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Varvarynets AV, Beliayev VD, Hechko MM, Kurakh AV. Ocular lesions in patients with ulcerative colitis. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2024; 77:445-449. [PMID: 38691785 DOI: 10.36740/wlek202403111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
OBJECTIVE Aim: To analyze the data and evaluate the prevalence of ocular lesions in patients with moderate ulcerative colitis. PATIENTS AND METHODS Materials and Methods: We observed 112 patients aged 18-75 years old with clinically, endoscopically and histologically confirmed moderate ulcerative colitis which lasted at least 6 months. An ophthalmologic exam was performed to determine the presence of ocular symptoms. RESULTS Results: Of the 112 patients with moderate ulcerative colitis, 21 (18,75%) had the following ocular lesions: episcleritis - 7 patients (6,25%), keratopathy - 5 patients (4,46%), uveitis - 5 patients (4,46%), cataract - 2 (1,78%) and scleritis - 2 (1.78%). CONCLUSION Conclusions: Because ocular symptoms in patients with UC are often nonspecific, it may be beneficial to perform ophthalmologic examinations as a routine follow-up component of in such patients.
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Ko YT, Wu YM, Wu HL, Lai SC, Dai YX, Chen TJ, Cherng YG, Tai YH, Kao CY. Inflammatory bowel disease and the associated risk of dry eye and ocular surface injury: a nationwide matched cohort study. BMC Ophthalmol 2023; 23:415. [PMID: 37833664 PMCID: PMC10576268 DOI: 10.1186/s12886-023-03165-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Accepted: 10/05/2023] [Indexed: 10/15/2023] Open
Abstract
BACKGROUND Inflammatory bowel disease (IBD) is associated with lacrimal gland dysfunction and ocular inflammation. The objective of this research was to elucidate the temporal relationships between IBD, dry eye disease (DED), and corneal surface damage. METHODS In a matched nationwide cohort study, we evaluated the risk of DED and corneal surface damage associated with IBD. Multivariable Cox proportional hazards regression analyses were implemented to estimate the risk of ocular complications. RESULTS A total of 54,293 matched pairs were included for analyses. The median follow-up time was 8.3 years (interquartile range: 5.5 - 10.5). The period incidence of DED was 8.18 and 5.42 per 1000 person-years in the IBD and non-IBD groups, respectively. After adjusting for confounders, statistically significant associations were found between IBD and DED [adjusted hazard ratio (aHR): 1.43, 95% confidence interval (CI): 1.35 - 1.51, p < 0.0001], Sjögren's syndrome-related (aHR: 1.67, 95% CI:1.46 - 1.90, p < 0.0001) and non-Sjögren's syndrome-related subtypes (aHR: 1.38, 95% CI: 1.30 - 1.46, p < 0.0001). Furthermore, increased risks of corneal surface damage (aHR: 1.13, 95% CI: 1.03 - 1.24, p = 0.0094) among the patients with IBD were observed when compared with the controls. Other independent factors associated with corneal surface damage were age (aHR: 1.003), sex (male vs. female, aHR: 0.85), and monthly insurance premium (501-800 vs. 0-500 U.S. dollars, aHR: 1.45; ≥ 801 vs. 0-500 U.S. dollars, aHR: 1.32). CONCLUSIONS Our results suggested that IBD was an independent risk factor for DED and ocular surface damage. Clinical strategies are needed to prevent visual impairment or losses in these susceptible patients.
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Affiliation(s)
- Yi-Ting Ko
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
| | - Yu-Ming Wu
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
| | - Hsiang-Ling Wu
- Department of Anesthesiology, Taipei Veterans General Hospital 11217, Taipei, Taiwan
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
| | - Shih-Chung Lai
- Department of Ophthalmology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan
- Department of Ophthalmology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
| | - Ying-Xiu Dai
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
- Department of Dermatology, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
| | - Tzeng-Ji Chen
- School of Medicine, National Yang Ming Chiao Tung University, Taipei, 11221, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, 11217, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, 31064, Taiwan
| | - Yih-Giun Cherng
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan
| | - Ying-Hsuan Tai
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan.
- Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, 11031, Taiwan.
| | - Chia-Yu Kao
- Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, 23561, Taiwan.
