Evaluation of Objective Signs and Subjective Symptoms of Dry Eye Disease in Patients with Inflammatory Bowel Disease

Barta, Zsolt; Czompa, Levente; Rentka, Anikó; Zöld, Éva; Remenyik, Judit; Bíró, Attila; Gesztelyi, Rudolf; Zsuga, Judit; Szodoray, Péter; Kemény-Beke, Ádám

doi:10.1155/2019/8310583

Cited by 10 publications

(9 citation statements)

References 35 publications

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“…A large number of our patients suffering of dry eye did not require a consultation at the university hospital and had been treated elsewhere (private ophthalmologist, general practitioner, non-prescription medication). Although frequent in the general population (3.8% to 93% [ 28 , 29 ]), dry eye may be directly related to digestive disease (systemic inflammation inducing hypo secretion [ 7 ], hypovitaminosis A [ 11 ] or iatrogenic with salicylates [ 30 , 31 ]. Contradictory data exists in the literature regarding anti-TNF use and dry eye [ 32 , 33 ].…”

Section: Discussionmentioning

confidence: 99%

Ocular Manifestations in Patients with Inflammatory Bowel Disease in the Biologics Era

Cuny

Guillo

Baumann³

et al. 2022

JCM

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Background: Extra-intestinal manifestations are frequent in inflammatory bowel disease (IBD). Ocular disorders are generally under diagnosed as they are challenging diagnosis. Aims: We assessed the prevalence of ophthalmological manifestations in patients with IBD, and investigated characteristics associated with ocular manifestations. Methods: We performed a retrospective study including patients followed for IBD and had an ophthalmologic visit from January 2013 to July 2020, among 1432 patients followed during this period. Two groups were considered: the first group included patients whose an ocular diagnosis was considered as “related to IBD”, and the second group including patients whose an ocular diagnosis was considered “not related to IBD”. Results: Among 1432 patients with IBD, eighty-seven (6.1%) patients had an ophthalmologic visit. Fifty-three patients (3.7%) were considered to have an ocular extra-intestinal manifestation or an iatrogenic effect of IBD treatment, and 34 diagnoses (2.4%) were considered not related to IBD. Inflammatory surface pathologies were the most frequent (33.2%), including 15 patients with dry eye (17.2%), 9 with blepharitis (10.3%), and 5 with chalazions (meibomian cyst) (5.7%). Uveitis was diagnosed in 13 patients (14.9%), episcleritis in 5 patients (5.7%), and scleritis in 2 patients (2.3%). Characteristics of patients with an ophthalmological diagnosis “related to IBD” versus “not related to IBD” were not statistically different. Conclusion: In our cohort, less than 5% of patients had ophthalmological extra-intestinal manifestation. The most frequent ocular diagnosis were dry eye and uveitis. No disease characteristics of IBD were found to be associated with ocular manifestations.

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Section: Discussionmentioning

confidence: 99%

Ocular Manifestations in Patients with Inflammatory Bowel Disease in the Biologics Era

Cuny

Guillo

Baumann³

et al. 2022

JCM

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“…Although not considered to be an extraintestinal manifestation of IBD, conjunctivitis and dry eye was the most frequently reported ophthalmologic condition in our patient cohort, and Sjögren's syndrome was also diagnosed in seven patients total: four with Crohn's disease and three with ulcerative colitis. Insufficient lacrimation is also recognized in IBD (DED-"dry eye disease"-dysfunction of the lacrimal glands), thereby not every case with reduced tear production qualifies as Sjögren's syndrome [42,43]. Moreover, Sjögren's syndrome can be associated with joint complaints and pancreatitis [44,45].…”

Section: Discussionmentioning

confidence: 99%

Temporal Relationship of Extraintestinal Manifestations in Inflammatory Bowel Disease

Fedor

Zöld

Barta

2021

JCM

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Objectives: Thus far, few attempted to characterize the temporal onset of extraintestinal manifestations (EIM) in inflammatory bowel diseases (IBD). We sought to determine the time of onset of these findings in a patient cohort with IBD. Methods: We reviewed the electronic health records of 508 IBD patients (303 CD, 205 UC) and summarized general patient characteristics and the temporal relationship and order of presentation of extraintestinal manifestations. Results: CD patients were younger at diagnosis. CD patients with ileocolonic involvement (L3) were younger, and UC patients with pancolitis (E3) were slightly younger at diagnosis. A total of 127 out of 303 (41.91%) CD and 81 out of 205 (39.51%) UC patients had EIMs (p = 0.5898). Some patients presented with EIMs before the diagnosis of IBD (9.45% of Crohn’s disease and 17.28% of ulcerative colitis patients with EIMs, respectively). Of these, seven cases (four in CD and three in UC) were visible by inspection of the patients (either dermatologic or ocular findings). The diagnosis of IBD and extraintestinal symptoms often occurred within a year (22.83% of CD and 16.04% of UC patients). Typically, the diagnosis of the first extraintestinal symptoms happened after the onset of bowel disease (+4.3 (±6.3) years, range: 10 years before to 30 years after in Crohn’s disease and +3.8 (±10) years, range: 24 years before to 30 years after) in ulcerative colitis. UC patients with pancolitis (E3) usually had EIMs earlier in the disease course and displayed EIMs more frequently before IBD diagnosis. Furthermore, patients with pancolitis developed EIMs more frequently than other sub-groups. Conclusion: Extraintestinal manifestations in inflammatory bowel diseases can present at any time, relative to the bowel symptoms. In cases, the presence of a characteristic EIM might be a harbinger of the development of IBD.

