Visual outcomes after management of bilateral cataract and retinal detachment in atopic dermatitis
Medical hypothesis, discovery & innovation in optometry,
Vol. 2 No. 3 (2021),
14 March 2022
,
Page 108-113
https://doi.org/10.51329/mehdioptometry133
Abstract
Background: Atopic dermatitis (AD) is a chronic pruritic inflammatory skin disorder of childhood with a broad spectrum of ocular manifestations, including keratoconjunctivitis, keratoconus, cataract, and rhegmatogenous retinal detachment (RRD). This study was aimed at reporting the visual outcomes in patients with bilateral cataract and RRD in the context of AD.Methods: This was a retrospective, observational case series. A thorough history, clinical features, and surgical management of seven consecutive patients who presented to the Birmingham and Midland Eye Centre with bilateral cataract and RRD secondary to severe AD were investigated.
Results: Fourteen eyes of seven patients with AD were analyzed. Twelve of the 14 eyes had cataract (85.7%). Seven patients had anterior or posterior subcapsular cataract (58.3%); 13 of the 14 eyes had RRD (92.8%). Most cases were bilateral or simultaneous (85.7% and 71.4%, respectively). Eight eyes had involvement of the temporal quadrant (61.5%): three eyes had giant retinal tears (23%) and five eyes with proliferative vitreoretinopathy (38.5%). Three eyes underwent scleral buckle surgery with or without cryotherapy (21.4%), and eight eyes had PPV (57.1%) combined with other procedures. Two eyes (15.4%) had persistent RRD postoperatively. The latest recorded postoperative best-corrected distance visual acuity was 6/36 or better in 10 (71.4%) eyes.
Conclusions: Temporal RRD was commonly observed in retinal detachment secondary to AD. Surgical repair was often challenging because of proliferative vitreoretinopathy and significant cataract. A further multidisciplinary study involving dermatologists would be helpful in identifying a larger high-risk population for AD and earlier detection of asymptomatic retinal tears or holes, which would allow preventive treatment and limit sight-threatening complications.
Keywords:
- atopic dermatitis
- cataract
- retinal detachment
- best-corrected distance visual acuity
- scleral buckle
- proliferative vitreoretinopathy
References
1. Cork MJ, Danby SG, Ogg GS. Atopic dermatitis epidemiology and unmet need in the United Kingdom. J Dermatolog Treat. 2020;31(8):801-809. doi: 10.1080/09546634.2019.1655137 pmid: 31631717
2. Pietruszy?ska M, Zawadzka-Krajewska A, Duda P, Rogowska M, Grabska-Liberek I, Kulus M. Ophthalmic manifestations of atopic dermatitis. Postepy Dermatol Alergol. 2020;37(2):174-179. doi: 10.5114/ada.2018.79445 pmid: 32489350
3. Lifschitz C. The impact of atopic dermatitis on quality of life. Ann Nutr Metab. 2015;66 Suppl 1:34-40. doi: 10.1159/000370226 pmid: 25925339
4. Chernyshov PV, Jirakova A, Ho RC, Moed H, Caldeira AP, Alvarenga TM, et al. An international multicenter study on quality of life and family quality of life in children with atopic dermatitis. Indian J Dermatol Venereol Leprol. 2013;79(1):52-8. doi: 10.4103/0378-6323.104669 pmid: 23254729
