Korean J Gastroenterol.  2019 May;73(5):269-275. 10.4166/kjg.2019.73.5.269.

Ophthalmologic Manifestation of Inflammatory Bowel Disease: A Review

• Lee DH
• Han JY
• Park JJ
• Cheon JH
• Kim M

• KMID: 2447596
• DOI: http://doi.org/10.4166/kjg.2019.73.5.269

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.

Keyword

Inflammatory bowel diseases; Ophthalmology; Uveitis; Colitis, ulcerative; Crohn disease

MeSH Terms

Colitis, Ulcerative
Crohn Disease
Humans
Inflammatory Bowel Diseases*
Ophthalmology
Optic Nerve
Orbit
Scleritis
Steroids
Uveitis
Uveitis, Anterior
Visual Acuity
Steroids

Figure

• 

  Fig. 1 Overview of eyeball structure.

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  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.

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  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.

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  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.

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  Fig. 6 Ultra wide-field retinal imaging of a patient with optic disc swelling. Note the disc hyperemia with blurring of the disc margin.

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  Fig. 7 Computed tomography of a patient with an orbital pseudotumor. Enlargement of extraocular muscles can be seen on the right eye.

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