目的:比较儿童和成人Stevens-Johnson综合征(SJS)和中毒性表皮坏死松解症(TEN)的临床特征和视觉结果。
方法:回顾性比较病例系列。
方法:这项回顾性研究包括2010年至2020年间接受SJS/TEN治疗的140名患者(35名儿童和105名成人)的280只眼。主要结果指标是最终最佳矫正视力(BCVA)和干眼的严重程度。次要结果指标是使用的药物和手术治疗。
结果:在这项研究中招募的64眼儿童中,急性眼部受累58眼(90.6%)。儿科患者的慢性评分明显高于成人患者(p=0.004)。使用抗生素/非甾体抗炎药(NSAIDs)和支原体感染是儿童中更常见的病因。在平均4.3年的随访时间内,75%的儿童眼睛保持20/40或更好的视力。儿童和成人组之间干燥的严重程度相当。慢性期儿童行羊膜和口腔黏膜移植的眼比例明显高于成人,反映出儿童表现出更严重的并发症。
结论:尽管儿童SJS/TEN患者比成人有更严重的眼部并发症,大多数儿童保持长期良好的视力。早期干预和积极治疗有助于保护视力。
To compare the clinical features and visual outcomes in children and adults with Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN).
Retrospective comparative case series.
This retrospective study included 280 eyes of 140 patients (35 children and 105 adults) with SJS/TEN treated between 2010 and 2020. The primary outcome measures were the final best-corrected visual acuity (BCVA) and severity of dry eye. The secondary outcome measure was the medical and surgical therapies used.
Among 64 eyes of children recruited in the study, acute ocular involvement was found in 58 eyes (90.6%). The chronic score in pediatric patients was significantly higher than that in adult patients (P = .004). The use of antibiotics/nonsteroidal anti-inflammatory drugs (NSAIDs) and Mycoplasma infection were the more common etiologies in children. In all, 75% of eyes in children maintained a visual acuity of 20/40 or better at a mean follow-up time of 4.3 years. The severity of dryness was comparable between the child and adult groups. The proportion of eyes undergoing amniotic membrane and oral mucosa transplantation was significantly higher in children than in adults in the chronic stage, reflecting that children exhibit much more severe complications.
Although pediatric SJS/TEN patients have more severe ocular complications than adults, most children maintain long-term good vision. Early intervention and aggressive treatment help to preserve vision.