Table 2.
Literature review focus on ocular management during acute phase of SJS/Lyell
| Treatments | Author/article [Ref] | Year/country | Study methodology | Number patients (n) | Conclusion |
|---|---|---|---|---|---|
| Topical treatment | |||||
| Topical corticosteroid therapy | Sotozono et al. [5] | 2009/ Japan | Retrospective controlled | 94 | Improvement of visual prognosis |
| Topical antibiotics | Yip et al. [12] | 2007/ Singapore | Retrospective | 117 | Increased risk of ocular complications |
| Antibiotics/corticosteroids/antiseptics | Gueudry et al. [9] | 2009/ France | Retrospective | 159 | No impact on ocular complications |
| Systemic treatment | |||||
| Systemic corticosteroid therapy | Power et al. [3] | 1995/USA | Retrospective controlled | 366 | At 3 months, no significant difference in ocular involvement |
| IV-Ig | Yip et al. [13] | 2005/Singapore | Retrospective controlled | 10 | No significant difference in ocular complications between patients treated with 2-day IV-Ig (2 g/kg) |
| IV-Ig | Kim et al. [14] | 2013/Korea | Retrospective comparative multicentric | 51 | An early high-dose IV-Ig or systemic steroid could improve VA on the long term |
| Systemic and topical corticosteroid therapy | Araki et al. [15] | 2009/Japan | Observational prospective | 5 | No late ocular complications in patients treated with corticosteroid pulse (500 mg - 1 g for 3 days) + topical corticosteroid |
| Systemic corticosteroid/ IV-Ig/ combined corticosteroid IV-Ig therapy/ supportive care only (combined antibio-corticosteroid eye drops, artificial tears) | Kim et al. [16] | 2015/Korea | Retrospective multicentric comparative | 43 | No significant difference between groups of patients treated with IV-Ig or systemic steroid or supportive care |
| Adjuvant treatment | |||||
| AMT | Sharma et al. [17] | 2016/India | Randomised controlled trial | 50 | Improvement of tear film break up time, visual acuity, Schirmer’s test, and reduction of conjunctival inflammation at 6 months |
| AMT/Self-retained AMT | Gregory [18] | 2011/USA | Observational prospective non-controlled | 10 | Decreased palpebral inflammation and symblepharon formation, lower incidence of late ocular complications at 6 months in patients treated with AMT or self-retained AMT |
| AMT/Self-retained AMT | Shanbhag et al. [19] | 2019/USA | Controlled retrospective observational | 48 | Reduced ocular complications and improved final VA in patients with early AMT or self-retained AMT |
| AMT | Gregory [20] | 2016/USA | Observational prospective non-controlled | 79 | Improvement of VA and decreased dry eye symptoms or scarring sequelae |
| AMT | Shammas et al. [21] | 2010/USA | Observational retrospective | 6 | Acute phase AMT combined with topical corticosteroids resulted in better VA and ocular surface preservation |
AMT amniotic membrane transplantation; IV-Ig intravenous immunoglobulins; VA visual acuity