Clinical Characteristics of Retinal Detachment Associated with Atopic Dermatitis

Seong Chan Choi; Han Joo Cho; Dong Won Lee; Sung Won Cho; Chul Gu Kim; Jong Woo Kim; Hyoung Seok Kim

doi:10.3341/jkos.2016.57.8.1233

Journal List > J Korean Ophthalmol Soc > v.57(8) > 1010363

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Choi, Cho, Lee, Cho, Kim, Kim, and Kim: Clinical Characteristics of Retinal Detachment Associated with Atopic Dermatitis

Original Article

J Korean Ophthalmol Soc 2016;57(8):1233-1240.

Published online: 25 September 2016

DOI: https://doi.org/10.3341/jkos.2016.57.8.1233

Clinical Characteristics of Retinal Detachment Associated with Atopic Dermatitis

Seong Chan Choi, MD, Han Joo Cho, MD, Dong Won Lee, MD, Sung Won Cho, MD, Chul Gu Kim, MD, Jong Woo Kim, MD, Hyoung Seok Kim, MD

Myunggok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea

Address reprint requests to Hyoung Seok Kim, MD Department of Ophthalmology, Kim's Eye Hospital, #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 07301, Korea Tel: 82-2-2639-7811, Fax: 82-2-2671-6359 E-mail: burnlife@kimeye.com

Received 25 February 2016 Revised 2 May 2016 Accepted 23 June 2016

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To evaluate the clinical characteristics and surgical outcomes of retinal detachment associated with atopic dermatitis.

Methods: A retrospective investigation of clinical notes of 37 patients with retinal detachment associated with atopic dermatitis was conducted from January 2009 to December 2015. Initial visual acuity, medical history, type of retinal detachment, number of tears, types of treatment, success rate of treatment, and presence of cataract were investigated. To evaluate the relationship with cataract, the patients were classified into three groups according to lens status: group A (eyes with clear lens), group B (eyes with cataract), and group C (pseudophakic eyes).

Results

Of the 37 patients, 29 were male and 8 were female; 10 patients had bilateral retinal detachment (27.0%). The retinal breaks were often located temporally (89.4%), with only 5 cases (10.6%) involving nasal-side retinal breaks. No significant differences were noted in the ratio of males to females, age distribution, visual acuity before and after treatments, axial length, and location of retina breaks among the three groups. After primary surgery, retinal detachment recurred in 12 patients (14 eyes), 5 of whom were initially diagnosed with bilateral retinal detachment. In addition, 12 of 14 eyes underwent a second operation, in which detachment recurred in 3 eyes.

Conclusions

Incidence of bilateral retinal detachment was high in patients with atopic dermatitis, and the retinal breaks were often found on the temporal side. Retinal redetachment was statistically high in patients with cataract or pseudophakic eyes compared to patients with clear lens (p = 0.024).

Keywords: Atopic dermatitis, Cataract, Retinal detachment

References

1. Inoue M, Shinoda K, Ishida S, et al. Intraocular lens implantation after atopic cataract surgery decreases incidence of postoperative retinal detachment. Ophthalmology. 2005; 112:1719–24.

2. Hida T, Tano Y, Okinami S, et al. Multicenter retrospective study of retinal detachment associated with atopic dermatitis. Jpn J abdominal. 2000; 44:407–18.

3. Sasoh M, Mizutani H, Matsubara H, et al. Incidence of retinal abdominal associated with atopic dermatitis in Japan: review of abdominal from 1992 to 2011. Clin Ophthalmol. 2015; 9:1129–34.

4. Park YH, Koo HM, Chung SK, Lee JY. Ocular complications in abdominals with atopic dermatitis. J Korean Ophthalmol Soc. 1999; 40:3422–8.

5. Ha SM, Shin JP, Kim SY. Rhegmatogenous retinal detachment abdominal with atopic dermatitis. J Korean Ophthalmol Soc. 2004; 45:419–24.