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Shah J, Shah A, Hassman L, Gutierrez A. Ocular Manifestations of Inflammatory Bowel Disease. Inflamm Bowel Dis 2021; 27:1832-1838. [PMID: 33501989 DOI: 10.1093/ibd/izaa359] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Indexed: 12/13/2022]
Abstract
Inflammatory bowel disease (IBD) is characterized by intestinal inflammation; however, it is also known to have extraintestinal manifestations. Ocular manifestations of IBD include keratopathy, episcleritis, scleritis, and uveitis and are among the most common extraintestinal manifestations. These diseases can lead to significant ocular morbidity if unrecognized and left untreated. A review of the literature was performed on PubMed and is summarized and critically appraised in this article with the aim being to describe the varying ocular manifestations of IBD and outlining their treatments. Ultimately, a framework is provided to investigate ocular symptoms in patients with IBD. An ocular review of systems is also provided as a tool to equip gastroenterologists and internal medicine physicians to be able to recognize and triage ocular complaints appropriately.
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Affiliation(s)
- Janaki Shah
- Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Aaditya Shah
- Department of Ophthalmology, Washington University in St. Louis, St. Louis, MO, USA
| | - Lynn Hassman
- Department of Ophthalmology, Washington University in St. Louis, St. Louis, MO, USA
| | - Alexandra Gutierrez
- Department of Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, USA
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Czompa L, Barta Z, Ziad H, Nemeth G, Rentka A, Aszalos Z, Zold E, Gesztelyi R, Zsuga J, Szodoray P, Kemeny-Beke A. Corneal Manifestations of Inflammatory Bowel Disease. Semin Ophthalmol 2019; 34:543-550. [PMID: 31657260 DOI: 10.1080/08820538.2019.1684525] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Purpose: To evaluate detailed corneal parameters of inflammatory bowel disease (IBD) patients, including Crohn's disease (CD) and ulcerative colitis (UC) patients, and to assess associations between anterior segment values and other clinical variables.Methods: This prospective cross-sectional case-control study at a tertiary referral center included 30 CD patients, 36 UC patients and 80 age- and gender-matched controls with no ocular symptoms or ocular surface disorders. All study participants underwent a comprehensive ophthalmological evaluation with special interest in dry eye disease (DED). Corneal parameters were evaluated by Pentacam.Results: The mean age of CD patients, UC patients, and controls was 45.80 ± 11.55 years, 52.00 ± 16.05, and 50.68 ± 14.62, respectively. The average disease duration was 12.72 ± 5.83 years for CD patients and 15.94 ± 10.09 years for UC patients. All pachymetric (center, apex and thinnest) and corneal volume (CV) measurements were significantly decreased, while anterior chamber angle width (ACA) values were significantly increased on both sides in all IBD patients compared to those in controls (p < .05). In addition, several anterior segment parameters were altered unilaterally in CD or UC patients. Negative correlations were found between corneal parameters and Schirmer I test values.Conclusions: Our investigations suggest that IBD patients have thinner corneas compared to that of controls. The coexistence of reduced tear quantity seems to have an additional impact on the thinning of the cornea in IBD patients. Early recognition of corneal impairments, a possible extraintestinal manifestation of IBD, should be included in the disease checkup to reduce vision-threatening developments.
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Affiliation(s)
- Levente Czompa
- Division of Oral and Maxillofacial Surgery, Faculty of Dentistry, University of Debrecen, Debrecen, Hungary
| | - Zsolt Barta
- Department of Gastroenterology, Institute of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Infectology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Hassan Ziad
- Orbi-Dent Refractive Surgery and Medical Center, Debrecen, Hungary
| | - Gabor Nemeth
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
- Department of Ophthalmology, Borsod-Abauj-Zemplen County Hospital and University Teaching Hospital, Miskolc, Hungary
| | - Aniko Rentka
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Zsuzsa Aszalos
- Department of Immunology, Institute of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Eva Zold
- Department of Immunology, Institute of Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Rudolf Gesztelyi
- Department of Pharmacology and Pharmacotherapy, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Judit Zsuga
- Department of Health Systems Management and Quality Management in Health Care, Faculty of Public Health, University of Debrecen, Debrecen, Hungary
| | - Peter Szodoray
- Institute of Immunology, Rikshospitalet, Oslo University Hospital, Oslo, Norway
| | - Adam Kemeny-Beke
- Department of Ophthalmology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
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