Corticosteroid Pulse Therapy for Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Patients With Acute Ocular Involvement

center dot PURPOSE: To investigate the long-term effects of corti-costeroid pulse therapy (CPT) for the treatment of acute -stage Stevens-Johnson syndrome (SJS) and toxic epider-mal necrolysis (TEN) patients with severe ocular in-volvement. center dot DESIGN: Retrospective, comparative case series. center dot METHODS: This study retrospectively reviewed the medical records of 116 SJS/TEN patients who developed the disease between 2002 and 2018. Patients with severe ocular disorders (ie, ocular surface epithelial defect, pseu-domembranous formation, or both) at the acute stage and who were followed for > 1 year post SJS/TEN onset were enrolled. In those patients, the treatments administered for acute-stage SJS/TEN and associated ocular sequelae were examined, including the best-corrected visual acu-ity (BCVA) in the patient's worse eye and the incidence of the ocular complications at the final follow-up exami-nation. center dot RESULTS: A total of 85 patients were enrolled. Of those, 36 received CPT within 4 days post disease onset (group A) and 49 patients did not receive CPT within 4 days post disease onset (group B). The percentage of eyes with a BCVA in the worse eye of >= 1.0 were 52.8% in group A and 14.3% in group B. Severe ocular sequelae (ie, a worsening of BCVA and corneal and conjunctival complications) were significantly less in group A than in group B. center dot CONCLUSIONS: In SJS/TEN patients with acute ocular involvement, CPT initiated within 4 days from disease onset may help reduce severe ocular sequelae. (Am J Ophthalmol 2021;231: 194-199. (c) 2021 Published by Elsevier Inc.)