[In vivoconfocal microscopic observation of corneal changes in patients with chronic Stevens-Johnson syndrome or toxic epidermal necrolysis].
Objective:To describe corneal alterations visible onin vivoconfocal microscopy in patients with debilitating ocular sequelae caused by Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).Methods:Twenty-two eyes of 11 consecutive patients suffering from chronic SJS or TEN were studied using slit lamp andin vivoconfocal microscopy in the Ophthalmology Outpatient Department of Peking Union Medical College Hospital from March 2014 to April 2015.Results:Dry eye with meibomian gland dysfunction (19 eyes of 10 patients, 86.4%) was the most frequent clinical sequelae. Two patients (3 eyes, 13.6%) had severe vison loss with corneal neovascularization and conjunctivization. One patient had asymmetric binocular disease. Corneal epithelial cells were observed at an active state in 10 patients (19 eyes, 86.4%) and corneal stromal cells at an active state in all patients (22 eyes, 100%). Twenty eyes (10 patients, 91%) were noted with abnormal nerve layout and 10 eyes (5 patients, 45.5%) with dendritic cell infiltration around pathological nerve damages. Numerous inflammory cells were observed in 6 eyes (3 patients, 27.3%).Conclusions:The corneas of patients with chronic ocular sequelae associated with SJS or TEN present a number of abnormalities.In vivoconfocal microscopy is a potetial useful tool for therapeutic indications and for follow-up of the debilitating chronic ocular problems linked to SJS and TEN.(Chin J Ophthalmol, 2017, 53:177-181).
Department of Ophthalmology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing 100730, China.
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Gao
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Li
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Liu
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Long
D002908:Chronic Disease; D003315:Cornea / Q000294:innervation; D003316:Corneal Diseases / Q000175:diagnosis* / Q000209:etiology; D016510:Corneal Neovascularization; D015352:Dry Eye Syndromes / Q000175:diagnosis*; D004847:Epithelial Cells / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D018613:Microscopy, Confocal; D013262:Stevens-Johnson Syndrome / Q000150:complications* / Q000175:diagnosis
Corneal diseases; Dry eye syndromes; Epidermal necrolysis, toxic; Keratitis; Microscopy, confocal; Stevens-Johnson syndrome