Purchase this article with an account.
Tais Wakamatsu, Myrna Santos, Telma Barreiro, Charles Farias, Flavio Hirai, Jose Gomes; Classification of the ocular surface manifestations in patients with Stevens-Johnson Syndrome. Invest. Ophthalmol. Vis. Sci. 2013;54(15):5445.
Download citation file:
© ARVO (1962-2015); The Authors (2016-present)
To evaluate and grade the extent and severity of ocular surface manifestations in patients with Stevens-Johnson Syndrome (SJS).
Thirty four eyes of 22 patients with SJS that underwent ocular surface surgery and twenty nine eyes of 19 patients with SJS without previous ocular surface surgery were studied. Ocular surface manifestations were categorized as corneal, conjunctival, eyelid complications and presence of dry eye disease and 9 components were evaluated and graded on a scale from 0 to 3 according to their severity. This grading system comprises of corneal (epitheliopathy, opacity and limbal stem cell deficiency), conjuntival (inflammation and cicatrization), eyelid (keratinization and eye lashes alterations) complications and dry eye status (Shirmer Test and corneal cicatrization). Interobserver agreement in grading the severity of SJS ocular surface findings was evaluated.
The proposed grading system for assessing ocular surface manifestations demonstrated a moderate agreement. When each feature was analyzed separately the data shows a strong agreement for limbal stem cell deficiency (kappa=0.67) and corneal opacity (kappa=0.75) and moderate agreement for conjunctival inflammation (kappa=0.40), conjunctival cicatrization (kappa=0.54), corneal and conjunctival keratinization (kappa=0.52), eyelid keratinization (kappa=0.42), eye lashes alterations (kappa=0.47). The most severely affected complication components were limbal stem cell deficiency (26 eyes; 41,2%) and dry eye (Shirmer Test - 15 eyes; 23,8%). The severity of corneal, conjunctival and dry eye disease was significantly correlated with logarithm of the minimum angle of resolution (logMAR) visual acuity.
The authors describe a new classification for grading the severity of ocular surface findings in patients with SJS. This grading system provides a more objective method for evaluating SJS patients and may be adapted for use in the analysis of surgery indications.
This PDF is available to Subscribers Only