期刊文献+

Stevens-Johnson综合征与中毒性表皮坏死溶解综合征患者角膜并发症与眼睑瘢痕性病理变化间的关系 被引量:1

Correlation of corneal complications with eyelid cicatricial pathologies in patientswith Stevens-Johnson syndrome and toxic epidermal necrolysis syndrome
下载PDF
导出
摘要 Purpose: To look at the correlation between many factors (time of hospitalizat ion, floppy eyelid syndrome, trichiasis, open lacrimal puncta, symblepharon, and aqueous tear deficiency)-and corneal complications in Stevens-Johnson syndrom e (SJS). Design: Observational cases series. Patients: Clinical data were retros pectively reviewed from 38 patients (32.7±20.1 years old) with SJS (n=11) and with toxic epidermal necro lysis (TENS) (n=27) from January 2002 to August 2004. One case report with SJS w as included to verify the presence of tarsal/lid margin ulceration at the acute stage. Methods: The medical history was retrieved regarding presumed causative m edications used within 15 days and the duration of hospitalization. Data of the latest photographic documentation and eye examination were compared and correlat ed in a masked fashion. Main Outcome Measures: Floppy eyelid, trichiasis, lid ma rgin keratinization, meibomian gland orifice metaplasia, symblepharon, tarsal sc ar, and corneal complications. Results: Acute SJS/TENS was characterized by tars al conjunctival ulceration. Keratinization of the eyelid margin with variable de grees of meibomian gland dysfunction was observed in all cases. Floppy eyelid, t richiasis, partially or totally opened lacrimal punctum, symblepharon, and aqueo us tear deficiency were not significantly correlated with corneal complications. In contrast, there was a strong correlation between the severity of eyelid marg in and tarsal pathology and the extent of corneal complications (Spearman r, 0.5 4; P=0.0005). A multivariable regression analysis also showed that the extent of eyelid and tarsal pathology had a significant effect on corneal complications ( coefficient, 0.84; P=0.006). Conclusions: Patients with acute SJS/TENS are chara cterized by severe inflammation and ulceration of the tarsal conjunctiva and lid margins. If left unattended, lid margin keratinization and tarsal scar, togethe r with lipid tear deficiency, contribute to corneal complications because of bli nk-related microtrauma. Attempts to suppress inflammation and scarring by amnio tic membrane transplantation at the acute stage and to prevent microtrauma at th e chronic stage are vital to avoid sight-threatening complications. Purpose: To look at the correlation between many factors (time of hospitalizat ion, floppy eyelid syndrome, trichiasis, open lacrimal puncta, symblepharon, and aqueous tear deficiency)-and corneal complications in Stevens-Johnson syndrom e (SJS). Design: Observational cases series. Patients: Clinical data were retros pectively reviewed from 38 patients (32.7±20.1 years old) with SJS (n=11) and with toxic epidermal necro lysis (TENS) (n=27) from January 2002 to August 2004. One case report with SJS w as included to verify the presence of tarsal/lid margin ulceration at the acute stage. Methods: The medical history was retrieved regarding presumed causative m edications used within 15 days and the duration of hospitalization. Data of the latest photographic documentation and eye examination were compared and correlat ed in a masked fashion. Main Outcome Measures: Floppy eyelid, trichiasis, lid ma rgin keratinization, meibomian gland orifice metaplasia, symblepharon, tarsal sc ar, and corneal complications. Results: Acute SJS/TENS was characterized by tars al conjunctival ulceration. Keratinization of the eyelid margin with variable de grees of meibomian gland dysfunction was observed in all cases. Floppy eyelid, t richiasis, partially or totally opened lacrimal punctum, symblepharon, and aqueo us tear deficiency were not significantly correlated with corneal complications. In contrast, there was a strong correlation between the severity of eyelid marg in and tarsal pathology and the extent of corneal complications (Spearman r, 0.5 4; P=0.0005). A multivariable regression analysis also showed that the extent of eyelid and tarsal pathology had a significant effect on corneal complications ( coefficient, 0.84; P=0.006). Conclusions: Patients with acute SJS/TENS are chara cterized by severe inflammation and ulceration of the tarsal conjunctiva and lid margins. If left unattended, lid margin keratinization and tarsal scar, togethe r with lipid tear deficiency, contribute to corneal complications because of bli nk-related microtrauma. Attempts to suppress inflammation and scarring by amnio tic membrane transplantation at the acute stage and to prevent microtrauma at th e chronic stage are vital to avoid sight-threatening complications.
机构地区 Ocular Sur face Center
出处 《世界核心医学期刊文摘(眼科学分册)》 2005年第10期57-58,共2页 Digest of the World Core Medical Journals:Ophthalmology
  • 引文网络
  • 相关文献

同被引文献13

引证文献1

二级引证文献19

;
使用帮助 返回顶部