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Amniotic membrane transplantation may prevent ocular sequelae in Stevens-Johnson syndrome

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LAS VEGAS — Ocular sequelae from Stevens-Johnson syndrome may be prevented with amniotic membrane transplantation when applied within the first 6 days after symptom onset, according to a paper presentation here.

“Medical management is appropriate for patients who have more mild ocular manifestations, and this often includes various combinations of antibiotics, topical steroids, as well as cyclosporine and lubrication,” Amy Marie Cherof, MD, said at the American Academy of Ophthalmology annual meeting. “In addition, amniotic membrane transplantation has been shown in many studies, including those of our own, to decrease the risk of this chronic cicatricial change.”

Amy Marie Cherof

In a retrospective study, Cherof and colleagues reviewed 74 eyes of 37 patients with acute Stevens-Johnson syndrome as well as severe ocular involvement treated with amniotic membrane transplantation.

“We looked for the presence of what we called significant chronic ocular sequelae. ... We defined it as decreased visual acuity, severe photophobia, lid or lash malposition, moderate to severe dry eye or moderate tarsal conjunctival scarring,” Cherof said.

The study found that patients who received amniotic membrane transplantation beyond the first 6 days had a higher risk of moderate to severe dry eye, a visual acuity of 20/30 or less and moderate tarsal scarring, she said.

“Earliest possible surgical intervention should be a priority as each day of delay presents a significant increase in the risk of decreased visual acuity and moderate tarsal scarring,” Cherof said. – by Nhu Te

Reference:

Cherof A. Acute Stevens-Johnson syndrome: The effect of the timing of amniotic membrane transplantation has on the occurrence of significant ocular sequelae. Presented at: American Academy of Ophthalmology meeting. Nov. 16, 2015; Las Vegas.

Disclosure: Cherof reports no relevant financial disclosures.