The findings of a new study suggest that there may be a way to treat vision side effects from Stevens-Johnson syndrome, helping individuals restore their eyesight after suffering the severe and life-threatening reaction linked to a number of medications.
Stevens-Johnson Syndrome (SJS) generally presents as a debilitating skin reaction, where the skin burns from the inside out, producing blisters, rash and causing the skin to separate from the body. In severe cases, Stevens-Johnson syndrome can also result in vision loss or permanent blindness.
When the skin lesions affect more than 30% of the body, the condition is typically referred to as toxic epidermal necrolysis (TEN), and treatments for the condition typically require inpatient care at a hospital Burn Unit.
One of the possible side effects of SJS is corneal neovascularization and eyelid scarring, which result in the vision loss problems for some patients. However, a new study by researchers from India suggests a procedure known as cultivated oral mucosal epithelial transplantation (COMET) could repair the eye structure and restore vision for some of these patients.
In findings published recently in the American Journal of Ophthalmology, researchers described a study involving 41 patients in an institutional setting with chronic SJS sequelae from 2013 to 2017. All of the patients underwent the COMET procedure, then followed up with the patients for two years.
According to the research, 82.2% of the eyes treated with the procedure experienced improvements in visual acuity, while in 13.3% of eyes, vision experienced no change. Only two eyes worsened during the procedure, or 4.4%.
“COMET allows successful and sustained restoration of ocular surface anatomy with functional improvement in eyes with chronic sequelae of SJS,” the researchers concluded.
Stevens-Johnson syndrome is often caused by drug side effects. Those most commonly associated with SJS include anti-convulsants, antibiotics, and anti-inflammatory medications. SJS results in death in five percent to 15% of patients.
One of the most popular drugs associated with SJS is acetaminophen, the active ingredient in Tylenol and used in numerous painkiller and cold treatment medications.
The FDA discovered the link between acetaminophen and skin problems through an analysis of medical literature and the FDA’s Adverse Event Reporting System (FAERS). Data from FAERS identified at least 107 cases of severe skin reactions from acetaminophen between 1969 and 2012, including 67 hospitalizations and 12 deaths. However, it is often assumed that adverse events are underreported to the FDA, particularly in cases where the drug is not believed to be linked to the side effect. By some estimates, only 1% to 10% of actual adverse events are ever reported to FAERS.
Even with much higher numbers, the FDA still believes that these skin reactions are extremely rare and that the benefits of acetaminophen outweigh the risks.