6. Chang PY, Yang CM, Yang CH, et al. Clinical characteristics and surgical outcomes of pediatric rhegmatogenous retinal detachment in Taiwan. Am J Ophthalmol. 2005; 139:1067–72.

7. Butler TK, Kiel AW, Orr GM. Anatomical and visual outcome of retinal detachment surgery in children. Br J Ophthalmol. 2001; 85:1437–9.

8. Weinberg DV, Lyon AT, Greenwald MJ, Mets MB. Rhegmatogenous retinal detachments in children: risk factors and surgical outcomes. Ophthalmology. 2003; 110:1708–13.

9. Won YH, Lee SC, Kim SJ, Shin SS. The relationship among abdominal severity, family history and immunologic analysis in atopic dermatitis. Korean J Dermatol. 1999; 37:1399–406.

10. Takahashi M, Suzuma K, Inaba I, et al. Retinal detachment abdominal with atopic dermatitis. Br J Ophthalmol. 1996; 80:54–7.

11. Cox MS, Schepens CL, Freeman HM. Retinal detachment due to ocular contusion. Arch Ophthalmol. 1966; 76:678–85.

12. Oka C, Ideta H, Nagasaki H, et al. Retinal detachment with atopic dermatitis similar to traumatic retinal detachment. Ophthalmology. 1994; 101:1050–4.

13. Weidenthal DT, Schepens CL. Peripheral fundus changes abdominal with ocular contusion. Am J Ophthalmol. 1966; 62:465–77.

14. Azuma N, Hida T, Katsura H, et al. Retrospective survey of abdominal outcomes on rhegmatogenous retinal detachments associated with atopic dermatitis. Arch Ophthalmol. 1996; 114:281–5.

15. Coles RS, Laval J. Retinal detachments occurring in cataract abdominal with neurodermatitis. AMA Arch Ophthalmol. 1952; 48:30–9.

16. Matsuo N, Matsuo T, Shiraga F, et al. Photoreceptor outer abdominals in the aqueous humor of patients with atopic dermatitis and retinal detachment. Am J Ophthalmol. 1993; 115:21–5.

17. Matsuo T, Shiraga F, Matsuo N. Intraoperative observation of the vitreous base in patients with atopic dermatitis and retinal abdominal. Retina. 1995; 15:286–90.

18. Yoneda K, Okamoto H, Wada Y, et al. Atopic retinal detachment. Report of four cases and a review of the literature. Br J Dermatol. 1995; 133:586–91.

19. Goffstein R, Burton TC. Differentiating traumatic from nontraumatic retinal detachment. Ophthalmology. 1982; 89:361–8.

20. Jung SK, Park YH. The prophylactic effect of 360 degree endolaser photocoagulation for prevention of retinal detachment. J Korean Ophthalmol Soc. 2012; 53:977–81.

21. Laidlaw DA, Karia N, Bunce C, et al. Is prophylactic 360-degree laser retinopexy protective? Risk factors for retinal redetachment after removal of silicone oil. Ophthalmology. 2002; 109:153–8.

22. Koh HJ, Cheng L, Kosobucki B, Freeman WR. Prophylactic abdominal 360 degrees laser retinopexy for prevention of retinal detachment. Retina. 2007; 27:744–9.

Table 1.

Summary of baseline patient characteristics

	A	B	C	p-value^*
No. of eyes (patients)	19 (16)	14 (9)	14 (12)
Mean age (year)	19.4 ± 4.0	20.1 ± 4.5	22.5 ± 2.7	0.084
Sex (male:female)	12:4	7:2	10:2	0.513
Involved eye (OD:OS)	9:10	6:8	8:6	0.744
Incidence of bilateral detachment	3:16	5:9	2:12	0.091
Preoperative VA (log MAR)	0.78 ± 0.92	1.1 ± 1.1	1.3 ± 1.2	0.358
Duration of follow up (months)	21.1 ± 20.9	28.6 ± 16.9	28.4 ± 23.3	0.331
Mean interval from symptom to hospital (days)	3.2 ± 5.2	4.8 ± 4.6	9.1 ± 9.8	0.219
Mean axial length (mm)	25.40 ± 0.97	25.19 ± 0.77	25.05 ± 1.6	0.668

Values are presented as mean ± SD unless otherwise indicated. ‘A’ is ‘patients with clear lens’, ‘B’ is ‘patients with cataract’, and ‘C’ is ‘patients with pseudophakic eyes’.

