Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Chiba, Japan; Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan.
Department of Data Science, The Institute of Statistical Mathematics, Tokyo, Japan.
Ocul Surf. 2019 Oct;17(4):722-728. doi: 10.1016/j.jtos.2019.07.006. Epub 2019 Jul 17.
To characterize the topography patterns and quantify corneal higher-order aberrations (HOAs) in the chronic phase of Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
This retrospective, consecutive case series included 84 eyes of 49 patients in the chronic phase of SJS/TEN. HOAs of the total cornea, and of the anterior and posterior surfaces were measured using anterior segment optical coherence tomography (AS-OCT). Corneal topography patterns were classified into one of the 4 types: ectasia-, asymmetric-, flattening- and minimal change- patterns.
Mean logarithm of the minimal angle of resolution (logMAR) was 0.93 ± 0.95. AS-OCT showed ectasia pattern in 16 eyes (19.0%), asymmetric pattern in 28 eyes (33.3%), flattening pattern in 11 eyes (13.0%) and minimal change pattern in 29 eyes (34.5%). The HOAs of the total cornea were 1.23 ± 1.04 μm within a 4-mm diameter, which were significantly larger than those in normal controls (P < 0.0001). LogMAR visual acuity was significantly correlated with corneal HOAs (4-mm: r = 0.793, P < 0.0001, 6-mm: r = 0.798, P < 0.0001) and corneal astigmatism (r = 0.508, P < 0.0001), but not with average keratometric value (r = 0.198, P = 0.065). When the participants were stratified based on corneal opacity, logMAR was significantly correlated with corneal HOAs within a 4-mm diameter in opacity grades 0 (35 eyes, r = 0.649, P < 0.0001), 1 (23 eyes, r = 0.678, P = 0.0004), and 2-3 (26 eyes, r = 0.570, P = 0.0024). Ectasia pattern was derived from either corneal thinning (68.7%) or epithelial hyperplasia (31.3%).
The most common topographic patterns for SJS/TEN were minimal change pattern and asymmetric pattern. Corneal HOAs were associated with decreased visual acuity in SJS/TEN.
描述 Stevens-Johnson 综合征（SJS）和中毒性表皮坏死松解症（TEN）慢性期的角膜高阶像差（HOAs）的地形模式并对其进行定量分析。
本回顾性连续病例系列研究纳入了 49 例 SJS/TEN 慢性期患者的 84 只眼。使用眼前节光学相干断层扫描（AS-OCT）测量总角膜、前表面和后表面的 HOAs。将角膜地形模式分为 4 种类型之一：扩张型、不对称型、扁平型和最小变化型。
平均最小分辨角对数（logMAR）为 0.93±0.95。AS-OCT 显示 16 只眼（19.0%）为扩张型，28 只眼（33.3%）为不对称型，11 只眼（13.0%）为扁平型，29 只眼（34.5%）为最小变化型。直径 4mm 范围内总角膜的 HOAs 为 1.23±1.04μm，显著大于正常对照组（P<0.0001）。logMAR 视力与角膜 HOAs（4mm：r=0.793，P<0.0001；6mm：r=0.798，P<0.0001）和角膜散光（r=0.508，P<0.0001）显著相关，但与平均角膜曲率值（r=0.198，P=0.065）无关。当根据角膜混浊程度对参与者进行分层时，在混浊程度为 0（35 只眼，r=0.649，P<0.0001）、1（23 只眼，r=0.678，P=0.0004）和 2-3（26 只眼，r=0.570，P=0.0024）时，直径 4mm 范围内的 logMAR 与角膜 HOAs 显著相关。扩张型模式来源于角膜变薄（68.7%）或上皮过度增生（31.3%）。
SJS/TEN 最常见的地形模式是最小变化型和不对称型。SJS/TEN 患者的角膜 HOAs 与视力下降有关。
