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Abstract #54715 Published in IGR 15-3
Managing IBD outside the gut: ocular manifestations
Calvo P; Pablo LDigestive diseases (Basel, Switzerland) 2013; 31: 229-232
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.
Department of Ophthalmology, Miguel Servet University Hospital, Instituto de Investigación Sanitaria de Aragón IIS-A, Zaragoza, Spain.
Full articleClassification:
9.4.15 Glaucoma in relation to systemic disease (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
9.4.1 Steroid-induced glaucoma (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)
9.4.6 Glaucomas associated with inflammation, uveitis (Part of: 9 Clinical forms of glaucomas > 9.4 Glaucomas associated with other ocular and systemic disorders)