The effects of systemic cyclosporine in acute Stevens-Johnson syndrome/toxic epidermal necrolysis on ocular disease

Leangelo N Hall; Swapna S Shanbhag; Ramy Rashad; James Chodosh; Hajirah N Saeed

doi:10.1016/j.jtos.2020.05.003

The effects of systemic cyclosporine in acute Stevens-Johnson syndrome/toxic epidermal necrolysis on ocular disease

Ocul Surf. 2021 Jan:19:128-132. doi: 10.1016/j.jtos.2020.05.003. Epub 2020 May 20.

Authors

Leangelo N Hall¹, Swapna S Shanbhag², Ramy Rashad³, James Chodosh¹, Hajirah N Saeed⁴

Affiliations

¹ Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA.
² Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; LV Prasad Eye Institute, Hyderabad, India.
³ Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA; Tufts University School of Medicine, Boston, MA, USA.
⁴ Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA. Electronic address: Hajirah_Saeed@meei.harvard.edu.

Abstract

Purpose: To evaluate the effect of systemic cyclosporine (CsA) on ocular disease in Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) patients.

Methods: In this retrospective, comparative cohort study at a single center, patients with a diagnosis of SJS/TEN and with at least 3 months of follow up were divided into two groups: those who received systemic CsA and those who did not receive systemic CsA. Best-corrected visual acuity (BCVA) and chronic ocular surface complications score (COCS) at final follow-up were compared between the two groups.

Results: The median age and follow-up period of patients was 29 years (range, 1.5-71 years) and 16.8 months (range, 3.67-91.58 months), respectively. BCVA, COCS, meibomian gland dysfunction, limbal stem cell deficiency, and the need for mucous membrane grafting and scleral lenses were not significantly different between patients who received systemic CsA as compared to patients who did not receive systemic CsA.

Conclusions: In this small cohort of patients with SJS/TEN, we could identify no association between the use of systemic CsA as a component of their initial therapy and chronic ocular complications.

Keywords: Cyclosporine; Ocular surface disease; Stevens-johnson syndrome; Toxic epidermal necrolysis.

Publication types

Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Cohort Studies
Corneal Diseases* / drug therapy
Cyclosporine / adverse effects
Follow-Up Studies
Humans
Retrospective Studies
Stevens-Johnson Syndrome*
Visual Acuity

Substances

Cyclosporine

Grants and funding

K23 EY028230/EY/NEI NIH HHS/United States