Retrospective survey of surgical outcomes on rhegmatogenous retinal detachments associated with atopic dermatitis
N. Azuma, T. Hida, H. Katsura, S. Takeuchi, S. Danjo and Y. Tano
Department of Ophthalmology, National Children's Hospital, Tokyo, Japan.
OBJECTIVE: To determine the clinical features and surgical outcomes of
retinal detachment associated with atopic dermatitis. METHODS: One hundred
twenty-one eyes of 98 patients with atopic dermatitis and rhegmatogenous
retinal detachment were surgically treated and followed up for 1 year or
longer. Fundus examination data on retinal breaks and detachment, and
follow-up data on anatomic reattachment were obtained and compared between
phakic and aphakic eyes using the chi 2 test. RESULTS: Breaks were often
multiple and located at the ora serrata (72%) and in the ciliary epithelium
(15%). Irregularly shaped breaks (13.5%) and giant breaks (16%) also were
seen. Most detachments (71%) were localized and shallow. No significant
difference was identified with or without a history of cataract surgery.
The prognosis after the initial surgery (reattachment rate, 72%) was
unfavorable because of new break formation, but the results of reoperation
(reattachment rate, 93%) were as successful. CONCLUSIONS: Patients with
atopic dermatitis may have an abnormality in the anterior retina and
ciliary epithelium that predisposes to retinal detachment. Findings suggest
a possible traumatic trigger and the need to perform an encircling scleral
buckle procedure with widespread retinopexy initially in these patients.
