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Ocular manifestations of inflammatory bowel disease

Thomas, Akshay S.; Lin, Phoebe

Current Opinion in Ophthalmology: November 2016 - Volume 27 - Issue 6 - p 552–560
doi: 10.1097/ICU.0000000000000310
OCULAR MANIFESTATIONS OF SYSTEMIC DISEASE: Edited by Russell W. Read
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Purpose of review Extraintestinal manifestations (EIMs) of inflammatory bowel disease (IBD) are numerous and can often involve the eye. This review highlights the ocular complications associated with IBD including the critical role the ophthalmologist can play in the diagnosis of IBD, the pathogenesis of IBD, its ocular complications, and the treatment of ocular inflammation associated with IBD.

Recent findings Polygenic and environmental influences, as well as gut microbial dysbiosis, have been implicated in the pathogenesis of IBD. IBD and its EIMs appear to respond well to TNFα-targeted biologics.

Summary IBD is thought to be caused by polygenic and environmental influences, including a dysbiotic gut microbiota. It is a systemic immune-mediated disease with varying types of ocular manifestations that can precede, occur simultaneously, or follow intestinal involvement. The diagnosis of IBD can be confused with other seronegative spondyloarthropathies as well as Behçet's disease. Treatment of IBD-associated ocular inflammation can range from corticosteroids to steroid-sparing immunosuppression such as azathioprine or methotrexate. Refractory disease can respond well to TNFα inhibitors.

Casey Eye Institute, Oregon Health and Sciences University, Portland, Oregon, USA

Correspondence to Phoebe Lin, MD, PhD, Casey Eye Institute, Oregon Health & Science University, 3375 SW Terwilliger Blvd, Portland, OR 97239, USA. Tel: +1 503 494 0007; fax: +1 503 494 7233; e-mail: linp@ohsu.edu

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