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

Abstract

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.

Inflammatory bowel disease and the associated risk of dry eye and ocular surface injury: a nationwide matched cohort study

“…Although ocular involvement is not uncommon among patients with IBD, few studies have evaluated the long-term temporal relationship between IBD, dry eye, and corneal damage. Most previous studies restricted their study population to single-hospital settings with small patient samples [ 15 – 17 ]. In a single-center prospective study, Czompa et al .…”

“…reported that patients with IBD had higher rates of dry eye and thin cornea with reduced tear quantity compared with non-IBD controls [ 15 ]. However, the relationship between IBD and DED remains unclear due to multiple methodological drawbacks of preceding studies, including small patient sample (< 1000 IBD subjects) [ 15 , 16 ], single-institution settings [ 15 – 17 ], and inadequate adjustment for confounding [ 15 – 17 ]. Importantly, the long-term risk and epidemiological statistics of ocular surface damage in IBD have not been estimated in previous studies.…”

“…In a nationwide matched cohort study, we aimed to examine the association between IBD, DED, and corneal surface damage using the administrative data from Taiwan's National Health Insurance (NHI) research database. Based on existing evidence [ 14 – 17 ], we hypothesized that IBD was significantly associated with more DED and corneal surface damage compared with non-IBD people.…”

Manifestations of Ocular Autoimmune Diseases - Literature Review

“…Ocular manifestations constitute the third, after rheumatological and dermatological, extraintestinal symptoms of CD and UC. [3] Eyeball involvement is observed in 12-35% of patients with ulcerative colitis and 25-70% of patients treated for Crohn's disease. [14] The first report on ocular manifestations in IBD was published by Crohn in 1925 and mentioned patients who were likely to have keratomalacia and xerophthalmia.…”

A Review of Ophthalmic Complications in Inflammatory Bowel Diseases

“…Episcleritis, the most common eye complication associated with IBD, is an index of the disease activity [26,33,34]. This self-limiting condition more commonly affects women.…”