Severe ocular complications of SJS/TEN and associations among pre-onset, acute, and chronic factors: a report from the international ophthalmology collaborative group
Issued Date
2023-01-01
Resource Type
eISSN
2296858X
Scopus ID
2-s2.0-85164493166
Journal Title
Frontiers in Medicine
Volume
10
Rights Holder(s)
SCOPUS
Bibliographic Citation
Frontiers in Medicine Vol.10 (2023)
Suggested Citation
Ueta M., Inoue C., Nakata M., Sotozono C., Kim M.K., Wakamatsu T., Jongkhajornpong P., Saeed H., Rauz S., Ma D.H.K., Yoon K.C., Puangsricharern V., Bouchard C., Ahmad S., Seo K.Y., Joo C.K., Gomes J.A.P., Chodosh J., Kinoshita S., Teramukai S. Severe ocular complications of SJS/TEN and associations among pre-onset, acute, and chronic factors: a report from the international ophthalmology collaborative group. Frontiers in Medicine Vol.10 (2023). doi:10.3389/fmed.2023.1189140 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/88027
Title
Severe ocular complications of SJS/TEN and associations among pre-onset, acute, and chronic factors: a report from the international ophthalmology collaborative group
Author's Affiliation
Ramathibodi Hospital
Graduate School of Medical Science
Severance Hospital
Chang Gung Memorial Hospital
Kyoto Prefectural University of Medicine
King Chulalongkorn Memorial Hospital
University of Birmingham
Chonnam National University Medical School
Moorfields Eye Hospital NHS Foundation Trust
Loyola University Health System
Universidade Federal de São Paulo
Massachusetts Eye and Ear Infirmary
Seoul National University College of Medicine
CK St. Mary's Eye Center
Graduate School of Medical Science
Severance Hospital
Chang Gung Memorial Hospital
Kyoto Prefectural University of Medicine
King Chulalongkorn Memorial Hospital
University of Birmingham
Chonnam National University Medical School
Moorfields Eye Hospital NHS Foundation Trust
Loyola University Health System
Universidade Federal de São Paulo
Massachusetts Eye and Ear Infirmary
Seoul National University College of Medicine
CK St. Mary's Eye Center
Other Contributor(s)
Abstract
We formed an international research collaboration that included Japan, South Korea, Brazil, Thailand, Taiwan, the UK, and the US (682 patients from 13 hospitals between 2005 and 2020), to better evaluate the role of race, ethnicity, and other risk factors in the pathophysiology of Stevens–Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN). Ophthalmologists often see SJS/TEN patients with severe ocular complications (SOC; frequency 50% SJS/TEN patients) when the patients are referred to them in the chronic stage after the acute stage has passed. Global data were collected using a Clinical Report Form, capturing pre-onset factors, as well as acute and chronic ocular findings. Key conclusions of this retrospective observational cohort study were as follows: (1) Ingestion of cold medications [acetaminophen and non-steroidal anti-inflammatory drugs (NSAIDs)] was significantly and positively correlated with trichiasis, symblepharon, and/or conjunctivalization of the cornea in the chronic stage; (2) common cold symptoms prior to onset of SJS/TEN were significantly and positively correlated with acute conjunctivitis and ocular surface erosions in the acute stage and with trichiasis and symblepharon and/or conjunctivalization of the cornea in the chronic stage; (3) patients with SJS/TEN who presented with SOC tended to be female; (4) patients less than 30 years of age are more likely to develop SOC in the acute and chronic stages of SJS/TEN; (5) patients with acute severe conjunctivitis with ocular surface erosion and pseudomembrane formation in the acute stage are more likely to develop ocular sequelae in the chronic stage; and (6) onychopathy in the acute stage was positively correlated with ocular sequelae in the chronic stage. Our findings show that the ingestion of cold medications, common cold symptoms prior to the onset of SJS/TEN, and a young age might strongly contribute to developing the SOC of SJS/TEN.