Skip to main content

ORIGINAL RESEARCH article

Front. Med.
Sec. Ophthalmology
Volume 11 - 2024 | doi: 10.3389/fmed.2024.1398506

Acute and Chronic Ocular Outcomes in SJS/TEN Patients treated with Oral Ciclosporin versus Intravenous Immunoglobulin

Provisionally accepted
Valencia Foo Valencia Foo 1Haur Yueh Lee Haur Yueh Lee 2Jodhbir Mehta Jodhbir Mehta 1Hon Shing Ong Hon Shing Ong 1*
  • 1 Singapore National Eye Center, Singapore, Singapore
  • 2 Singapore General Hospital, Singapore, Singapore

The final, formatted version of the article will be published soon.

    Background/Aim: To evaluate differences in ocular complications of Stevens Johnson Syndrome (SJS)/Toxic Epidermal Necrolysis (TEN) patients receiving either systemic IVIG or Ciclosporin (CsA) as initial treatments. Methods: Retrospective review of consecutive patients admitted for SJS/TEN at the Singapore General Hospital (SGH) from 2011 to 2017 who received either IVIG or Ciclosporin at the onset of the disease and had ophthalmological follow-up of at least 6 months were included. Acute ocular severity of SJS/TEN was graded using the Gregory grading score; chronic ocular complications were graded using the Sotozono system. Results: A total of 18 subjects were included for analysis, with 8 in the IVIG group and 10 in the CsA group. There were no significant differences in acute Gregory severity grading between the 2 groups. The CsA group had a trend toward worse overall chronic Sotozono grading scores compared to the IVIG group (median [IQR]: 2 [0 – 3] vs 1 [0 – 6.5], p=0.27), with a higher incidence of acute severe cornea involvement (60% vs 25%, p=0.93) and chronic corneal and eyelid involvement in the former than the latter. SJS/TEN patients with worse acute ocular involvement were more likely to have TEN and perianal mucosal involvement. (50% vs 0, p=0.01). Conclusion: Compared to those who received IVIG, SJS/TEN patients who received CsA at the acute disease stage, seemed to have worse acute corneal and chronic corneal and eyelid complications. Larger studies are needed to confirm this finding.

    Keywords: ocular, Stevens-Johnson Syndrome, toxic epidermal necrolysis, Ciclosporin, Intravenous Immunoglobulin

    Received: 10 Mar 2024; Accepted: 29 Jul 2024.

    Copyright: © 2024 Foo, Lee, Mehta and Ong. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Hon Shing Ong, Singapore National Eye Center, Singapore, Singapore

    Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.