Factors Contributing to Long-Term Severe Visual Impairment in Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Abstract EN

Purpose.

To study the correlation between demographics and clinical variables and long-term severe visual impairment in patients with Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).

Methods.

A retrospective chart review of SJS/TEN patients between 2004 and 2014 was conducted.

Demographics, causative agents, ocular manifestations, and visual outcomes were collected.

The data were analyzed using a multivariate logistic regression model.

Results.

Of the 89 patients including SJS (65, 73.03%), TEN (15, 16.85%), and SJS-TEN overlap (9, 10.11%), 55 were female.

The mean age was 41.58 ± 19.17 years.

The most common identified agents were medications.

Among these groups, antibiotics were the most prevalent (47.19%).

Three patients (3.7%) had unknown etiology.

Antibiotics and nonpharmaceutical triggers were significantly associated with long-term severe visual impairment (odds ratio 4.32; P=0.015 and 7.20; P=0.037, resp.).

There was a significant negative relationship between HIV infection and long-term severe visual impairment (P=0.021).

Among all chronic ocular complications, only corneal neovascularization significantly correlated with severe visual impairment (P=0.001).

Conclusions.

SJS/TEN patients caused by nonpharmaceutical triggers or antibiotics have an increased risk of developing long-term severe visual impairment from corneal neovascularization.

HIV infection might be a protective factor against long-term poor visual outcomes.