Ocular symptoms are not predictive of ophthalmologic inflammation in inflammatory bowel disease

Cloché, Véronique; Buisson, Anthony; Tréchot, F; Batta, B; Locatelli, A.; Favel, Constance; Premy, Shanour; Collet-Fenêtrier, Benjamin; Fréling, E.; Lopez, Anthony; Massoure, Marie Pauline; Humbert, Anne-Laure; Hansmannel, Franck; Guéant, Jean‐Louis; Bigard, Marc‐André; Peyrin–Biroulet, Laurent; Angioï, K.

doi:10.1016/j.dld.2012.10.013

Cited by 18 publications

(14 citation statements)

References 35 publications

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“…Cloché et al[ 59 ] evaluated 74 of 305 IBD patients with ophthalmological symptoms. Only one patient presented with scleritis and they concluded that ocular symptoms were neither specific nor associated with ocular inflammation.…”

Section: Ocular Involvementmentioning

confidence: 99%

Ophthalmic manifestations in patients with inflammatory bowel disease: A review

Troncoso

Biancardi

Moraes

et al. 2017

WJG

112

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Clinical manifestations of inflammatory bowel disease (IBD) are not locally restricted to the gastrointestinal tract, and a significant portion of patients have involvement of other organs and systems. The visual system is one of the most frequently affected, mainly by inflammatory disorders such as episcleritis, uveitis and scleritis. A critical review of available literature concerning ocular involvement in IBD, as it appears in PubMed, was performed. Episcleritis, the most common ocular extraintestinal manifestation (EIM), seems to be more associated with IBD activity when compared with other ocular EIMs. In IBD patients, anterior uveitis has an insidious onset, it is longstanding and bilateral, and not related to the intestinal disease activity. Systemic steroids or immunosuppressants may be necessary in severe ocular inflammation cases, and control of the underlying bowel disease is important to prevent recurrence. Our review revealed that ocular involvement is more prevalent in Crohn’s disease than ulcerative colitis, in active IBD, mainly in the presence of other EIMs. The ophthalmic symptoms in IBD are mainly non-specific and their relevance may not be recognized by the clinician; most ophthalmic manifestations are treatable, and resolve without sequel upon prompt treatment. A collaborative clinical care team for management of IBD that includes ophthalmologists is central for improvement of quality care for these patients, and it is also cost-effective.

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Section: Ocular Involvementmentioning

confidence: 99%

Ophthalmic manifestations in patients with inflammatory bowel disease: A review

Troncoso

Biancardi

Moraes

et al. 2017

WJG

112

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“…Cloche at al. reported that low rate ocular inflammation may have a role ocular symptoms of IBD in a large cohort study (14). Önal at al.…”

Section: Discussionmentioning

confidence: 95%

Effect of the Inflammatory Bowel Diseases on Choroidal and Macular Thickness

Akay

Genç

2018

SDÜ Tıp Fakültesi Dergisi

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Amaç: Crohn hastalığı (CD) ve ülseratif kolit (ÜK) bir grup inflamatuar barsak hastalığıdır (IBD) .IBD'de oftalmik bozukluklar ortaya çıkabilir. En sık görülen bulgular episklerit ve üveittir. Çalışmanın amacı IBD'deki koroidal ve maküla kalınlığını (MT ve CT) değerlendirmek ve bunu hastalık aktivitesi ile kontrol etmektir. Yöntem: IBD grubu 50 hastanın 50 sağ gözünü içeriyorken, kontrol grubu ise 50 sağlıklı gönüllünün herhangi bir gözünden oluşmuştu. Tüm katılımcılar spectral domain optical coherence tomography (SD-OCT) ile test edildi. CT değerleri yedi farklı noktada elde edildi. Bulgular: IBD'nin ortalama süresi 3.9 ± 1.5 yıl idi. Foveal maküler kalınlık; çalışma grubunda 258.1 ± 14.2 µm, kontrol grubunda 262.7 ± 20.9 µm idi. Gruplar arasında anlamlı fark yoktu (P = 0,19). Subfoveal, temporal 500 µm, 1000 µm ve 1500 µm CT ölçümleri, çalışma grubunda sırasıyla istatistiksel olarak anlamlıydı (p <0.001). Çalışma grubunda ortalama BT 289.8 ± 25.6 µm, kontrol grubunda 273.9 ± 33.2 µm idi. Gruplar arasında anlamlı fark vardı (P = 0.008). Ortalama BT ve eritrosit sedimentasyon hızı, C-reaktif protein düzeyi ve diğer klinik parametreler arasında korelasyon yoktu (P = 0,05). Sonuç: Bağırsak iltihabı, koroidal vasküler yapıyı etkileyebilir.

