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  • Corneal ectasia often missed in Stevens-Johnson syndrome

    Cornea/External Disease

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    Investigators of this prospective analysis examined topographic changes in patients with chronic Stevens-Johnson syndrome (SJS).

    Study design

    This observational study included 21 eyes from 15 consecutive patients who were diagnosed with Stevens-Johnson syndrome at a tertiary care center. Corneal topography using Scheimpflug imaging was performed on all eyes, examining anterior and posterior elevation along with Amsler-Krumeich scale and Sotozono grade.

    Outcomes

    At a median of 7 years from the diagnosis of SJS, 76.2% of eyes exhibited corneal ectasia. Mean Kmax was 58.4 D, while mean corneal pachymetry was 377.8 μm. Posterior float examination revealed significant elevation in more than 90% of eyes.

    Limitations

    The use of Kmax as a diagnostic factor may have contributed to the high rate of ectasia. The authors note that selection bias may have influenced their diagnostic rate.

    Clinical significance

    Consistent with past reports, the authors found that patients with SJS are at high risk for developing corneal ectasia. This finding may help tailor visual rehabilitation in these patients towards the treatment of corneal ectasia, which to date has often been ignored.