5. Margolin L, Hershko K, Garcia-Rojas M, Ingber A. Andogsky syndrome variant: atopic dermatitis associated with bilateral cataracts and retinal degeneration with left retinal detachment. Pediatr Dermatol. 2003;20(5):419-20. doi: 10.1046/j.1525-1470.2003.20510.x pmid: 14521560
6. Bair B, Dodd J, Heidelberg K, Krach K. Cataracts in atopic dermatitis: a case presentation and review of the literature. Arch Dermatol. 2011;147(5):585-8. doi: 10.1001/archdermatol.2010.411 pmid: 21242345
7. Gan NY, Lam WC (2021). Rhegmatogenous Retinal Detachments in the Pediatric Population and Special Considerations for Pediatric Vitreoretinal Surgery p. 297-308. In: Wu WC., Lam WC. (editors) A Quick Guide to Pediatric Retina. Springer, Singapore. doi: 10.1007/978-981-15-6552-6_33
8. Carmi E, Defossez-Tribout C, Ganry O, Cene S, Tramier B, Milazzo S, et al. Ocular complications of atopic dermatitis in children. Acta Derm Venereol. 2006;86(6):515-7. doi: 10.2340/00015555-0163 pmid: 17106598
9. Lee Y, Park WK, Kim RY, Kim M, Park YG, Park YH. Characteristics of retinal detachment associated with atopic dermatitis. BMC Ophthalmol. 2021;21(1):359. doi: 10.1186/s12886-021-02135-7 pmid: 34635058
10. Sakata H, Harada Y, Hiyama T, Kiuchi Y. Infectious necrotizing scleritis and proliferative vitreoretinopathy after scleral buckling in a patient with atopic dermatitis. Am J Ophthalmol Case Rep. 2021;22:101066. doi: 10.1016/j.ajoc.2021.101066 pmid: 33748537
11. Choi M, Byun SJ, Lee DH, Kim KH, Park KH, Park SJ. The Association with rhegmatogenous retinal detachment and paediatric atopic dermatitis: a 12-year Nationwide Cohort Study. Eye (Lond). 2020;34(10):1909-1915. doi: 10.1038/s41433-020-0816-1 pmid: 32080352
12. Yamamoto K, Wakabayashi Y, Kawakami S, Numata T, Ito T, Okubo Y, et al. Recent trends of ocular complications in patients with atopic dermatitis. Jpn J Ophthalmol. 2019;63(5):410-416. doi: 10.1007/s10384-019-00678-3 pmid: 31243592
13. Cho AR, Yoon YH. Adjunctive dexamethasone implant in patients with atopic dermatitis and retinal detachment undergoing vitrectomy and silicone oil tamponade: an interventional case series. BMC Ophthalmol. 2019;19(1):86. doi: 10.1186/s12886-019-1094-1 pmid: 30943922
14. Jeon HS, Choi M, Byun SJ, Hyon JY, Park KH, Park SJ. Association of Pediatric Atopic Dermatitis and Cataract Development and Surgery. JAMA Ophthalmol. 2018;136(8):912-918. doi: 10.1001/jamaophthalmol.2018.2166 pmid: 29879279
15. Agarkar S, Gokhale VV, Raman R, Bhende M, Swaminathan G, Jain M. Incidence, Risk Factors, and Outcomes of Retinal Detachment after Pediatric Cataract Surgery. Ophthalmology. 2018;125(1):36-42. doi: 10.1016/j.ophtha.2017.07.003 pmid: 28844322
16. Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66 Suppl 1:8-16. doi: 10.1159/000370220 pmid: 25925336
17. Sasoh M, Mizutani H, Matsubara H, Furuta M, Matsui Y, Yamanaka K, et al. Incidence of retinal detachment associated with atopic dermatitis in Japan: review of cases from 1992 to 2011. Clin Ophthalmol. 2015;9:1129-34. doi: 10.2147/OPTH.S85020 pmid: 26150692
