Bilateral total cataract as the presenting feature of celiac disease

Evaluation of Retinal Microvascular Perfusion Changes in Patients with Celiac Disease

PURPOSE

We aimed to determine whether there are retinal microvascular changes in patients with celiac disease (CD).

METHODS

A total of 30 patients with CD (group 1) and 30 healthy controls (group 2) were included in this study. AngioVue optical coherence tomography angiography (OCTA) device was used to evaluate the retinal microvascular structure.

RESULTS

Some of the values of both optic nerve head (ONH) vessel density (VD) and radial peripapillary capillary VDs were found to be significantly lower in group 1 than in group 2. These 2 groups were similar except for one of the parameters of superficial capillary plexus VD (SCP-VD), whereas it was found that deep capillary plexus VD (DCP-VD) was lower in group 1 than in group 2 except for the foveal area.

CONCLUSION

It was determined that some VDs obtained from the ONH and DCP-VD obtained from most areas of the macular region were significantly lower.

Ocular manifestations in celiac disease: an overview

PURPOSE

To review and highlight the ocular manifestations associated with celiac disease (CD) and presentation of their pathogenetic mechanisms.

METHODS

A thorough review of the literature was performed using PubMed to identify articles about serrated polyposis syndrome. The search was performed using the search string: ("celiac disease" OR "coeliac disease") AND ("ocular manifestations" OR "eye" OR "orbitopathy" OR "uveitis" OR "neuro-ophthalmic manifestations"). Only articles in English were reviewed.

RESULTS

Several ocular symptoms and disorders have been associated with CD and are a result of defective intestinal absorption and immunological mechanisms. These include nyctalopia, dry eye, cataract, thyroid-associated orbitopathy, uveitis, central retinal vein occlusion and neuro-ophthalmic manifestations. In addition, CD-related ocular disease may represent the first manifestation of CD.

CONCLUSION

CD may hold accountable for the development of ocular diseases of obscure etiology.

Local ocular surface parameters in patients with systemic celiac disease

PurposeThis was a collaborative study from the Ophthalmology and Gastroenterology departments of a tertiary care hospital, designed to investigate the local ocular surface parameters in patients with celiac disease (CD).MethodsFifty-six eyes of 28 patients with CD and 58 eyes of 29 healthy adult subjects serving as controls were evaluated. The Schirmer test, tear-film break-up time, and conjunctival impression cytology were performed in addition to a complete ophthalmological examination. Impression cytology specimens of each group were graded and scored in the range 0-3.ResultsThe 28 patients with CD consisted of 24 females (86%) and 4 males (14%). The mean age was 34.4±11.3 years (22-55 years). Tear-film break-up time and Schirmer test results were significantly lower in the study group than in the controls (P<0.05). Also, there was a significant difference between the groups for impression cytology grading scores (P=0.001).ConclusionsThe CD group showed a marked preponderance of females with an F/M ratio of six females per male, as reported in the literature. Tear-film functions and conjunctival surface epithelial morphology were significantly altered in patients with CD.

The eyes of children with celiac disease

PURPOSE

To determine possible eye involvement in pediatric patients with celiac disease.

METHODS

Children (aged 5-18 years) with classic celiac disease and sex- and age-matched controls were included. In addition to a complete ophthalmologic examination, all patients were scanned by a Scheimpflug camera and spectral domain optical coherence tomography, and Schirmer and break-up time (BUT) tests were performed. Data were evaluated by paired t test, with a P value of <0.05 considered statistically significant.

RESULTS

A total of 31 celiac patients (19 females [61%]) and 34 controls (20 females [59%]) were included. Mean age of the celiac patients was 11.0 ± 4.4 years (range, 4-18 years); of the controls, 10.4 ± 2.6 years (range, 5-15 years; P = 0.473). Mean follow-up of patients was 5.4 ± 1.7 years (range, 3-7.2 years). The eyes of children with celiac disease, compared to controls, did show decreased anterior chamber depth (3.5 ± 0.2 vs 3.7 ± 0.2, resp.; P < 0.001), decreased anterior chamber volume (170.8 ± 25.5 vs 190.7 ± 27.4; P < 0.001), lower Schirmer (17.9 ± 9.1 vs 21.6 ± 4.1; P = 0.038), and lower BUT (10.8 ± 3.8 vs 12.1 ± 1.7; P = 0.046), as well as lower retinal nerve fiber layer (general 102.8 ± 8.2 vs 108.9 ± 10.1; P < 0.001).

CONCLUSIONS

Decreases in retinal nerve fiber, anterior chamber shallowing, and qualitative and quantitative reduction in tears can occur in celiac patients, even if routine ocular examination reveals no abnormality.

Eye Disorders in Children with Celiac Disease

Purpose

To determine the prevalence of eye disorders in children with celiac disease (CD).

Methods

A total of 67 patients with CD aged from 1 to 16 years and 38 age- and sex-matched healthy children were screened for decreased visual acuity, cataract, uveitis, and diabetic retinopathy at diagnosis and during follow‐up.

Results

None of the patients had eye disorders at diagnosis. Only 2 of the patients had accommodative dysfunction and the others had no change in visual function during the follow-up. One of the controls had accommodative dysfunction.

Conclusions

No significant association was found between CD and eye disorders such as visual acuity, cataract, and uveitis among children.