VA = visual acuity.

^* p-value by Kruskal-Wallis test.

Table 2.

Configuration and extent of retinal detachment of study patients

Patient group	Configuration (%)		Affected quadrants (%)
Patient group	Shallow	Bullous	1	2	3	4
A	12 (63)	7 (37)	4 (21)	6 (32)	7 (37)	2 (11)
B	6 (43)	8 (57)	4 (29)	6 (43)	1 (7)	3 (21)
C	6 (43)	8 (57)	0 (0)	5 (36)	6 (43)	3 (21)
Total	24 (52)	23 (48)	8 (17)	17 (36)	14 (30)	8 (17)

Values are presented as n (%). ‘A’ is ‘patients with clear lens’, ‘B’ is ‘patients with cataract’, and ‘C’ is ‘patients with pseudophakic eyes’.

Table 3.

Characteristics of retinal breaks

Patien group	t Retinal tear (%)	Lattice hole (%)	Giant tear (%)	Dialysis (%)	Breaks at the vitreous base (%)	No definite tear (%)
A	3 (16)	10 (53)	2 (11)	4 (21)	0 (0)	0 (0)
B	2 (14)	0 (0)	4 (29)	6 (43)	1 (7)	1 (7)
C	3 (21)	2 (14)	3 (21)	3 (21)	1 (7)	2 (14)
Total	8 (17)	12 (26)	9 (19)	13 (28)	2 (4)	3 (6)

Values are presented as n (%). ‘A’ is ‘patients with clear lens’, ‘B’ is ‘patients with cataract’, and ‘C’ is ‘patients with pseudophakic eyes’.

Table 4.

Location of breaks by fundus quadrant

Quadrant	Patient group			Total (%)
Quadrant	A (%)	B (%)	C (%)	Total (%)
Superior temporal	9 (35)	11 (48)	6 (30)	26 (37.7)
Inferior temporal	13 (50)	11 (48)	9 (45)	33 (47.8)
Superior nasal	2 (8)	0 (0)	2 (10)	4 (5.8)
Inferior nasal	2 (8)	1 (4)	3 (15)	6 (8.7)
Total	26	23	20	69

Values are presented as n (%) unless otherwise indicated. ‘A’ is ‘patients with clear lens’, ‘B’ is ‘patients with cataract’, and ‘C’ is ‘patients with pseudophakic eyes’.

Table 5.

Type of surgery in each patient group

	A	B	C	Total
Type of surgery
Scleral buckle	16	7	6	29
Encircling	2	0	1	3
Segmental	11	6	3	20
Both	3	1	2	6
Vitrectomy	3	7	8	18
Vitrectomy only	1	2	2	5
With encircling	2	5	6	13
Cataract surgery	0	6	0	6

‘A’ is ‘patients with clear lens’, ‘B’ is ‘patients with cataract’, and ‘C’ is ‘patients with pseudophakic eyes’.

Table 6.

Surgical results in each patient group

	A	B	C	p-value^*
Preoperative VA (log MAR)	0.78 ± 0.92	1.13 ± 1.05	1.32 ± 1.22	0.358
Final postoperative VA (log MAR)	0.63 ± 0.97	0.41 ± 0.35	0.58 ± 0.88	0.881
Retinal redetachment after surgery (patients)	2/19 (10.5%)	6/14 (42.9%)	6/14 (42.9%)	0.063
Number of patients with reoperation	2/2 (100%)	5/6 (83.3%)	5/6 (83.3%)
Mean time of redetachment after primary surgery (months)	2.6 ± 3.3	8.7 ± 7.8	7.0 ± 6.5	0.501

Values are presented as mean ± SD unless otherwise indicated. ‘A’ is ‘patients with clear lens’, ‘B’ is ‘patients with cataract’, and ‘C’ is

‘patients with pseudophakic eyes’.

