Crohn’s Disease Ocular Manifestations

Open access

Summary

Crohn’s disease is an inflammatory bowel disease which causes inflammation of the digestive tract. Crohn’s disease most frequently affects the ileum and the colon. In the active stage of the disease signs and symptoms may include diarrhea, abdominal pain and cramping, blood in the stools, reduced appetite and weight loss. In patients with severe Crohn’s disease the following signs and symptoms may be observed: fever, fatigue, arthritis, eye inflammation, oral ulcers, skin disorders, inflammation of the liver or bile ducts or delayed growth. Heredity and dysfunctions of the immune system are considered to cause the development of Crohn’s disease. About 10% of people with inflammatory bowel disease have also ocular problems. The most common ocular manifestations of Crohn’s disease are uveitis, iritis, episcleritis, keratopathy, keratoconjunctivitis and retinal vasculitis. Untreated uveitis may cause glaucoma and vision loss. Uveitis and iritis are four times more common in women than in men. In patients in the active stage of the disease, episcleritis also flares. Symptoms of episcleritis include inflammation, bright red spots on the sclera and localized pain. Keratoconjunctivitis in Crohn’s disease is caused by decreased tear production or increased tear film evaporation. Dry eyes can cause itching, burning or infection. Keratopathy usually causes no pain or vision loss, therefore in most cases no treatment is needed. In retinal vasculitis tortuosity of retinal veins, retinal edema at the posterior pole and intraretinal blood near blood vessels are observed. Intravenous fluorescein angiography shows intraretinal neovascularisation and haemorrhage in the posterior pole.

1 . Hindryckx, P. et al. Clinical trials in luminal Crohn’s disease: A historical perspective. - J. Crohns. Colitis, 2014, May 16, pii: S1873-9946 (14) 00152-4.

2 . Burgdorf , W. Cutaneous manifestations of Crohn’s disease. - J. Am. Acad. Dermatol., 5, 1981, 689.

3 . Wakefield, A. J., A. M. Sawyerr et A. P. Dhillon. Pathogenesis of Crohn’s disease: multifocal gastrointestinal infarction. - Lancet, 2, 1989, (8671), 1057-1062.

4 . Bernstein, C. N. et al. The prevalence of extraintestinal diseases in inflammatory bowel disease: a population-based study. - Am. J. Gastroenterol., 96, 2001, 1116.

5 . Greenstein , A. J., H. D. Janowitz et D. B. Sachar. The extra-intestinal complications of Crohn’s disease and ulcerative colitis: a study of 700 patients. - Medicine (Baltimore), 55, 1976, № 5, 401-412.

6 . Ricart , E. et al. Autoimmune disorders and extraintestinal manifestations in first-degree familial and sporadic inflammatory bowel disease: a case-control study. - Inflamm. Bowel. Dis., 10, 2004, 207.

7 . Cloché , V., A. Buisson et F. Tréchot. Ocular symptoms are not predictive of ophthalmologic inflammation in inflammatory bowel disease. - Dig. Liver Dis., 45, 2013, № 3, 195-199.

8 . Lyons, J. L. et J. T. Rosenbaum. Uveitis associated with inflammatory bowel disease compared with uveitis associated with spondyloarthropathy. - Arch. Ophthalmol., 115, 1997, 61.

9 . Culver, E. L., J. F. Salmon et P. Frith. Recurrent posterior scleritis and orbital myositis as extra-intestinal manifestationsof Crohn’s disease: Case report and systematic literature review. - J. Crohns. Colitis., 2, 2008, № 4, 337-342.

10 . Knox , D. L., R. C. Snip et W. J. Stark. The keratopathy of Crohn’s disease. - Am. J. Ophthalmol., 90, 1980, 862.

11 . Duker, J. S., G. C. Brown et L. Brooks. Retinal vasculitis in Crohn’s disease. - Am. J. Ophthalmol., 103, 1987, № 5, 664-668.

12 . Ruby, A. J. et L. M. Jampol. Crohn’s disease and retinal vascular disease.- Am. J. Ophthalmol., 110, 1990, 349.

13 . Wakefield, A. J., E. A. Sankey et A. P. Dhillon. Granulomatous vasculitis in Crohn’s disease. - Gastroenterology, 100, 1991, (5 Pt 1), 1279-1287.

14 . Schneiderman , J. H., J. A. Sharpe et D. M. Sutton. Cerebral and retinal vascular complications of inflammatory bowel disease. - Ann. Neurol., 5, 1979, № 4, 331-337.

15 . Falavarjani, K. G., M. M. Parvaresh et K. Shahraki. Central retinal artery occlusion in Crohn disease. - J. AAPOS, 16, 2012, № 4, 392-393.

16 . Novotny, D. A., R. J. Rubin et F. A. Slezak. Arterial thromboembolic complications of inflammatory bowel disease. Report of three cases. - Dis. Colon. Rectum., 35, 1992, № 2, 193-196.

17 . Petrelli, E. A., M. McKinley et F. J. Troncale. Ocular manifestations of inflammatory bowel disease. - Ann. Ophthalmol., 14, 1982, 356.

18 . Lin, J. F., J. M. Chen et J. H. Zuo. Meta-analysis: Fecal Calprotectin for Assessment of Inflammatory Bowel DiseaseActivity. - Inflamm. Bowel. Dis., 2014, Jun 30.

19 . Manganelli , C., S. Turco et E. Balestrazzi. Ophthalmological aspects of IBD. - Eur. Rev. Med. Pharmacol. Sci., 13, 2009, Suppl. 1, 11-13.

20 . Present, D. H. et al. Treatment of Crohn’s disease with 6-mercaptopurine. A long-term, randomized, double-blind study. - N. Engl. J. Med., 302, 1980, 981-987.

Journal Information

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 265 241 10
PDF Downloads 77 74 5