Ocular manifestations of children with atopic dermatitis in Saudi Arabia.

AIM: To examine the incidence of ocular abnormalities in children with atopic dermatitis (AD) in Saudi Arabia and its association with the severity of AD. METHODS: This is a cross-sectional study on 50 children with AD who were between 5 and 16 years of age. The severity of AD was evaluated using the SCORing Atopic Dermatitis (SCORAD) index. All the children underwent slit lamp exams, visual acuity assessment, intraocular pressure measurement, and corneal topography. The children were considered to have an ophthalmic abnormality if one or more of the following signs were present: glaucoma, keratoconus suspicion, in addition to lid, conjunctival, corneal, lenticular, or retinal abnormalities. RESULTS: Based on the SCORAD severity index, 14% of children had mild AD (7/50), 38% had moderate AD (19/50), and nearly half had severe AD. More than half the children exhibited facial involvement, and half had peri-orbital signs. The mean SCORAD index was 35.75. The mean age was 10.48±3.6y, and the cohort showed a slight male predominance (54% males). Both eyes of the 50 children in the cohort were studied. Based on the ocular examinations, 92% of the patients showed ocular abnormalities: lid abnormalities (27/50) followed by keratitis (22/50). Four patients had moderate risk for keratoconus in one eye and eight patients were suspected to have keratoconus. However, SCORAD severity index was not associated with age, sex, or the number or presence of ophthalmic abnormalities. CONCLUSION: This is the first study in Saudi Arabia to evaluate the prevalence of ocular manifestations in children with AD. The results indicate that the majority of children with AD have ocular abnormalities that mainly include lid abnormalities. Based on these findings, larger scale studies are needed to affirm whether regular screening for ophthalmic abnormalities would be beneficial for children with AD in terms of early intervention and prevention of sight-threatening complications.

Idiopathic choroidal neovascular membrane in a young female.

A case of idiopathic choroidal neovascular membrane (CNVM) is described in a 17-year-old female patient. On initial examination her vision was counting fingers at one meter in the left eye (OS) and Fluorescein angiography showed a well-defined hyperfluorescent area corresponding to the CNVM. Intravitreal bevacizumab was injected into OS, and at a five-week follow-up visit, visual acuity improved to 20/100 OS. This case is unusual, in that the CNVM developed in a young lady with no significant past medical history and with the absence of a choroidal or retinal pigment epithelial disease process that may be associated with a CNVM.