Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome

Jessica B Ciralsky, Kimberly C SippelDepartment of Ophthalmology, Weill Cornell Medical College, New York, NY, USABackground: Stevens-Johnson syndrome is often associated with blinding ocular surface cicatricial sequelae. Recent reports have described markedly improved clinical outcomes with the app...

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Autores principales:	Ciralsky JB, Sippel KC
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2013
Materias:	Ophthalmology RE1-994
Acceso en línea:	https://doaj.org/article/8a400da757d1454cbf1cfd8551dac735
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spelling	oai:doaj.org-article:8a400da757d1454cbf1cfd8551dac7352021-12-02T09:03:43ZPrompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome1177-54671177-5483https://doaj.org/article/8a400da757d1454cbf1cfd8551dac7352013-05-01T00:00:00Zhttp://www.dovepress.com/prompt-versus-delayed-amniotic-membrane-application-in-a-patient-with--a13212https://doaj.org/toc/1177-5467https://doaj.org/toc/1177-5483Jessica B Ciralsky, Kimberly C SippelDepartment of Ophthalmology, Weill Cornell Medical College, New York, NY, USABackground: Stevens-Johnson syndrome is often associated with blinding ocular surface cicatricial sequelae. Recent reports have described markedly improved clinical outcomes with the application of amniotic membrane to the ocular surface during the acute phase. Here we describe the clinical outcome of a patient with acute Stevens-Johnson syndrome and severe ocular surface involvement in whom the evolving medical condition and family consent resulted in amniotic membrane application to each eye at differing intervals from disease onset.Methods: We undertook a retrospective chart review of a woman with Stevens-Johnson syndrome who presented within hours of disease onset. She underwent application of amniotic membrane to the ocular surface of the left eye during the hyperacute phase (<72 hours after disease onset) and to the right eye at a later time point during the acute phase (six days after disease onset). The clinical outcomes of the two eyes, as well as associated ocular symptoms, were compared over a one-year postoperative period.Results: The right eye, treated later in the course of the disease, required additional surgical procedures and ultimately exhibited significantly more advanced ocular surface pathology than the left. Further, the patient reported more pronounced issues of chronic eye pain and visual difficulties in the right eye.Conclusion: Earlier intervention with application of amniotic membrane to the ocular surface in this patient with severe ocular involvement secondary to Stevens-Johnson syndrome proved superior. Application of amniotic membrane as soon as possible after disease onset, preferably in the hyperacute phase, appears to result in a significantly better clinical outcome than application later in the disease course.Keywords: Stevens-Johnson syndrome, toxic epidermal necrolysis, amniotic membraneCiralsky JBSippel KCDove Medical PressarticleOphthalmologyRE1-994ENClinical Ophthalmology, Vol 2013, Iss default, Pp 1031-1034 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Ophthalmology RE1-994
spellingShingle	Ophthalmology RE1-994 Ciralsky JB Sippel KC Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome
description	Jessica B Ciralsky, Kimberly C SippelDepartment of Ophthalmology, Weill Cornell Medical College, New York, NY, USABackground: Stevens-Johnson syndrome is often associated with blinding ocular surface cicatricial sequelae. Recent reports have described markedly improved clinical outcomes with the application of amniotic membrane to the ocular surface during the acute phase. Here we describe the clinical outcome of a patient with acute Stevens-Johnson syndrome and severe ocular surface involvement in whom the evolving medical condition and family consent resulted in amniotic membrane application to each eye at differing intervals from disease onset.Methods: We undertook a retrospective chart review of a woman with Stevens-Johnson syndrome who presented within hours of disease onset. She underwent application of amniotic membrane to the ocular surface of the left eye during the hyperacute phase (<72 hours after disease onset) and to the right eye at a later time point during the acute phase (six days after disease onset). The clinical outcomes of the two eyes, as well as associated ocular symptoms, were compared over a one-year postoperative period.Results: The right eye, treated later in the course of the disease, required additional surgical procedures and ultimately exhibited significantly more advanced ocular surface pathology than the left. Further, the patient reported more pronounced issues of chronic eye pain and visual difficulties in the right eye.Conclusion: Earlier intervention with application of amniotic membrane to the ocular surface in this patient with severe ocular involvement secondary to Stevens-Johnson syndrome proved superior. Application of amniotic membrane as soon as possible after disease onset, preferably in the hyperacute phase, appears to result in a significantly better clinical outcome than application later in the disease course.Keywords: Stevens-Johnson syndrome, toxic epidermal necrolysis, amniotic membrane
format	article
author	Ciralsky JB Sippel KC
author_facet	Ciralsky JB Sippel KC
author_sort	Ciralsky JB
title	Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome
title_short	Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome
title_full	Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome
title_fullStr	Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome
title_full_unstemmed	Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome
title_sort	prompt versus delayed amniotic membrane application in a patient with acute stevens-johnson syndrome
publisher	Dove Medical Press
publishDate	2013
url	https://doaj.org/article/8a400da757d1454cbf1cfd8551dac735
work_keys_str_mv	AT ciralskyjb promptversusdelayedamnioticmembraneapplicationinapatientwithacutestevensjohnsonsyndrome AT sippelkc promptversusdelayedamnioticmembraneapplicationinapatientwithacutestevensjohnsonsyndrome
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Prompt versus delayed amniotic membrane application in a patient with acute Stevens-Johnson syndrome

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