Risk Factors for the Development of Ocular Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Gueudry, J.; Roujeau, Jean‐Claude; Binaghi, M; Soubrane, G.; Muraine, M.

doi:10.1001/archdermatol.2009.540

Cited by 129 publications

(124 citation statements)

References 37 publications

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“…4 Amongst survivors, long-term ocular complications can be serious and are thought to affect approximately 60% of patients. 6 Corneal damage in the form of scarring or limbal stem cell failure is the most severe ocular outcome.Conjunctival scarring can contribute to longterm corneal pathology and subsequent visual impairment.For example, palpebral conjunctival scarring can cause chronic micro-trauma with the blink reflex, while symblepharon formation can lead to poor tear film dynamics and predisposition to severe dry eye.…”

Section: Discussionmentioning

confidence: 99%

Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report

Goswami

Asaduzzaman

2017

Birdem Med J

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Stevens-Johnson syndrome(SJS) causes various ocular complications in which symblepharon and ankyloblepharon are very common. Ankyloblepharon is potentially blinding, which can be prevented by adequate medical measurement. Here we present such a case. Case ReportA 16-year-old girl presented with complete obscuration of vision and fusion of eye lids of both eyes for the last six months. About sixmonths back she developed diffuse rash in her face and body after taking an analgesic. The rash spread throughout allover the body including limbs, trunk and face. The eyes and oral cavity were also involved. She was diagnosed as a case of SJS in a tertiary hospital and was treated conservatively with systemic antibiotic and steroids. Ophthalmic drops were prescribed, but not instilled properly and no separation of bulbar and palpebral conjunctiva was done. The eyes remained closed. After a few weeks, she got well but the eyelids remained fused with each other and the patient became blind.At our care, on ocular examination, both eyes were found to have complete ankyloblepharon having no vision in both eyes. Behind the fused eyelids the movement of eyeballs were sufficient. The contour of the eyeballs were also normal (Figure 1). General examination reveals diffuse skin pigmentation in the face and body (Figure 2).The patient was diagnosed as a case of bilateral ankylobleaphron due to SJS.The patient underwent lid reconstruction surgery (separation of fused eyelids, separation of adhesion between bulberand palpebral conjunctiva) and contact shield was placed on both eyes.On the first postoperative day, the patient gained formed vision (right eye 6/60 and left eye 6/24).Postoperatively she was treated with topical antibiotic, steroid and artificial tear.Gradually the vision of the patent improved but ocular surface was dry.Cornea of both eyes werevascularised from the periphery to midperiphery.After one month, the patent gained vision up to 6/12 in both eyes (Figure 3).Now the patient is getting topical artificial tears frequently and is being observed in outpatient department regularly at an interval of three months. Case

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Section: Discussionmentioning

confidence: 99%

Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report

Goswami

Asaduzzaman

2017

Birdem Med J

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“…However, data from ONIAM showed that files of 13 dead patients reached the end of CCI/ONIAM procedures and compensation was proposed for 8 of these patients (25% of all accepted files). Although the diseases are now managed by multidisciplinary teams, long-term sequelae with severe functional impairment may still be underestimated [4] and could explain why some records were refused because of insufficient disability (9/23 = 39% of refusals). Sequelae might be perhaps better estimated if dermatologists were always included in expert committees.…”

Section: Discussionmentioning

confidence: 99%

“…Recent data show that the mortality of these severe cutaneous adverse reactions (SCARs) to drugs is 23% 6 weeks and 34% 1 year after the acute phase [3]. Long-term psychological and physical sequelae may occur, especially mucosal and ocular scars that may induce severe visual impairment or even blindness [4,5]. Thus, many patients report altered quality of life [6].…”

Section: Introductionmentioning

confidence: 99%

Severe Cutaneous Adverse Reactions to Drugs: From Patients to the National Office for Compensation of Medical Accidents

Isvy-Joubert

Ingen‐Housz‐Oro

Vincent³

et al. 2014

Dermatology

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Background: Administrative bodies for compensating medical accidents were created in France in 2002. Objectives: To evaluate the knowledge patients with severe cutaneous adverse reactions (SCARs) have of procedures and to compare the rate of compensation for SCARs for France and for our referral center. Methods: A questionnaire was sent to 247 patients of our SCARs referral center and 225 patients with Stevens-Johnson syndrome and toxic epidermal necrolysis from the patient association AMALYSTE. We calculated the rate of compensation for France and our center. Results: Among the 123 respondents (26%), 28 (23%) knew the compensation procedure; 13 (11%) had received compensation. The Commission of Conciliation and Compensation had received 63 applications for SCARs since 2002 and proposed compensation for 56%. The estimated rate of compensation for France was 2.6% and 2.5% for our referral center (p = 0.9). Conclusions: The procedure of compensation for SCARs is misunderstood. Better information should be disseminated for patients with threshold disability conditions.

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“…The failed case had immune dysregulation, which persisted after surgery, leading to the recurrence. 26 Therefore further studies are necessary to improve the management of preoperative and postoperative inflammation in patients with autoimmune disease.…”

Section: The Surgical Goals Of Treating Symblepharon Arementioning

confidence: 99%

Sealing of the Gap between the Conjunctiva and Tenon Capsule to Improve Symblepharon Surgery

Zhao

Yin

Cheng

et al. 2015

American Journal of Ophthalmology

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Risk Factors for the Development of Ocular Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Abstract: To describe the acute and late ocular manifestations of toxic epidermal necrosis (TEN), Stevens-Johnson syndrome (SJS), and overlap syndrome and to identify predictors for the development of ocular complications.

Cited by 129 publications

References 37 publications

Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report

Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report

Severe Cutaneous Adverse Reactions to Drugs: From Patients to the National Office for Compensation of Medical Accidents

Sealing of the Gap between the Conjunctiva and Tenon Capsule to Improve Symblepharon Surgery

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Risk Factors for the Development of Ocular Complications of Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Abstract: To describe the acute and late ocular manifestations of toxic epidermal necrosis (TEN), Stevens-Johnson syndrome (SJS), and overlap syndrome and to identify predictors for the development of ocular complications.

Cited by 129 publications

References 37 publications

Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report

Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report

Severe Cutaneous Adverse Reactions to Drugs: From Patients to the National Office for Compensation of Medical Accidents

Sealing of the Gap between the Conjunctiva and Tenon Capsule to Improve Symblepharon Surgery

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Product

Resources

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Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report

Preventable Blindness due to Ankyloblepharonin Stevens- Johnson SyndromeA Case Report