Ophthalmologic Manifestation of Inflammatory Bowel Disease: A Review

Dong Hyun Lee; Jae Yong Han; Jae Jun Park; Jae Hee Cheon; Min Kim

doi:10.4166/kjg.2019.73.5.269

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Lee, Han, Park, Cheon, and Kim: Ophthalmologic Manifestation of Inflammatory Bowel Disease: A Review

Special Review

Extraintestinal Manifestations of Inflammatory Bowel Disease

The Korean Journal of Gastroenterology 2019; 73(5): 269-275.

Published online: 27 May 2019

DOI: https://doi.org/10.4166/kjg.2019.73.5.269

Ophthalmologic Manifestation of Inflammatory Bowel Disease: A Review

Dong Hyun Lee, Jae Yong Han, Jae Jun Park¹, Jae Hee Cheon¹, Min Kim

Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

¹Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.

Correspondence to: Min Kim, Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea. Tel: +82-2-2019-3445, Fax: +82-2-3463-1049, minkim76@gmail.com

Received 3 April 2019 Revised 30 April 2019 Accepted 8 May 2019

Korean Society of Gastroenterology

(open-access):

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In patients with inflammatory bowel disease (IBD), ocular extraintestinal manifestations (EIM) are less common than EIM of other systems, but they are clinically important because they can lead to complications that can cause catastrophic damage to the visual acuity and ocular structure. Anterior uveitis and episcleritis are the most common ocular EIM. Involvement of the orbit, posterior segment, and optic nerve can also occur. A variety of treatments are available ranging from topical steroids to systemic immunosuppressive therapies. The treatment of IBD is also essential if the activity of inflammatory bowel disease affects the ocular symptoms.

Keywords: Inflammatory bowel diseases, Ophthalmology, Uveitis, Colitis, ulcerative, Crohn disease

Figures and Tables

Fig. 1

Overview of eyeball structure.

Fig. 2

Slit lamp photograph of a patient with anterior uveitis. (A) Note the presence of cells and flare of the anterior chamber. (B) Multiple keratic precipitates are present in the inside of the cornea (corneal endothelium). (C) Hypopyon, yellowish exudate in the lower part of the anterior chamber, is also present.

Fig. 3

Slit lamp photograph of a patient with episcleritis. Note the slight focally injected conjunctiva with engorged episcleral vessels.

Fig. 4

Slit lamp photograph of a patient with scleritis. (A) Engorged scleral vessels with moderate to severe conjunctival injection can be seen. (B) Recurrent episodes of scleritis can make the sclera translucent and thinning, known as scleromalacia.

Fig. 5

Fundus photograph of (A) retinal vasculitis and (B) central retinal vein occlusion. (A) Perivascular sheathing and hemorrhage can be seen. Mild swelling of the optic disc can also be seen. (B) Vascular tortuosity and dilation of central retinal vein were observed. Multiple flame-shaped retinal hemorrhages were also noted.

Fig. 6

Ultra wide-field retinal imaging of a patient with optic disc swelling. Note the disc hyperemia with blurring of the disc margin.

Fig. 7

Computed tomography of a patient with an orbital pseudotumor. Enlargement of extraocular muscles can be seen on the right eye.

Table 1

Ophthalmic Manifestations of Inflammatory Bowel Disease

Notes

^{Financial support} None.

^{Conflict of interest} None.

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ORCID iDs: Min Kim
https://orcid.org/0000-0003-1873-6959
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