Foetal Membrane Transplantation Prevents Blindness

Stevens-Johnson syndrome (SJS) is a disorder in which skin and mucous membranes, including the eye surface, react severely to a medication or infection. SJS causes painful skin blisters, and as the disease progress, the skin sloughs off as if the patient had been burned. A more severe form of the disease, involving more than 30 per cent of the body surface, is called toxic epidermal necrolysis (TEN).

Between 50 per cent and 81 per cent of SJS/TEN patients experience eye problems, ranging from mild dry eye to severe scarring that can cause blindness.

Loyola researchers studied a relatively new eye treatment for SJS/TEN patients called amniotic membrane transplantation. Amniotic membrane is part of the foetal membranes that surround and protect the baby in the womb, and have natural therapeutic properties. When placed on the eye, amniotic membrane can help aid healing, decrease inflammation and minimize scarring. Amniotic membrane is donated by a consenting mother following the birth of her baby.

SJS/TEN has an earlier acute stage and a later chronic stage. Previous studies have found that amniotic membrane transplantation is effective in the chronic stage. The Loyola case-control study is one of the largest studies to examine the effect of amniotic membrane transplantation in the early, acute stage.

Researchers examined the records of 128 SJS/TEN patients admitted to the Loyola University Medical Centre Burn Intensive Care Unit from 1998 to 2010. Some patients died and others did not have adequate follow-up. Among the remaining patients, researchers compared recent patients with mild, moderate and severe disease who received amniotic membrane transplantation with similar patients who did not receive amniotic membrane treatment because it was not available at the time.

Thirteen of the recent patients underwent amniotic membrane transplantation on a total of 25 eyes during the early stage of the disease, and 17 patients (33 eyes) received standard medical management but no transplantation. After three months, only 4.3 per cent of the eyes treated with amniotic membrane transplantation were legally blind (vision worse than 20/200 when corrected). By comparison, 35 per cent of the eyes treated with medical management alone were legally blind.; Source: Loyola University