THE FUCHS STEVEN JOHNSON-SYNDROME - CAUSATIVE FACTORS AND PROGNOSIS OF THE VISUAL ACUITY

97th DOG Annual Meeting 1999

P68
THE FUCHS STEVEN JOHNSON-SYNDROME - CAUSATIVE FACTORS AND PROGNOSIS OF THE VISUAL ACUITY

S. Schumacher, M. J. M. Groh, M. E. M. Groh und G. O. H. Naumann

The Fuchs Steven Johnson syndrome as a immunological disease is a challange for ophthalmologists in case of conservative or surgical treatment. We report on 19 patients treated in our department between 1980 and 1999.

Patients and Methods: Between 1980 and 1999 19 patients were treated in our department because of Fuchs Steven Johnson syndrome. In this retrospective study we focused on causative factors, the prognosis of the visual acuity and the surgical treatment. The studygroup consists of 11 females and 8 males aged four to 71 years (mean age at onset of the disease 25 ± 10 years).

Results: Causative factors in our patients were: penicilline (4 patients), sulfonamide (2 patients), erythromycine (2 patients), acetylsalicylacid (1 patient), allopurinol (1 patient), fansidar (1 patient). In seven patients the causative factor could not be detected. Visual acuity preoperatively ranged from 20/20 to light perception. At the end of the follow up period (mean 60 ± 13 month) visual acuity ranged from 20/20 to light perception. Most performed surgical treatment was the ciliary electroepilation and cauterization of the lacrimal punctums (19 patients), perforating keratoplasty in 12 patients (in 8 patients more than one) and lamellary keratoplasty (6 patients). Nasal mucosa grafts were necessary in 9 patients. In 17 patients lid surgery were performed. One patient with severe corneal findings showed a dramatically improvement after superinfection with adenovirus.

Conclusion: The Fuchs Steven Johnson syndrome can be caused by many, in most cases not predictable medications. The prognosis concerning the visual acuity depends on the grade of the disease.

Department of Ophthalmology, University Erlangen-Nuernberg

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