Ophthalmic manifestations in patients with inflammatory bowel disease: A review

Abstract

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.

Corneal Manifestations of Inflammatory Bowel Disease

“…17 Troncoso et al reported some diverse corneal manifestations of IBD in a review paper. 18 Corneal impairments can occur in diverse corneal layers: epithelial, deep stromal, or endothelial, [19][20][21][22][23][24][25][26] but it is important to remember that some corneal findings are rather unusual and that there are cases associated with other inflammatory disorders. Diverse diagnostic tools : flattest meridian; K2: steepest meridian; K m : mean corneal power; R min : minimum radius of the cornea; ACA: anterior chamber; K max : maximal keratometry; CV: corneal volume; ACV: anterior chamber volume; ACD: anterior chamber depth; ACA: anterior chamber angle width; D: diopter Seminars in Ophthalmology 547 have already been used to examine corneal impairments related to IBD, such as videokeratography 27 or confocal microscopy 28 ; nevertheless, detailed corneal and anterior segment parameters have not been investigated thus far.…”

Inflammatory eye and rheumatic disease

“…As so many of the uveitides have systemic associations, a multidisciplinary approach to care improves the coordination of pretreatment evaluation, treatment and decreases the required number of appointments, allowing management decisions in relation to both the ophthalmic and systemic disease to be made early in the course of the disease …”

Zaćma posteroidowa – polekowe uszkodzenie narządu wzroku, na które warto zwrócić uwagę w terapii nieswoistych chorób zapalnych jelit

“…Objawy ze strony narządu wzroku w NZJ przyjmują postać zapalenia tęczówki, spojówki, twardówki, nadtwardówki czy naczyniówki [10][11][12][13]. Z drugiej strony, z racji tego, że GKS są jednymi z najważniejszych leków stosowanych w leczeniu NZJ, objawy oczne takie jak zaćma czy jaskra mogą przebiegać wtórnie i tym samym być powikłaniem sterydoterapii [14].…”