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“…Posterior scleritis has also been described associated with choroidal infiltrates and retinal detachment [15]. However, Cloché et al [4] reported that up to 30% of the IBD patients showed posterior segment complications.…”

Section: Posterior Segment Complicationsmentioning

confidence: 99%

“…The prevalence of dry eye has been reported in up to 40% of IBD patients [4,19]. The etiology of the high prevalence of dry eye symptoms in this population is unclear.…”

Section: Treatment-related Pathologiesmentioning

confidence: 99%

“…Recently, Cloché et al [4] published the largest study (n = 305) investigating the frequency and type of ocular symptoms among IBD patients. In this cohort, 32% patients reported at least one ocular symptom: ocular irritation (56.8%), red eye (40.5%), blurred vision (37.8%), ocular pain (31.1%), progressive visual loss (34.4%), myodesopsia (23.3%), eyelid secretion (12.2%), dry eye (9.5%), watering (6.8%), diplopia (5.4%), metamorphopsia (4%) and sudden visual loss (4%).…”

Section: Clinical Featuresmentioning

confidence: 99%

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Managing IBD Outside the Gut: Ocular Manifestations

Calvo

Júlvez

2013

Dig Dis

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Extraintestinal manifestations are common in inflammatory bowel disease (IBD), being reported in over 25% of patients. Ocular complications of IBD occur in around 10% of cases, but may precede systemic symptoms and are usually nonspecific. Complications of therapy, such as cataracts or glaucoma from steroid use or keratoconjunctivitis sicca related to 5-aminosalicylic acid medications, may also involve the eyes. The pathogenesis remains unclear, but factors such as the extent of intestinal disease, disease activity, and the presence of associated arthritis have been associated with ocular involvement. Conjunctivitis, episcleritis, scleritis and uveitis are by far the most common ophthalmic complications of IBD. However, posterior uveitis, intraretinal hemorrhages, vasculitis, choroiditis, optic neuropathy, and vaso-occlusive phenomena may also occur. The most frequent severe ocular manifestation is anterior uveitis (more common in women). It usually presents as a mild anterior nongranulomatous uveitis (60% of the cases). The inflammation in the eye and the inflammation in the gut are rarely correlated. Patients with uveitis, scleritis, and other anterior segment inflammation usually respond to steroids (topical, periocular or systemic). If the inflammation is resistant to steroids, or if appreciable steroid adverse effects are encountered, systemic immunosuppressive treatment should be considered; this is more likely in HLA-B27-positive patients with uveitis. Evaluation of the eye should be a routine component in the care of patients with IBD.

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Ocular symptoms are not predictive of ophthalmologic inflammation in inflammatory bowel disease

Abstract: Ocular symptoms are frequent in inflammatory bowel disease, but are non-specific and rarely associated with ocular inflammation. Systematic ocular symptoms assessment is of poor value for diagnosing ocular inflammation in inflammatory bowel disease.

Cited by 18 publications

References 35 publications

Ophthalmic manifestations in patients with inflammatory bowel disease: A review

Ophthalmic manifestations in patients with inflammatory bowel disease: A review

Effect of the Inflammatory Bowel Diseases on Choroidal and Macular Thickness

Managing IBD Outside the Gut: Ocular Manifestations

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