Observation of clinical characteristics and surgical outcomes of retinal detachment associated with atopic dermatitis
10.3760/cma.j.cn511434-20230619-00273
- VernacularTitle:特应性皮炎相关视网膜脱离的临床特征及手术疗效观察
- Author:
Songshan LI
1
;
Xinyu LIU
;
Limei SUN
;
Xiaoyan DING
Author Information
1. 中山大学中山眼科中心 眼科学国家重点实验室 广东省眼科视觉科学重点实验室 广东省眼部疾病临床医学研究中心, 广州 510060
- Keywords:
Atopic dermatitis;
Retinal detachment;
Ciliary epithelial detachment;
Scleral buckling
- From:
Chinese Journal of Ocular Fundus Diseases
2023;39(12):991-996
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To observe the clinical characteristics and surgical outcomes in patients with retinal detachment associated with atopic dermatitis (AD-RD).Methods:A retrospective case series. From January 2015 to April 2023, 8 patients (12 eyes) with AD-RD at Zhongshan Ophthalmic Center of Sun Yat-sen University were included. All patients underwent best-corrected visual acuity (BCVA), ultra-wide-field fundus photography, B-mode ultrasound, ultrasound biomicroscopy (UBM), and wide-field optical coherence tomography (OCT). BCVA was examined by standard logarithmic visual acuity chart and was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical purposes. In the primary surgery, 9 eyes underwent scleral buckling; 1 eye underwent pars plana vitrectomy (PPV) combined with silicone oil tamponade; 1 eye underwent PPV combined with C 3F 8 tamponade; 1 eye underwent C 3F 8 tamponade combined with retinal laser photocoagulation. The follow-up time was (29.1±40.9) months. BCVA before and after surgery was compared using paired t test. Results:Among the 8 patients, 6 were male and 2 were female. The mean age was (23.38±7.95) years old. Among them, 4 patients had bilateral affliction while the remaining 4 had unilateral involvement. The logMAR BCVA was 0.86±0.86. All 12 eyes were with a history of uveitis. Among 8 eyes with bilateral involvement, 6 of them were misdiagnosed as uveitis with exudative retinal detachment; 11 eyes had anterior uveitis at presentation; 9 eyes had a history of cataract, with 4 eyes having concurrent cataract and 5 eyes with intraocular lens. All affected eyes displayed as focal retinal detachment. UBM revealed ciliary epithelial detachment in 9 eyes, and no definite ciliary epithelial break was found in any case. Retinal breaks were observed in only 2 eyes in the pre-surgery retina examination, while ciliary epithelial holes were discovered in other 10 eyes during surgery. The retina was successfully reattached in 10 eyes after one surgery, including 9 eyes received scleral buckling. During the final follow-up, the logMAR BCVA of the affected eye improved significantly to 0.30±0.25 compared to pre-surgery values ( t=2.43, P=0.03). Conclusions:AD-RD is a challenging complication of AD with a high rate of young onset, bilateral involvement, associated with concurrent cataracts, and shallow temporal retinal detachment associated with ciliary epithelial detachment. Scleral buckling is an effective treatment for AD-RD.
