Fetal Membrane Transplant Prevents Blindness

Transplantation of donated fetal membrane preventing vision loss

(RxWiki News) The key to treating a rare disease that can cause blindness may be transplanting tissue from newborn fetal membranes, a study has found.

The procedure could benefit patients with Stevens-Johnson syndrome (SJS), a devastating condition in which mucous membranes, including eye surfaces, severely react to a drug or infection.

It causes painful blisters and the skin sloughs off much like burns. Most with the condition experience eye problems ranging from mild dry eye to severe scarring that can lead to blindness.

"Talk to an ophthalmologist about treatments for eye complications of the condition."

In a more severe form of the disease called toxic epidermal necrolysis (TEN), about 30 percent of the body surface is involved.

Charles Bouchard, MD, senior study author and chairman of the department of ophthalmology at Loyola University Chicago Stritch School of Medicine, and a team of researchers determined that the use of early amniotic membrane transplantation over the entire ocular surface within the first three to five days of developing SJS could be beneficial.

They found that the benefit could be reduced if the transplant occurred more than a week after the onset of the disease.

Previous studies found that such transplantation was effective in the chronic stages of SJS. Amniotic membrane is a portion of the fetal membranes that protects a baby in the womb, and it contains natural therapeutic properties.

Placing the membrane over the eye was found to aid healing, and reduce inflammation and scarring. The membranes are donated by consenting mothers following the birth of their baby.

The current study examined amniotic membrane transplantation during early stages of SJS. During the study investigators examined the records of 128 SJS/TEN patients admitted to the Loyola University Medical Center burn intensive care unit between 1998 and 2010.

Some patients did not survive or have adequate follow up. Among the other cases, investigators compared recent patients with mild, moderate and severe disease who received amniotic membrane transplantation with similar patients who did not receive a transplant because it was not available at the time.

Of the recent patients, 13 received amniotic membrane transplantation on a total of 25 eyes during the disease's early stage. An additional 17, a total of 33 eyes, received standard medical care, but no transplant.

Three months later, only 4 percent of patients who received an amniotic membrane transplant were legally blind compared to 35 percent who received traditional care without a transplant.

"Treatment of severe ocular surface disease conditions like Stevens-Johnson Syndrome with amniotic membrane grafts is increasingly recognized as a good option and has been gaining acceptance over the past several years," said Dr. Christopher Quinn, an optometrist with Omni Eye Associates.

"This study confirms the clinical impression of many, that for these types of severe ocular surface diseases, amniotic membrane is an excellent adjunctive treatment in addition to anti-inflammatory medications to preserve the clarity of the cornea and to help maintain vision."

The study has been published in journal Cornea.

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Review Date: 
April 27, 2012