Abstract
Purpose :
The incidence, demographics and risk factors of Stevens-Johnson syndrome (SJS) in developing countries are poorly understood. The study aimed to describe the epidemiology of SJS in patients presenting to a multi-tier ophthalmology hospital network in India.
Methods :
This was an electronic medical record based cross-sectional obervational study of 1,458,832 new patients presenting between 16th August 2010 and 31st August 2018 to a multi-tier ophthalmology network located in 200 different geographical locations spread across 4 states. The diagnosis of SJS was made based on suggestive medical history and clinical findings. The data were entered in an electronic medical record system. The demographic and clinical data were extracted into a spreadsheet for analysis. Descriptive statistics, chi-square test and multiple logistic regression were used for analysis of the data. Odds ratios (OR) were calculated for the factors associated with higher risk of SJS.
Results :
During the 8-year study period, 908 new patients developed SJS with an incidence rate of 622 per million population. The incidence was 21% greater in children than adults (731 vs. 606/million population, p<0.00001). The mean age of patients with SJS was 33± 16 years with a median age of 31 (range of 0-86) years. The male to female ratio was 407: 501 and the adult to child ratio was 381:73. Patients with SJS accounted for 4.3% of all new patients diagnosed with dry eye disease (DED). In children, SJS was responsible for 27.2% of all DED as compared to only 3.7% in adults (p<0.00001). The incidence of SJS was also significantly greater in females (4.9%) as compared to males (3.7%) with DED (p<0.00001). Out of the total number of eyes, 44% eyes had best-corrected visual acuity ≤ 20/400 at presentation. Multiple logistic regression analysis revealed that younger age (OR 4.5), people from poorer socio-economic background (OR 2.8) and female homemakers (OR 1.7) and unemployed and retired individuals (OR 2) were at a significantly higher risk of developing SJS.
Conclusions :
The study results indicate that the incidence of SJS is alarmingly high in the Indian population with children being particularly at risk, with high ocular morbidity at presentation. Since SJS can cause serious long-term ocular and visual morbidity, healthcare resources need to be directed towards its primary and secondary prevention.
This abstract was presented at the 2019 ARVO Annual Meeting, held in Vancouver, Canada, April 28 - May 2, 2019.