Posters

Atopic dermatitis and cataracts in adulthood: case report

Poster Details

First Author: C.Oliveira-Ferreira PORTUGAL

Co Author(s):    S. Perestrelo   J. Tavares-Ferreira   J. Macedo   F. Falcao-Reis           

Abstract Details

Purpose:

Atopic dermatitis (AD) is a chronic, pruritic, eczematous skin disease mediated through an immediate (type I) hypersensitivity reaction. Ocular sequelae are commonly seen in AD and include subcapsular cataracts, herpes simplex, conjunctivitis, keratoconus, and retinal detachment. The incidence for cataract development in patients with AD has been reported from 5% to 38%. The mechanism of posterior and anterior subcapsular cataracts is not known, however, habitual rubbing of the face in pruritic conditions may play a role, and patients with AD have higher levels of protein flare in the aqueous humor.

Setting:

Centro Hospitalar São João, Porto, Portugal

Methods:

We describe a 21-year-old African Portuguese boy, with no ocular history, but with severe AD which was diagnosed at age 3 months, that required regular hydrocortisone 1% cream to control his symptoms on his arms and face.

Results:

He presented to the Ophthalmology Urgency Service with 1-year history of progressive blurring of vision in the right and left eye. On ophthalmologic examination, visual acuity was 0.5 (with best correction), in both eyes. On slit-lamp, we observed anterior subcapsular cataracts in both eyes. Fundoscopic examination was normal. Additionally, face and arms skin showed a severe AD. He denied history of inhaler or oral medication (like steroids). In blood tests, there were no endocrine disorders and biochemical abnormalities (serum levels of glucose, calcium, phosphorus, copper, and thyroid hormones). In two months, the cataracts had a severe progression to Morgagnian cataracts.

Conclusions:

Atopic dermatitis alone is a risk factor to develop both Posterior (PSCs) and anterior (ASCs) subcapsular cataracts. ASC are more specific to AD, but PSCs are more common. The incidence of cataract in AD corticosteroid-naive patients was no different when compared with the patients with a history of topical use. This strongly implies that the incidence of subcapsular cataracts formation in patients with AD cannot be explained by the use of corticosteroids alone.

Financial Disclosure:

None