Comprehensive Ophthalmological Evaluation in Atopic Dermatitis

• Published in: Dermatology (Basel) Vol. 240; no. 3; p. 434
• Main Authors: Valeille, Anaïs, Ouilhon, Coralie, Subtil, Fabien, Hacard, Florence, Jaulent, Coline, Bérard, Fréderic, Nicolas, Jean-François, Fauquert, Jean-Luc, Nosbaum, Audrey
• Format: Journal Article
• Language: English
• Published: Switzerland 01.06.2024
• Subjects: Adolescent; Adult; Aged; Blepharitis - epidemiology; Blepharitis - etiology; Conjunctivitis, Allergic - complications; Conjunctivitis, Allergic - epidemiology; Dermatitis, Atopic - complications; Dermatitis, Atopic - epidemiology; Dry Eye Syndromes - diagnosis; Dry Eye Syndromes - epidemiology; Dry Eye Syndromes - etiology; Eye Diseases - epidemiology; Eye Diseases - etiology; Female; Humans; Male; Middle Aged; Prevalence; Retrospective Studies; Risk Factors; Young Adult; Referral criteria; Prevalence; Atopic dermatitis; Ocular diseases; Risk factors
• ISSN: 1421-9832
• DOI: 10.1159/000536233

Atopic dermatitis (AD), a chronic type 2 inflammatory skin disease, is frequently associated with ocular surface diseases (OSD) which may appear or worsen under anti-type 2-targeted treatments. However, the exact prevalence of OSD and the ophthalmology referral criteria remain ill-defined in AD patients before initiating such biotherapies. We aimed to characterize the prevalence, the nature and the factors related to OSD development in AD that may justify an ophthalmological management. A total of 98 consecutive AD inpatients without biological treatment were retrospectively included. These were systematically evaluated by an ophthalmologist during their dermatological care. Clinical and laboratory data were analysed to characterize OSD and their risk factors. OSD were found in 83/98 AD patients (85%); mainly dry eye syndrome (64%, 63/98), allergic conjunctivitis (42%, 41/98), posterior (33%, 32/98), and anterior blepharitis (27%, 26/98). In AD patients without ocular symptoms, OSDs were also frequently found (63%, 12/19) and were mostly mild. Risk factors for OSD were history of allergic rhinitis, allergic sensitization, head and neck AD, ocular symptoms (foreign body sensation in the eye, burning, itching, photophobia), and total IgE level >3,000 kU/L. The prevalence of OSD was high, even in asymptomatic patients. The risk factors identified may indicate the need for ophthalmological examination for therapeutic management, especially when biological agents targeting type 2 inflammation are considered.