ObjectiveTo observe the clinical characteristics and surgical outcomes in patients with retinal detachment associated with atopic dermatitis (AD-RD). MethodsA retrospective case series. From January 2015 to April 2023, 8 patients (12 eyes) with AD-RD at Zhongshan Ophthalmic Center of Sun Yat-sen University were included. All patients underwent best-corrected visual acuity (BCVA), ultra-wide-field fundus photography, B-mode ultrasound, ultrasound biomicroscopy (UBM), and wide-field optical coherence tomography (OCT). BCVA was examined by standard logarithmic visual acuity chart and was converted into logarithm of the minimum angle of resolution (logMAR) visual acuity for statistical purposes. In the primary surgery, 9 eyes underwent scleral buckling; 1 eye underwent pars plana vitrectomy (PPV) combined with silicone oil tamponade; 1 eye underwent PPV combined with C3F8 tamponade; 1 eye underwent C3F8 tamponade combined with retinal laser photocoagulation. The follow-up time was (29.1±40.9) months. BCVA before and after surgery was compared using paired t test. ResultsAmong the 8 patients, 6 were male and 2 were female. The mean age was (23.38±7.95) years old. Among them, 4 patients had bilateral affliction while the remaining 4 had unilateral involvement. The logMAR BCVA was 0.86±0.86. All 12 eyes were with a history of uveitis. Among 8 eyes with bilateral involvement, 6 of them were misdiagnosed as uveitis with exudative retinal detachment; 11 eyes had anterior uveitis at presentation; 9 eyes had a history of cataract, with 4 eyes having concurrent cataract and 5 eyes with intraocular lens. All affected eyes displayed as focal retinal detachment. UBM revealed ciliary epithelial detachment in 9 eyes, and no definite ciliary epithelial break was found in any case. Retinal breaks were observed in only 2 eyes in the pre-surgery retina examination, while ciliary epithelial holes were discovered in other 10 eyes during surgery. The retina was successfully reattached in 10 eyes after one surgery, including 9 eyes received scleral buckling. During the final follow-up, the logMAR BCVA of the affected eye improved significantly to 0.30±0.25 compared to pre-surgery values (t=2.43, P=0.03). ConclusionsAD-RD is a challenging complication of AD with a high rate of young onset, bilateral involvement, associated with concurrent cataracts, and shallow temporal retinal detachment associated with ciliary epithelial detachment. Scleral buckling is an effective treatment for AD-RD.
Tuberculosis caused by Mycobacterium tuberculosis is the leading infectious killer posing a major public health threat. The clinical manifestations of ocular tuberculosis are highly heterogeneous. Currently, the diagnosis of ocular tuberculosis still heavily relies on comprehensive clinical judgment and response to anti-tuberculosis therapy. Tuberculosis-specific T-cell detection quantifies the intensity of antigen-specific T-cell responses, providing indirect evidence for the diagnosis of tuberculosis infection. It has become a key auxiliary examination in the diagnosis and management of ocular tuberculosis but must be closely integrated with clinical manifestations and imaging features. A positive result suggests the involvement of a tuberculous immune response but cannot alone confirm a diagnosis of ocular tuberculosis. Future efforts should integrate T-SPOT.TB testing with other diagnostic tools, standardize diagnostic procedures, and explore the mechanisms linking T-cell subset functions with the intraocular immune microenvironment. Further elucidation of the relationship between T-cell responses and ocular tuberculosis phenotypes will help advance personalized treatment.