18. Beck KM, Seitzman GD, Yang EJ, Sanchez IM, Liao W. Ocular Co-Morbidities of Atopic Dermatitis. Part I: Associated Ocular Diseases. Am J Clin Dermatol. 2019;20(6):797-805. doi: 10.1007/s40257-019-00455-5 pmid: 31359350
19. Hida T, Tano Y, Okinami S, Ogino N, Inoue M. Multicenter retrospective study of retinal detachment associated with atopic dermatitis. Jpn J Ophthalmol. 2000;44(4):407-18. doi: 10.1016/s0021-5155(00)00174-x pmid: 10974298
20. Tatham A. Atopic dermatitis, cutaneous steroids and cataracts in children: two case reports. J Med Case Rep. 2008;2:124. doi: 10.1186/1752-1947-2-124 pmid: 18442376
21. Tan L, Teo L, Lee SY. Case Series: Bilateral Rhegmatogenous Retinal Detachments in Atopic Dermatitis. Optom Vis Sci. 2018;95(7):621-624. doi: 10.1097/OPX.0000000000001244 pmid: 29957736
22. Gnana Jothi V, McGimpsey S, Sharkey JA, Chan WC. Retinal detachment repair and cataract surgery in patients with atopic dermatitis. Eye (Lond). 2017;31(9):1296-1301. doi: 10.1038/eye.2017.151 pmid: 28799561
23. Beck KM, Seitzman GD, Yang EJ, Sanchez IM, Liao W. Ocular Co-Morbidities of Atopic Dermatitis. Part II: Ocular Disease Secondary to Treatments. Am J Clin Dermatol. 2019;20(6):807-815. doi: 10.1007/s40257-019-00465-3 pmid: 31352589
24. James ER. The etiology of steroid cataract. J Ocul Pharmacol Ther. 2007;23(5):403-20. doi: 10.1089/jop.2006.0067 pmid: 17900234
25. Taniguchi H, Ohki O, Yokozeki H, Katayama I, Tanaka A, Kiyosawa M, et al. Cataract and retinal detachment in patients with severe atopic dermatitis who were withdrawn from the use of topical corticosteroid. J Dermatol. 1999;26(10):658-65. doi: 10.1111/j.1346-8138.1999.tb02068.x pmid: 10554432
26. Govind K, Whang K, Khanna R, Scott AW, Kwatra SG. Atopic dermatitis is associated with increased prevalence of multiple ocular comorbidities. J Allergy Clin Immunol Pract. 2019;7(1):298-299. doi: 10.1016/j.jaip.2018.10.009 pmid: 30339855
27. Wei CC, Kung YJ, Chen CS, Chang CY, Lin CJ, Tien PT, et al. Allergic Conjunctivitis-induced Retinal Inflammation Promotes Myopia Progression. EBioMedicine. 2018;28:274-286. doi: 10.1016/j.ebiom.2018.01.024 Erratum in: EBioMedicine. 2019;41:717-718. pmid: 29398596
28. Hayashi H, Igarashi C, Hayashi K. Frequency of ciliary body or retinal breaks and retinal detachment in eyes with atopic cataract. Br J Ophthalmol. 2002;86(8):898-901. doi: 10.1136/bjo.86.8.898 pmid: 12140212
29. Brunner PM, Guttman-Yassky E. Racial differences in atopic dermatitis. Ann Allergy Asthma Immunol. 2019;122(5):449-455. doi: 10.1016/j.anai.2018.11.015 pmid: 30465859
30. Paternoster L, Standl M, Waage J, Baurecht H, Hotze M, Strachan DP, et al. Multi-ancestry genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis. Nat Genet. 2015;47(12):1449-1456. doi: 10.1038/ng.3424 pmid: 26482879
2. Pietruszy?ska M, Zawadzka-Krajewska A, Duda P, Rogowska M, Grabska-Liberek I, Kulus M. Ophthalmic manifestations of atopic dermatitis. Postepy Dermatol Alergol. 2020;37(2):174-179. doi: 10.5114/ada.2018.79445 pmid: 32489350
3. Lifschitz C. The impact of atopic dermatitis on quality of life. Ann Nutr Metab. 2015;66 Suppl 1:34-40. doi: 10.1159/000370226 pmid: 25925339
