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Table 2 Literature review focus on ocular management during acute phase of SJS/Lyell

From: Management of ocular involvement in the acute phase of Stevens-Johnson syndrome and toxic epidermal necrolysis: french national audit of practices, literature review, and consensus agreement

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
  1. AMT amniotic membrane transplantation; IV-Ig intravenous immunoglobulins; VA visual acuity