Predictive Factors Associated With Acute Ocular Involvement in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

被引：96

作者：

Sotozono, Chie ^{[1
]}

Ueta, Mayumi ^{[1
]}

Nakatani, Eiji ^{[7
]}

Kitami, Amane ^{[2
]}

Watanabe, Hideaki ^{[2
]}

Sueki, Hirohiko ^{[2
]}

Iijima, Masafumi ^{[2
]}

Aihara, Michiko ^{[3
]}

Ikezawa, Zenro ^{[3
]}

Aihara, Yukon ^{[4
]}

Kano, Yoko ^{[5
]}

Shiohara, Tetsuo ^{[5
]}

Tohyama, Mikiko ^{[6
]}

Shirakata, Yuji ^{[6
]}

Kaneda, Hideaki ^{[7
]}

Fukushima, Masanori ^{[7
]}

Kinoshita, Shigeru ^{[1
]}

Hashimoto, Koji ^{[6
]}

机构：

[1] Kyoto Prefectural Univ Med, Dept Ophthalmol, Kyoto 6020841, Japan

[2] Showa Univ, Sch Med, Dept Dermatol, Tokyo 142, Japan

[3] Yokohama City Univ, Med Ctr, Dept Dermatol, Yokohama, Kanagawa 232, Japan

[4] Yokohama City Univ, Med Ctr, Dept Pediat, Yokohama, Kanagawa 232, Japan

[5] Kyorin Univ, Sch Med, Dept Dermatol, Tokyo, Japan

[6] Ehime Univ, Grad Sch Med, Dept Dermatol, Matsuyama, Ehime, Japan

[7] Fdn Biomed Res & Innovat, Translat Res Informat Ctr, Kobe, Hyogo, Japan

来源：

AMERICAN JOURNAL OF OPHTHALMOLOGY | 2015年 / 160卷 / 02期

关键词：

MUCOSAL EPITHELIAL TRANSPLANTATION; ERYTHEMA MULTIFORME MAJUS; SURFACE RECONSTRUCTION; GENE POLYMORPHISMS; JAPANESE PATIENTS; MANIFESTATIONS; EUROSCAR;

D O I：

10.1016/j.ajo.2015.05.002

中图分类号：

R77 [眼科学];

学科分类号：

100212 ;

摘要：

PURPOSE: To suggest an objective score for grading the acute ocular severity of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN), and to determine predictive factors for severe acute ocular involvement such as ocular surface epithelial defect and/or pseudomembrane formation. DESIGN: Retrospective cohort study. METHODS: The medical records of SJS (n = 87) and TEN (n = 48) patients between 2005 and 2007 were reviewed. An acute ocular severity score was determined on a scale from 0 to 3 (none, mild, severe, and very severe) according to the existence of hyperemia, corneal or conjunctival epithelial defect, and pseudomembrane formation. The associations between the severe acute ocular involvement and factors such as patient age, exposed drugs, systemic severity, and the prevalence of ocular sequelae were examined. RESULTS: The number of cases with score grade 0, 1, 2, and 3 was 19 (21.8%), 31(35.6%), 22 (25.3%), and 15 (17.2%) in 87 SJS cases and 12 (25.0%), 11(22.9%), 17 (35.4%), and 8 (16.7%) in 48 TEN cases. Multivariate logistic regression analysis revealed that patient age (odds ratio [OR], 0.98; 95% confidence interval [CI], 0.96 0.99; P = .007) and nonsteroidal anti-inflammatory drugs NSAIDs or cold remedies (OR, 2.58; 95% CI, 1.26-5.29; P = .010) were predictive factors for severe acute ocular involvement. The prevalence of visual disturbance and eye dryness increased according to the increase of acute ocular severity (P = .001 and P = .007 in SJS; P = .007 and P = .014 in TEN, respectively). CONCLUSIONS: At the onset of SJS/TEN, strict attention should be paid to ocular involvement in young patients and in patients exposed to NSAIDs or cold remedies. ((C) 2015 by Elsevier Inc. All rights reserved.)

引用

页码：228 / 237

页数：10