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眼部症状不能预测炎症性肠病的眼部炎症。

Ocular symptoms are not predictive of ophthalmologic inflammation in inflammatory bowel disease.

机构信息

Department of Ophthalmology, Nancy University Hospital, Vandoeuvre-lès-Nancy, France.

出版信息

Dig Liver Dis. 2013 Mar;45(3):195-9. doi: 10.1016/j.dld.2012.10.013. Epub 2012 Nov 29.

Abstract

BACKGROUND

Ocular manifestations are frequent in patients with inflammatory bowel disease.

AIM

To evaluate for the first time the value of ocular symptoms in predicting ophthalmologic inflammation in inflammatory bowel disease.

METHODS

All consecutive inflammatory bowel disease patients seen in the Department of Gastroenterology (Nancy, University Hospital, France) between April 2009 and July 2011 were interviewed for this cross-sectional study using a pre-established questionnaire. If the patient had at least one ocular symptom, he systematically underwent an ophthalmologic examination (visual acuity, Break-Up Time test, Schirmer Test, slit-lamp exam with fundus examination).

RESULTS

This cross-sectional survey was completed by 305 patients: 169 were women (55.2%), 228 had Crohn's disease (74.5%). Ninety-eight patients (32%) reported at least one ocular symptom: ocular irritation (56.8%), red eye (40.5%), blurred vision (37.8%), progressive visual loss (34.4%), ocular pain (31.1%), myodesopsia (23.3%), eyelid secretion (12.2%), dry eye (9.5%), watering (6.8%), diplopia (5.4%), metamorphopsia (4%), and sudden visual loss (4%). Following ophthalmologic examination (n=74), 41.9% patients had evidence of dry eye (n=31), 14.9% blepharitis (n=11) and 1.4% scleritis (n=1). No uveitis was reported.

CONCLUSION

Ocular symptoms are frequent in inflammatory bowel disease, but are non-specific and rarely associated with ocular inflammation. Systematic ocular symptoms assessment is of poor value for diagnosing ocular inflammation in inflammatory bowel disease.

摘要

背景

眼部表现是炎症性肠病患者的常见症状。

目的

首次评估眼部症状对预测炎症性肠病眼部炎症的价值。

方法

本横断面研究对 2009 年 4 月至 2011 年 7 月期间在法国南锡大学医院消化科就诊的所有炎症性肠病患者进行了问卷调查。如果患者存在至少一种眼部症状,则对其进行系统的眼科检查(视力、泪膜破裂时间、Schirmer 试验、裂隙灯检查联合眼底检查)。

结果

本横断面研究共纳入 305 例患者:女性 169 例(55.2%),克罗恩病 228 例(74.5%)。98 例(32%)患者报告至少有一种眼部症状:眼部刺激(56.8%)、眼红(40.5%)、视力模糊(37.8%)、进行性视力丧失(34.4%)、眼部疼痛(31.1%)、视物变形(23.3%)、眼睑分泌物(12.2%)、干眼症(9.5%)、溢泪(6.8%)、复视(5.4%)、一过性视力丧失(4%)。对 74 例患者进行眼科检查后,发现 41.9%的患者有干眼症(31 例),14.9%的患者有睑缘炎(11 例),1.4%的患者有巩膜炎(1 例)。未报告葡萄膜炎。

结论

眼部症状在炎症性肠病中很常见,但缺乏特异性,且很少与眼部炎症相关。系统评估眼部症状对诊断炎症性肠病的眼部炎症价值有限。

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