Ocular Manifestations

Abstract

Crohn’s disease (CD), or regional enteritis, is a segmentary granulomatous inflammatory bowel pathology of unknown etiology although autoimmunity is probably involved. In addition, there are extraintestinal manifestations, such as arthritis, cutaneous lesions, and hepatic, renal, and ocular involvement. The incidence of the latter, manifested as uveitis, scleritis, and episcleritis, is about 2–9% of the cases of CD [1–4]. Moreover, 30–40% of patients with scleritis also have a systemic autoimmune disease, such as rheumatoid arthritis, Wegener granulomatosis, and inflammatory bowel disease (IBD) [5], and 2% of patients with uveitis may develop IBD; indeed uveitis may even precede IBD onset. Nearly 40% of patients with IBD-associated uveitis are positive for HLA B27. Arthritis in CD may develop os peripheral arthropathies or as ankylosing spondylitis. Among the latter, nearly 70% are HLA-B27 positive and 50% of the patients in this group develop ocular involvement, mainly uveitis. In addition to these immunological pathologies in patients with CD, an infection of the eye, mycotic endophthalmitis, may develop as a complication in patients receiving parenteral nutrition to treat malabsorption or following bowel surgery.