4. Chernyshov PV, Jirakova A, Ho RC, Moed H, Caldeira AP, Alvarenga TM, et al. An international multicenter study on quality of life and family quality of life in children with atopic dermatitis. Indian J Dermatol Venereol Leprol. 2013;79(1):52-8. doi: 10.4103/0378-6323.104669 pmid: 23254729
5. Margolin L, Hershko K, Garcia-Rojas M, Ingber A. Andogsky syndrome variant: atopic dermatitis associated with bilateral cataracts and retinal degeneration with left retinal detachment. Pediatr Dermatol. 2003;20(5):419-20. doi: 10.1046/j.1525-1470.2003.20510.x pmid: 14521560
6. Bair B, Dodd J, Heidelberg K, Krach K. Cataracts in atopic dermatitis: a case presentation and review of the literature. Arch Dermatol. 2011;147(5):585-8. doi: 10.1001/archdermatol.2010.411 pmid: 21242345
7. Gan NY, Lam WC (2021). Rhegmatogenous Retinal Detachments in the Pediatric Population and Special Considerations for Pediatric Vitreoretinal Surgery p. 297-308. In: Wu WC., Lam WC. (editors) A Quick Guide to Pediatric Retina. Springer, Singapore. doi: 10.1007/978-981-15-6552-6_33
8. Carmi E, Defossez-Tribout C, Ganry O, Cene S, Tramier B, Milazzo S, et al. Ocular complications of atopic dermatitis in children. Acta Derm Venereol. 2006;86(6):515-7. doi: 10.2340/00015555-0163 pmid: 17106598
9. Lee Y, Park WK, Kim RY, Kim M, Park YG, Park YH. Characteristics of retinal detachment associated with atopic dermatitis. BMC Ophthalmol. 2021;21(1):359. doi: 10.1186/s12886-021-02135-7 pmid: 34635058
10. Sakata H, Harada Y, Hiyama T, Kiuchi Y. Infectious necrotizing scleritis and proliferative vitreoretinopathy after scleral buckling in a patient with atopic dermatitis. Am J Ophthalmol Case Rep. 2021;22:101066. doi: 10.1016/j.ajoc.2021.101066 pmid: 33748537
11. Choi M, Byun SJ, Lee DH, Kim KH, Park KH, Park SJ. The Association with rhegmatogenous retinal detachment and paediatric atopic dermatitis: a 12-year Nationwide Cohort Study. Eye (Lond). 2020;34(10):1909-1915. doi: 10.1038/s41433-020-0816-1 pmid: 32080352
12. Yamamoto K, Wakabayashi Y, Kawakami S, Numata T, Ito T, Okubo Y, et al. Recent trends of ocular complications in patients with atopic dermatitis. Jpn J Ophthalmol. 2019;63(5):410-416. doi: 10.1007/s10384-019-00678-3 pmid: 31243592
13. Cho AR, Yoon YH. Adjunctive dexamethasone implant in patients with atopic dermatitis and retinal detachment undergoing vitrectomy and silicone oil tamponade: an interventional case series. BMC Ophthalmol. 2019;19(1):86. doi: 10.1186/s12886-019-1094-1 pmid: 30943922
14. Jeon HS, Choi M, Byun SJ, Hyon JY, Park KH, Park SJ. Association of Pediatric Atopic Dermatitis and Cataract Development and Surgery. JAMA Ophthalmol. 2018;136(8):912-918. doi: 10.1001/jamaophthalmol.2018.2166 pmid: 29879279
15. Agarkar S, Gokhale VV, Raman R, Bhende M, Swaminathan G, Jain M. Incidence, Risk Factors, and Outcomes of Retinal Detachment after Pediatric Cataract Surgery. Ophthalmology. 2018;125(1):36-42. doi: 10.1016/j.ophtha.2017.07.003 pmid: 28844322
16. Nutten S. Atopic dermatitis: global epidemiology and risk factors. Ann Nutr Metab. 2015;66 Suppl 1:8-16. doi: 10.1159/000370220 pmid: 25925336
