ISSN: 1300-0292
İndekslendiği Dizinler: SCIENCE CITATION INDEX EXPANDED
CINAHL, Index Copernicus,
Chemical Abstracts (CA),
Excerpta Medica / EMBASE
Dil: Türkçe, İngilizce
İçerik: Orijinal Araştırma, Derleme, Editöre Mektup, Olgu Sunumu, Tıp Eğitimi, Tıbbi Kitap İncelemeleri
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Ocular Findings And Management In Stevens-johnson Syndrome
Dr.Aysel PELİT,a Dr.Yonca AKOVAb
aGöz Hastalıkları AD, Başkent Üniversitesi Tıp Fakültesi Adana Uygulama ve Araştırma Hastanesi, ADANA
bGöz Hastalıkları AD, Başkent Üniversitesi Tıp Fakültesi, ANKARA
Stevens-Johnson syndrome is an acute, generally self-limiting, severe mucocutaneous vesiculobullous disease. Immune-complex deposition in the dermis and conjunctival stroma has been implicated in the pathogenesis of this syndrome. The most common inciting agents include drugs such as sulfonamides, anticonvulsants, salicylates, penicillin, ampicillin and isoniazid, as well as infectious organisms such as herpes simplex virus, streptococci, adenovirus, and certain mycoplasma. Recent reports have suggested that patients with AIDS are at a higher risk of developing Stevens-Johnson syndrome, particularly those treated for pneumocystis carinii pneumonia. Stevens-Johnson syndrome occurs most commonly in children and young adults, and in females more often than males. Fever, arthralgia, malaise and upper or lower respiratory symptoms are usually sudden in onset. The mucous membranes of the eyes, mouth and genitalia may be affected by bullous lesions with membrane or pseudo-membrane formation. The primary ocular finding is a mucopurulent conjunctivitis and episcleritis. The distinctive pathologic changes of Stevens-Johnson syndrome are subepithelial bullae and subsequent scarring. The conjunctiva are involved in about 90% of cases. Conjunctivitis, conjunctival bullae formation, keratopathy, and secondary infection are the typical acute ocular manifestations. Subepithelial fibrosis of the conjunctiva produces chronic consequences such as symblepharon formation, entropion, trichiasis, and distichiasis. Management of Stevens-Johnson syndrome is mainly supportive. The mainstay of therapy is ocular lubrication with artificial tears and ointments with vigilant surveillance for the early manifestations of ocular infections. Late eyelid sequelae, such as entropion, trichiasis and loss of the fornices, can be surgically corrected after disease quiescence. Because of the altered ocular surface and corneal neo-vascularization that frequently develops in these patients, penetrating keratoplasty has an extremely poor prognosis.Keywords: Stevens-Johnson syndrome, erythema multiforme major, mucopurulent conjunctivitis, symblepharon, entropionTurkiye Klinikleri J Med Sci 2004, 24:284-288
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