FREQUENCY OF OPHTHALMOLOGICAL POSTERIOR SEGMENT FINDINGS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE
Inflammatory bowel disease (IBD) is a systemic inflammatory disease classified as Crohn Disease (CD) or Ulcerative Colitis (UC), according to the portion of gastrointestinal tract commitment. It could present extra intestinal findings, such as fever, weight loss, arthralgia, mucocutaneous lesions, hepatic, renal and ophthalmological involvement.
Among ophthalmological findings, posterior segment findings are present in less then 1% of patients with IBD, however, these findings could bring definitive visual impairment.
Our study objective was to evaluate ocular posterior segment findings is patients with IBD, through retinal mapping, color fundus retinography, Optical Coherence Tomography (OCT) and OCT Angiography, and compare our results to literature
We evaluated 80 patients with IBD trough complete ophthalmological examination and posterior segment assessment. Color fundus retinography, OCT and OCT Angiography was performed with Topcon Triton (Topcon®, Tokyo, Japan). Macula and posterior pole were evaluated with binocular indirect ophthalmoscopy and Fundus Biomicroscopy.
Participants mean age was 44.16 years (18.08 - 68.58), 28 male patients (35%) and 52 female patients (65%).
35 with diagnosis of Crohn Disease (44%), 41 patients with diagnosis of Ulcerative Colitis (52%) and 3 patients with undetermined diagnosis.
We found abnormal exams in 21 patients (26.25%).
Isolated arteriolar tortuosity was observed in 11 patients (13.75%), with mean age of 37.03 years, with maximum of 59.25 and minimum 18.8 years. (figure 3)
Hard drusen were found in 6 patients (7.5%), with mean age of 61.34 years, with maximum 68.58 and minimum 50.75 years.
Both arterial and venous tortuosity were found in 3 patients (3,7%), with mean age of 52.33 years, with maximum 63.5 and minimum 40.5 years. (figure 2)
Our study is the first to describe those vascular, mainly arteriolar, changes in these patients. However, more studies are necessary to establish a more accurate relation between vascular tortuosity changes and intestinal inflammatory disease, and establish if it could be an method to grade IBD severity or activity.
Retina, Doença Inflamatória Intestinal
Escola Paulista de Medicina - Sao Paulo - Brasil
Luis Filipe Nakayama, Vinicius Campos Bergamo, Marina Lourenço Conti, Livia Almeida Costa, Nilva Simeren Moraes, Orlando Ambrogini Jr