Association of Atopic Dermatitis with Retinal Detachment and Postoperative Proliferative Vitreoretinopathy Risk

To evaluate the association between atopic dermatitis (AD) and risk of retinal detachment (RD), postoperative proliferative vitreoretinopathy (PVR), and complex RD repair after initial RD repair.

Retrospective, population-based cohort study.

Adults aged ≥18 years with and without a diagnosis of AD identified from March 2006 to March 2026.

This retrospective cohort study used data from a federated health research network containing aggregated, deidentified electronic health records from 72 US health care organizations. Patients with AD, identified by International Classification of Diseases, 10th revision codes, were matched 1:1 to controls without documented AD using propensity scores, balancing for demographic characteristics, ocular comorbidities, tobacco use, and systemic corticosteroid exposure. Two analyses were performed: (1) risk of RD diagnosis and RD repair after initial AD diagnosis or outpatient clinic visit; and (2) risk of postoperative PVR and complex RD repair after initial RD repair.

Outcomes for the first analysis included rates of RD repair and RD diagnosis at 1 and 5 years after the index event. Outcomes in the second analysis included rates of PVR (International Classification of Diseases, 10th revision: H35.2) and complex RD repair (Current Procedural Terminology: 67113) within a 180-day period of initial RD repair.

A total of 285 408 subjects with a history of AD and 2 856 666 without a history of AD were identified, with 274 547 remaining in each cohort after matching. At 5 years, compared with controls, patients with AD demonstrated increased rates of RD diagnosis (0.7% vs. 0.2%; hazard ratio [HR] 2.74; 95% confidence interval [CI], 2.50-3.00; P < 0.0001) and RD repair (0.2% vs. 0.04%; HR, 4.56; 95% CI, 3.76-5.57; P < 0.0001). In the RD repair cohort (n = 1689 per cohort), AD was associated with increased risk of PVR diagnosis (5.9% vs. 4.0%; HR, 1.45; 95% CI, 1.12-1.87; P = 0.002) and complex RD repair (8.9% vs. 6.6%; HR, 1.36; 95% CI, 1.10-1.62; P = 0.002) at 6 months.

A history of AD is associated with a greater risk of RD and postoperative PVR; however, electronic health record data cannot confirm if PVR occurred in the operative eye. These findings suggest that patients with AD may warrant heightened vigilance for RD symptoms and closer postoperative monitoring after RD repair.

Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.