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“… 6 DED symptoms can be particularly heterogeneous in patients with immune-mediated diseases, such as inflammatory bowel disease or Sjogren’s syndrome, and the correlation between subjective and objective parameters for DED is not always clear. 7 , 8 The risk of DED increases with age and disproportionately affects women, with some studies finding the prevalence of DED to be two times higher in women compared to men. 2 , 4 Other risk factors associated with DED development include select autoimmune diseases, certain medications (eg, anti-histamines, diuretics, etc), frequent use of electronic devices, and wearing contact lenses.…”

Section: Introductionmentioning

confidence: 99%

“… 10 DED is associated with a 30% impairment in workplace performance and work productivity. 7 Along with DED affecting QoL and work productivity, the average annual direct cost of DED on the US healthcare system is estimated at $3.8 billion. 4 , 10 Therefore, understanding and treating DED properly and timely are of utmost importance to address the needs of all relevant stakeholders, including patients, physicians, the governments, and more broadly the healthcare systems.…”

Section: Introductionmentioning

confidence: 99%

Real-World Experience with Lifitegrast Ophthalmic Solution (Xiidra®) in the US and Canada: Retrospective Study of Patient Characteristics, Treatment Patterns, and Clinical Effectiveness in 600 Patients with Dry Eye Disease

Hovanesian¹,

Nichols²,

Jackson³

et al. 2021

OPTH

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Purpose This study evaluated real-world treatment of dry eye disease (DED) with lifitegrast. Patients and Methods Ophthalmologists and optometrists treating patients with DED were invited to participate through a healthcare provider (HCP)-based panel. HCPs completed a provider survey and contributed data toward a chart review for up to five qualifying patients with DED who initiated lifitegrast ophthalmic solution (index date) between 01/01/2017 (US) or 01/01/2018 (Canada) and 06/30/2019. Patient demographics, treatments, clinical characteristics, and outcomes (ie, severity, signs, symptoms) were collected for the 6-month pre-index period and up to 12-months post-index. Results For this study, 517 HCPs contributed 600 patient charts. Among 554 and 281 patients with follow-up at 6 and 12-months post-index, 512 (92.4%) and 238 (84.7%) patients had ongoing lifitegrast treatment, respectively. Other DED-related treatments were less frequently used post-index with lifitegrast vs pre-index: over-the-counter artificial tear use (45.2% vs 75.5%), topical corticosteroids (3.8% vs 18.8%), any cyclosporine (3.0% vs 20.5%). At 3-months (n=571) and 12-months (n=320) post-index vs pre-index, fewer patients had eye dryness (47 [8.2%] and 16 [5.0%] vs 525 [87.5%]), blurred vision (28 [4.9%] and 11 [3.4%] vs 346 [57.7%]), ocular burning/stinging (25 [4.4%] and 8 [2.5%] vs 336 [56.0%]), depression (8 [1.4%] and 9 [2.8%] vs 55 [9.2%]), fatigue (4 [0.7%] and 1 [0.3%] vs 82 [13.7%]), and headache (1 [0.2%] and 0 vs 19 [3.2%]). At 3 and 12-months post-index vs pre-index, average corneal staining score was numerically lower (2.7 and 2.0 vs 6.5), and average Schirmer score (10.6 and 10 vs 6.3) and tear film break-up time (7.3 and 8.0 vs 4.8) higher. Conclusion The majority of patients had ongoing lifitegrast treatment 6-months post-index with reduction in overall treatment burden. Improvement in DED signs and symptoms, including QoL impacts, was evident at 3 months and up to 12 months after lifitegrast initiation.

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Evaluation of Objective Signs and Subjective Symptoms of Dry Eye Disease in Patients with Inflammatory Bowel Disease

Cited by 10 publications

References 35 publications

Ocular Manifestations in Patients with Inflammatory Bowel Disease in the Biologics Era

Ocular Manifestations in Patients with Inflammatory Bowel Disease in the Biologics Era

Temporal Relationship of Extraintestinal Manifestations in Inflammatory Bowel Disease

Real-World Experience with Lifitegrast Ophthalmic Solution (Xiidra®) in the US and Canada: Retrospective Study of Patient Characteristics, Treatment Patterns, and Clinical Effectiveness in 600 Patients with Dry Eye Disease

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