Shay Elizabeth, Kheirkhah Ahmad, Liang Lingyi, Sheha Hossam, Gregory Darren G, Tseng Scheffer C G
TissueTech Inc., Miami, Florida, USA.
Surv Ophthalmol. 2009 Nov-Dec;54(6):686-96. doi: 10.1016/j.survophthal.2009.03.004. Epub 2009 Aug 21.
Stevens-Johnson syndrome and its more severe variant, toxic epidermal necrolysis, have relatively low overall incidence; however, this disease presents with high morbidity and mortality. The majority of patients develop ocular inflammation and ulceration at the acute stage. Due to the hidden nature of these ocular lesions and the concentration of effort toward life-threatening issues, current acute management has not devised a strategy to preclude blinding cicatricial complications. This review summarizes recent literature data, showing how sight-threatening corneal complications can progressively develop from cicatricial pathologies of lid margin, tarsus, and fornix at the chronic stage. It illustrates how such pathologies can be prevented with the early intervention of cryopreserved amniotic membrane transplantation to suppress inflammation and promote epithelial healing at the acute stage. Significant dry eye problems and photophobia can also be avoided with this intervention. This new therapeutic strategy can avert the catastrophic ophthalmic sequelae of this rare but devastating disease.
史蒂文斯 - 约翰逊综合征及其更严重的变体中毒性表皮坏死松解症的总体发病率相对较低;然而,这种疾病的发病率和死亡率很高。大多数患者在急性期会出现眼部炎症和溃疡。由于这些眼部病变的隐匿性以及对危及生命问题的关注集中,目前的急性治疗尚未制定出预防致盲性瘢痕并发症的策略。这篇综述总结了近期的文献数据,展示了在慢性期,威胁视力的角膜并发症如何从睑缘、睑板和穹窿的瘢痕性病变逐渐发展而来。它说明了如何通过在急性期进行冷冻保存羊膜移植的早期干预来预防此类病变,以抑制炎症并促进上皮愈合。通过这种干预还可以避免严重的干眼问题和畏光现象。这种新的治疗策略可以避免这种罕见但具有毁灭性疾病的灾难性眼科后遗症。