AUTHOR=Shanbhag Swapna S. , Tahboub Mohammad A. , Chodosh James , Saeed Hajirah N. 

TITLE=Visual function and quality of life in patients with Stevens-Johnson syndrome who received acute protocol-based ocular care

JOURNAL=Frontiers in Toxicology

VOLUME=4

YEAR=2022

URL=https://www.frontiersin.org/journals/toxicology/articles/10.3389/ftox.2022.992696

DOI=10.3389/ftox.2022.992696

ISSN=2673-3080

ABSTRACT=<p><bold>Purpose:</bold> To report visual function and quality of life (VF/QOL) using the National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) and the ocular surface disease index (OSDI) in patients in the chronic phase of Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN).</p><p><bold>Methods:</bold> The NEI-VFQ-25 questionnaire was administered to 15 patients who received protocol-based care in the form of topical medications with or without amniotic membrane transplantation (AMT) for acute SJS/TEN. The scores obtained were compared with scores from a healthy population. The associations between the NEI-VFQ-25 and dry eye symptoms as measured by OSDI questionnaire were also studied.</p><p><bold>Results:</bold> Patients were surveyed at a mean of 4.47 ± 2.22 years after acute SJS/TEN. Eleven patients received AMT in the acute phase. The median best corrected visual acuity at the time of administration of the questionnaire was 20/20. The mean composite NEI-VFQ-25 score was 86.48 ± 12. Patients who received protocol-based treatment in the acute phase of SJS/TEN had comparable NEI-VFQ-25 scores with healthy subjects on all subscales except ocular pain (<italic>p</italic> = 0.027) and mental health (<italic>p</italic> = 0.014), which were significantly reduced. The NEI-VFQ-25 composite scores significantly correlated with OSDI (R = -0.75, <italic>p</italic> = 0.001).</p><p><bold>Conclusion:</bold> A protocol-based management strategy composed of early ophthalmic evaluation, grading based on severity, the use of topical corticosteroids and AMT in the acute phase of SJS/TEN in patients with ocular complications helped preserve the VF/QOL. This study highlights the impact of appropriate management of the ocular complications in the acute phase of SJS/TEN.</p>