Corticosteroid Pulse Therapy for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Patients With Acute Ocular Involvement.

ABSTRACT PURPOSE : To investigate the long-term effects of corticosteroid pulse therapy (CPT) for the treatment of acute-stage Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) patients with severe ocular involvement. DESIGN : Retrospective, comparative case series. METHODS : In this study, we retrospectively reviewed the medical records of 116 SJS/TEN patients who developed the disease between 2002 and 2018. Patients with severe ocular disorders (ie, ocular surface epithelial defect, pseudomembranous formation, or both) at the acute stage and who were followed for more than 1-year post SJS/TEN onset were enrolled. In those patients, we examined the treatments administered for acute-stage SJS/TEN and associated ocular sequelae, including the best-corrected visual acuity (BCVA) in the patient's worse eye and the incidence of the ocular complications at the final follow-up examination. RESULTS : A total of 85 patients were enrolled. Of those, 36 received CPT within 4 days post disease onset (Group A) and 49 patients did not receive CPT within 4 days post disease onset (Group B). The percentage of eyes with a BCVA in the worse eye of ≥ 1.0 were 52.8% in Group A and 14.3% in Group B. Severe ocular sequelae, ie, a worsening of BCVA and corneal and conjunctival complications, were significantly less in Group A than in Group B. CONCLUSIONS : In SJS/TEN patients with acute ocular involvement, CPT initiated within 4 days from disease onset may help reduce severe ocular sequelae.