondary to TEN. Effective management is dependent on early and active communication between the patient's family, pediatricians, intensive care physicians and ophthalmologists.

show abstract

“…AMT is widely applied in a variety of ocular surface diseases [ 11 12 13 14 15 ]. It is indeed an effective treatment for most nontraumatic acute perforations.…”

Section: Discussionmentioning

confidence: 99%

Modified conjunctival flap as a primary procedure for nontraumatic acute corneal perforation

2018

View full text Add to dashboard Cite

Objective:Appropriate management of nontraumatic acute corneal perforation is always a challenge even with the many advances in surgical materials and techniques. We reported the outcomes of a case series of acute corneal perforation repair using a newly modified conjunctival flap with amniotic membrane transplant (AMT), fibrin glue, and a bandage soft contact lens (BCL).Materials and Methods:A total of 13 consecutive referral cases with nontraumatic acute corneal perforation at the University of Washington were reviewed. All open globes were repaired by a combined surgery with a modified conjunctival flap, AMT, fibrin glue, and BCL. Visual acuity, a slit lamp examination, and the patient-reported pain level were collected preoperatively and postoperatively. Subsequent corneal surgeries to improve visual function were also reviewed.Results:All ocular surfaces of the 13 eyes were stable at postoperative follow-up. Eleven of the 13 patients had the same or worse visual acuity 1 week postoperatively. Nine of the 13 patients achieved better vision 6 months postoperatively. None of the patients developed perioperative or postoperative complications. Five patients with good visual potential underwent further corneal surgeries, including Boston keratoprosthesis and penetrating keratoplasty. The average referral distance was 217 miles and the median number of follow-up visits within 6 months was 4.Conclusions:The combination of a modified conjunctival flap, AMT, fibrin glue, and a BCL could provide a temporary method to stabilize and secure the integrity of the globe as well as the ocular surface after a nontraumatic acute corneal perforation. This approach allows easy follow-up and preserves the eye for future corneal surgery under optimal conditions.

show abstract

Amniotic Membrane Transplantation in Acute Toxic Epidermal Necrolysis: Histopathologic Changes and Ocular Surface Features after 1-Year follow-up

Cited by 7 publications

References 36 publications

Effects of Autologous Serum Eye Drops on Conjunctival Expression of MUC5AC in Patients With Ocular Surface Disorders

Effects of Autologous Serum Eye Drops on Conjunctival Expression of MUC5AC in Patients With Ocular Surface Disorders

Early Bilateral Amniotic Membrane Transplantation in the Management of Severe Ocular Involvement from Acute Toxic Epidermal Necrolysis in a Chinese Pediatric Patient

Modified conjunctival flap as a primary procedure for nontraumatic acute corneal perforation

Contact Info

Product

Resources

About