Case Report: Clinical manifestations of retinal detachment in patients with atopic dermatitis: two cases and potential immunopathogenic mechanism.

Background: Retinal detachment (RD) represents a sight-threatening ocular sequela among individuals affected by atopic dermatitis (AD). Chronic habitual eye rubbing may impair the structural stability of the ocular tissues. Here, we report two patients with AD-associated RD, emphasizing both surgical characteristics and potential immune-mediated mechanisms. Methods: Two cases of AD-associated RD were included. For each one, the clinical picture, intraoperative findings, and potential immune pathway hypotheses were taken into account. Results: Our first patient was a 15-year-old boy with a history of toric intraocular lens implantation who initially presented with elevated intraocular pressure and vitreous hemorrhage, later developing RD characterized by retinal dialysis, retinal tear, and ciliary epithelium detachment. Patient two was a man of 43, in whom RD coexisted with posterior subcapsular cataract as well as astigmatism. Severe systemic AD was present in both, and both had a long history of rubbing their eyes. Each underwent vitrectomy with internal tamponade. In one of them, recurrence ensued because of proliferative vitreoretinopathy. Conclusion: This series illustrates the typical features and surgical challenges of RD in AD, which arise from chronic eye rubbing-induced mechanical damage and astigmatism. Timely ophthalmic evaluation and systemic AD control aid visual preservation. Our findings propose a preliminary hypothesis of interactive immune and mechanical mechanisms underlying AD-associated RD, which warrants further experimental validation.