Early Use of Amniotic Membrane Transplantation Helps Prevent Vision Loss from SJS/TENS

As we continue our efforts to help spread awareness of Stevens Johnson Syndrome (SJS) and Toxic Epidermal Necrolysis (TENS), we also like to share information on advances in treatment of these devastating illnesses.  A 2012 study led by Dr. Charles Bouchard, chair of the department of ophthalmology at Loyola University Medical Center, analyzed the use of amniotic membrane transplants on the eyes of patients with SJS and TENS.

Dr. Bouchard, a BFS supporter, refers a number of his patients to our BFS clinic in Chicago at the University of Illinois (UIC) Department of Ophthalmology and Visual Sciences.

SJS and TENS are severe, autoimmune reactions to medications or infections that affect the skin and mucus membranes, including the eyes. Approximately 50 to 81 percent of patients with SJS/TENS have eye involvement that can range from mild to severe and can cause lasting impacts, from dry eyes to blindness. Early diagnosis and treatment of the condition are critical for preventing permanent organ damage.

Dr. Bouchard’s studyperformed at Loyola University Medical Center was the largest to date to determine whether transplantation of amniotic membranes on the eyes of patients with SJS/TENS could improve their ability to heal and minimize vision loss. An amniotic membrane is the protective sac surrounding a fetus prior to birth. The amniotic membranes used in the study came from mothers who donated the membranes to use for research purposes after giving birth. When used as a covering for the eye, this membrane can promote healing, decrease inflammation, and minimize scarring of the eye surface.

In this study, “Indications and Outcomes of Amniotic Membrane Transplantation” published in the journal Cornea, amniotic membranes were transplanted on the eyes of SJS/TENS patients during the acute (early) stage of the illness. The transplants were attached to the inner lining of the eyelids, the surface of the eyes, and the inner portion of the eyelids. Stitches and plastic rings serve to hold the membrane in place. When transplanted, the membrane then serves as a dressing over the cornea and eventually melts. Of the patients treated with the amniotic transplants, only 4.3 percent of the eyes became legally blind (vision worse than 20/200 when corrected) in contrast to 35 percent of the eyes that had been medically managed only. Based on their results, the researchers concluded that early use of amniotic membrane transplantation over the entire ocular surface was effective in preventing permanent vision loss in SJS/TENS patients.

These results indicate a significant benefit to future patients and highlight the importance for accurate early diagnosis of SJS/TENS. For more information on SJS/TENS or to lend your support for spreading awareness, look to the Stevens Johnson Syndrome Foundation.

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