Corneal Manifestations of Inflammatory Bowel Disease

Abstract

Purpose: To evaluate detailed corneal parameters of inflammatory bowel disease (IBD) patients, including Crohn's disease (CD) and ulcerative colitis (UC) patients, and to assess associations between anterior segment values and other clinical variables. Methods: This prospective cross-sectional case-control study at a tertiary referral center included 30 CD patients, 36 UC patients and 80 age-and gender-matched controls with no ocular symptoms or ocular surface disorders. All study participants underwent a comprehensive ophthalmological evaluation with special interest in dry eye disease (DED). Corneal parameters were evaluated by Pentacam. Results: The mean age of CD patients, UC patients, and controls was 45.80 ± 11.55 years, 52.00 ± 16.05, and 50.68 ± 14.62, respectively. The average disease duration was 12.72 ± 5.83 years for CD patients and 15.94 ± 10.09 years for UC patients. All pachymetric (center, apex and thinnest) and corneal volume (CV) measurements were significantly decreased, while anterior chamber angle width (ACA) values were significantly increased on both sides in all IBD patients compared to those in controls (p < .05). In addition, several anterior segment parameters were altered unilaterally in CD or UC patients. Negative correlations were found between corneal parameters and Schirmer I test values. Conclusions: Our investigations suggest that IBD patients have thinner corneas compared to that of controls. The coexistence of reduced tear quantity seems to have an additional impact on the thinning of the cornea in IBD patients. Early recognition of corneal impairments, a possible extraintestinal manifestation of IBD, should be included in the disease checkup to reduce vision-threatening developments.

A Multimodal Eye Assessment in Psoriatic Arthritis Patients sine-Psoriasis: Evidence for a Potential Association with Systemic Inflammation

“…Moreover, a significant correlation resulted between inflammatory markers, OSDI, and the Schirmer test. These findings are consistent with the idea of multiorgan inflammatory involvement in PsA disease sine-PsO [8,31] as demonstrated in other chronic inflammatory disorders, such as PsO [8][9][10][11][12][13], diabetes mellitus [32,33], and thyreopathies [34]. In this context, the presence of dry eye might reflect the inflammatory status being an indicator of the systemic involvement in PsA [35].…”

“…As widely documented from both case-series studies and population-based studies, the presence of PsO is related to dry eye disease and its possible complications (as keratopathy) [10,11]. Dry-eye disease, in systemic inflammatory diseases, is associated with elevated levels of pro-inflammatory cytokines in tear film [12,13] Data concerning dry eye syndrome in PsA patients without PsO is lacking to date.…”

Lymphocytes in Dry Eye Disease

“…DED is the most common eye pathology because this disease can emerge as a primary phenotype; that is, a local immune response is generated and sustained in the ocular surface and draining lymph nodes [9]. DED is also found as a secondary phenotype, where both autoinflammatory (e.g., colitis) [10,11] and autoimmune diseases (Sjögren's syndrome, rheumatoid arthritis, and lupus) present DED symptoms [12][13][14]. The relevant finding that DED onset precedes autoimmune and non-autoimmune diseases in several patients is puzzling, and it has attracted interest from researchers worldwide, but the pathways remain to be elucidated.…”

Epidemiology of Ocular Manifestations in Autoimmune Disease

“…For example, there has been limited research into how the cornea is affected in IBD patients. Recent research, however, found Crohn’s disease patients who showed no symptoms of ocular involvement were observed to have reduced corneal thickness and reduced tear quantity ( 30 ).…”