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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