Table 4. Treatment initiated at time of diagnosis and during follow-up.
CC category (no. of patients) | Ocular mucous membrane pemphigoid (n=50) | Stevens-Johnson syndrome/toxic epidermal necrolysis (n=16) | Other cicatrising conjunctivitis (n=16) | |||
---|---|---|---|---|---|---|
At diagnosis, n=50 | At follow-up, n=40 | At diagnosis, n=16 | At follow-up, n=9 | At diagnosis, n=16 | At follow-up, n=13 | |
|
n (%) |
n (%) |
n (%) |
n (%) |
n (%) |
n (%) |
Systemic medication | ||||||
Any immunosuppressant | 32 (64) | 26 (65) | 10 (63) | 2 (22) | 4 (25) | 2 (15) |
Corticosteroids | 18 (36) | 12 (30) | 4 (25) | 1 (11) | 1 (6) | 0 |
Dapsone | 10 (20) | 7 (18) | 0 | 0 | 2 (13) | 1 (8) |
Mycophenolate | 9 (18) | 13 (33) | 2 (13) | 1 (11) | 1 (6) | 0 |
IV Methyl prednisolone | 3 (6) | 3 (8) | 1 (6) | 0 | 0 | 0 |
Azathioprine | 6 (12) | 5 (13) | 0 | 0 | 0 | 0 |
Cyclophosphamide | 8 (16) | 4 (10) | 1 (6) | 0 | 0 | 1 (8) |
Cyclosporin | 1 (2) | 0 | 1 (6) | 0 | 1 (6) | 0 |
Methotrexate | 1 (2) | 0 | 0 | 0 | 1 (6) | 0 |
Sulphamethoxypyridazine | 1 (2) | 1 (3) | 0 | 0 | 0 | 0 |
Doxycycline | 0 | 0 | 0 | 0 | 2 (13) | 0 |
Othera | 0 | 0 | 11 (69) | 2 (22) | 0 | 0 |
Changes in immunosuppression | ||||||
Stepped up | 30 (60) | 6 (15) | 10 (63) | 0 | 4 (25) | 1 (8) |
Stepped up then down | 2 (5) | 0 | 0 | |||
Stepped down (improvement) | 4 (10) | 3 (33) | 1 (8) | |||
Stepped down (refusal/intolerance) | 6 (15) | 0 | 1 (8) | |||
No change | 15 (38) | 2 (22) | 1 (8) | |||
Not given immunosuppression | 7 (18) | 3 (33) | 9 (69) | |||
Topical medication | ||||||
Steroids | 26 (52) | 22 (55) | 15 (94) | 6 (67) | 10 (63) | 6 (46) |
Lubricants | 31b (62) | 33b (83) | 15 (94) | 8 (89) | 15 (94) | 11 (85) |
Otherc | 9 (18) | 5 (13) | 8 (50) | 6 (67) | 5 (31) | 3 (23) |
Surgery during follow-up | ||||||
Any surgery | 12 (30) | 2 (22) | 1 (8) | |||
Entropion surgery | 8 (20) | 0 | 0 | |||
Electrolysis | 5 (13) | 0 | 0 | |||
Cryotherapy | 2 (5) | 0 | 1 (8) | |||
Amniotic membrane graft | 1 (3) | 1 (11) | 0 | |||
Division of symblephara | 1 (3) | 0 | 0 | |||
Superficial keratectomy | 1 (3) | 0 | 0 | |||
Tectonic graft | 0 | 1 (11) | 0 |
Other systemic medications, for SJS/TEN: IV immunoglobulins (7), ganciclovir (1), infliximab (1), meropenem (1), and vancomicin (1) at diagnosis; IV immunoglobulins (1) and infliximab (1) at the time of follow-up.
Among OcMMP patients there was an increased use of lubricants since diagnosis, P=0.008.
Other topical medications: antibiotics (15), glaucoma therapy (2), autologous serum (1), cyclosporin (2), mitomicin (1), and sodium cromoglycate (1) at diagnosis; antibiotics (5), glaucoma therapy (3), autologous serum (1), cyclosporin (2), mitomicin (1), retinoic acid (1), and sodium cromoglycate (1) at the time of follow-up.