VA = visual acuity.

^* p-value by Kruskal-Wallis test.

Table 7.

Surgical results in patient with or without cataract

	A (n = 19)	B + C (n = 28)	p-value
Preoperative VA (log MAR)	0.78 ± 0.92	1.22 ± 1.11	0.152^*
Final postoperative VA (log MAR)	0.63 ± 0.97	0.49 ± 0.66	0.726^*
Retinal redetachment after surgery (patients)	2/19 (10.5%)	12/28 (42.9%)	0.024^†
Number of patients with reoperation	2/2 (100%)	10/12 (83.3%)
Mean time of redetachment after primary surgery (months)	2.6 ± 3.3	7.8 ± 6.9	0.448^*

Values are presented as mean ± SD unless otherwise indicated.

VA = visual acuity

^* p-value by Mann-Whitney test

^† p-value by Fisher's exact test.

Table 8.

Characteristics of re-detached patients

	A (n = 2)	B + C (n = 12)
Characteristics of retinal breaks	2 retinal dialysis	3 retinal tear
		2 giant tear
		4 retinal dialysis
		3 no definite tear
Number of patients with final postoperative VA ≤ HM	1/2	1/12
Type of initial surgery	Scleral buckle 1	Scleral buckle 9
	Vitrectomy 1	Vitrectomy 3
		(Cataract op. 3)
Type of second surgery	Vitrectomy 1	Vitrectomy 7 (with Cataract op. 2)
		FGE only 3
		No op. 2
Number of patients with reoperation	2/2 (100%)	10/12 (83.3%)
Number of patients with more than 2 operation	2/2 (100%)	3/10 (30%)

VA = visual acuity; HM = hand motion; FGE = fluid-gas exchange; op. = operation.

Table 9.

Factors associated with redetachment

Factor	State of retina		Significance of association (p-value)
Factor	Attached after 1st surgery	Re-detached after 1st surgery	Significance of association (p-value)
Age (years)			0.330^*
Median (range)	21.1 (13–28)	19.8 (13–25)
Gender			0.373^†
Male	23 (82.1)	9 (75.0)
Female	5 (17.9)	3 (25.0)
Involved eye			0.924^‡
Right	16 (48.5)	7 (50.0)
Left	17 (51.5)	7 (50.0)
Both (20 eyes)	13/20	7/20
Mean axial length (mm)	25.29 ± 1.04	25.08 ± 1.04	0.561^§
Previous eye surgery			0.742^†
Yes	10 (30.3)	5 (35.7)
No	23 (69.7)	9 (64.3)
Detached quadrants			0.355^‡
1–2	19 (57.6)	6 (42.9)
3–4	14 (42.4)	8 (57.1)
Cataract			0.024^†
Yes	16 (48.5)	12 (85.7)
No	17 (51.5)	2 (14.3)
Location of breaks			0.171^∏
Nasal	5 (15.2)	0 (0.0)
Temporal	25 (75.8)	12 (85.7)
Both	3 (10.0)	2 (14.3)
Type of breaks
Retinal tear	5 (15.2)	3 (21.4)	0.679^†
Lattice hole	12 (36.4)	0 (0.0)	0.009^†
Giant tear	7 (21.2)	2 (14.3)	0.704^†
Dialysis	7 (21.2)	6 (42.9)	0.163^‡
Breaks in ciliary epithelium	2 (6.1)	0 (0.0)	1.000^†
No definite tear	0 (0.0)	3 (21.4)	0.022^†

Values are presented as mean ± SD or n (%) unless otherwise indicated.

^* Data expressed as median and range, and compared by independent t-test

^† Data expressed as count and percentage, and tested by the Fisher's exact test

^‡ Data expressed as count and percentage, and tested by the Chi-square test

^§ Data expressed as median and standard deviation, and compared by independent t-test

^∏ Data expressed as count and percentage, and tested by the linear by linear association.

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