17. Sasoh M, Mizutani H, Matsubara H, Furuta M, Matsui Y, Yamanaka K, et al. Incidence of retinal detachment associated with atopic dermatitis in Japan: review of cases from 1992 to 2011. Clin Ophthalmol. 2015;9:1129-34. doi: 10.2147/OPTH.S85020 pmid: 26150692
18. Beck KM, Seitzman GD, Yang EJ, Sanchez IM, Liao W. Ocular Co-Morbidities of Atopic Dermatitis. Part I: Associated Ocular Diseases. Am J Clin Dermatol. 2019;20(6):797-805. doi: 10.1007/s40257-019-00455-5 pmid: 31359350
19. Hida T, Tano Y, Okinami S, Ogino N, Inoue M. Multicenter retrospective study of retinal detachment associated with atopic dermatitis. Jpn J Ophthalmol. 2000;44(4):407-18. doi: 10.1016/s0021-5155(00)00174-x pmid: 10974298
20. Tatham A. Atopic dermatitis, cutaneous steroids and cataracts in children: two case reports. J Med Case Rep. 2008;2:124. doi: 10.1186/1752-1947-2-124 pmid: 18442376
21. Tan L, Teo L, Lee SY. Case Series: Bilateral Rhegmatogenous Retinal Detachments in Atopic Dermatitis. Optom Vis Sci. 2018;95(7):621-624. doi: 10.1097/OPX.0000000000001244 pmid: 29957736
22. Gnana Jothi V, McGimpsey S, Sharkey JA, Chan WC. Retinal detachment repair and cataract surgery in patients with atopic dermatitis. Eye (Lond). 2017;31(9):1296-1301. doi: 10.1038/eye.2017.151 pmid: 28799561
23. Beck KM, Seitzman GD, Yang EJ, Sanchez IM, Liao W. Ocular Co-Morbidities of Atopic Dermatitis. Part II: Ocular Disease Secondary to Treatments. Am J Clin Dermatol. 2019;20(6):807-815. doi: 10.1007/s40257-019-00465-3 pmid: 31352589
24. James ER. The etiology of steroid cataract. J Ocul Pharmacol Ther. 2007;23(5):403-20. doi: 10.1089/jop.2006.0067 pmid: 17900234
25. Taniguchi H, Ohki O, Yokozeki H, Katayama I, Tanaka A, Kiyosawa M, et al. Cataract and retinal detachment in patients with severe atopic dermatitis who were withdrawn from the use of topical corticosteroid. J Dermatol. 1999;26(10):658-65. doi: 10.1111/j.1346-8138.1999.tb02068.x pmid: 10554432
26. Govind K, Whang K, Khanna R, Scott AW, Kwatra SG. Atopic dermatitis is associated with increased prevalence of multiple ocular comorbidities. J Allergy Clin Immunol Pract. 2019;7(1):298-299. doi: 10.1016/j.jaip.2018.10.009 pmid: 30339855
27. Wei CC, Kung YJ, Chen CS, Chang CY, Lin CJ, Tien PT, et al. Allergic Conjunctivitis-induced Retinal Inflammation Promotes Myopia Progression. EBioMedicine. 2018;28:274-286. doi: 10.1016/j.ebiom.2018.01.024 Erratum in: EBioMedicine. 2019;41:717-718. pmid: 29398596
28. Hayashi H, Igarashi C, Hayashi K. Frequency of ciliary body or retinal breaks and retinal detachment in eyes with atopic cataract. Br J Ophthalmol. 2002;86(8):898-901. doi: 10.1136/bjo.86.8.898 pmid: 12140212
29. Brunner PM, Guttman-Yassky E. Racial differences in atopic dermatitis. Ann Allergy Asthma Immunol. 2019;122(5):449-455. doi: 10.1016/j.anai.2018.11.015 pmid: 30465859
30. Paternoster L, Standl M, Waage J, Baurecht H, Hotze M, Strachan DP, et al. Multi-ancestry genome-wide association study of 21,000 cases and 95,000 controls identifies new risk loci for atopic dermatitis. Nat Genet. 2015;47(12):1449-1456. doi: 10.1038/ng.3424 pmid: 26482879
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