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March 1996

Retrospective Survey of Surgical Outcomes in Rhegmatogenous Retinal Detachments Associated With Atopic Dermatitis

Author Affiliations

From the Departments of Ophthalmology, National Children's Hospital (Dr Azuma), Kyorin University School of Medicine (Dr Hida), Keio University School of Medicine (Dr Katsura), Toho University School of Medicine (Dr Takeuchi), Tokyo, Japan; and National Osaka (Japan) Hospital (Drs Danjo and Tano).; Drs Danjo and Tano are now with the Department of Ophthalmology, Osaka University Medical School.

Arch Ophthalmol. 1996;114(3):281-285. doi:10.1001/archopht.1996.01100130277008

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 χ2 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.