Gnana Jothi V, McGimpsey S, Sharkey J A, Chan W C
Department of Ophthalmolgy, Royal Victoria Hospital, Belfast, UK.
Eye (Lond). 2017 Sep;31(9):1296-1301. doi: 10.1038/eye.2017.151. Epub 2017 Aug 11.
PurposeThe aim of this study is to report a case series of ocular complications including retinal detachment (RD) and cataract in atopic dermatitis (AD) and surgical management involving a majority of Caucasian patients.Patients and methodsThis study is an observational case series, originally designed as an audit. It involves detailed discussion of history, clinical features, and surgical management of patients presenting with retinal detachment and cataracts secondary to severe AD. Six consecutive patients with diagnosis of severe AD requiring posterior segment and cataract surgery were included in the study.ResultsEight eyes of six patients had retinal detachment. Most of them involved the temporal retina. The retinal breaks were located anteriorly close to the ora serrata in six eyes and Giant tear retinal (GRT) detachment was found in two eyes. Five eyes had proliferative vitreo-retinopathy (PVR) at presentation. All six patients had bilateral cataracts and cataract surgery was performed in eleven eyes. Bilateral simultaneous surgery was essential in two patients. Three eyes had secondary intra-ocular lens (IOL) implantation with pars plana vitrectomy for subluxed lens implant.ConclusionsAnterior retinal breaks and temporal RD are common in retinal detachment secondary to AD. PVR is often present, which makes surgical management difficult. Cataract formation is quite often and late subluxation of IOL may occur.
目的
本研究旨在报告一系列眼部并发症,包括特应性皮炎(AD)患者的视网膜脱离(RD)和白内障,以及涉及大多数白种人的手术治疗情况。
患者与方法
本研究为观察性病例系列,最初设计为一项审计。它涉及对因严重AD继发视网膜脱离和白内障的患者的病史、临床特征及手术治疗进行详细讨论。本研究纳入了连续6例诊断为严重AD且需要进行后段及白内障手术的患者。
结果
6例患者的8只眼发生视网膜脱离。其中大多数累及颞侧视网膜。视网膜裂孔位于6只眼前部靠近锯齿缘处,2只眼发现巨大视网膜裂孔(GRT)脱离。5只眼在就诊时存在增生性玻璃体视网膜病变(PVR)。所有6例患者均有双侧白内障,11只眼进行了白内障手术。2例患者必须进行双侧同时手术。3只眼因晶状体半脱位植入人工晶状体(IOL)并进行了玻璃体切除联合前段玻璃体切除术。
结论
AD继发视网膜脱离中,前部视网膜裂孔和颞侧RD较为常见。常出现PVR,这使得手术治疗困难。白内障形成较为常见,IOL后期可能发生半脱位。