Naviglio Samuele, Parentin Fulvio, Nider Silvia, Rassu Nicolò, Martelossi Stefano, Ventura Alessandro
*Department of Medicine, Surgery, and Health Sciences, University of Trieste, Trieste, Italy; and †Institute for Maternal and Child Health IRCCS "Burlo Garofolo," Trieste, Italy.
Inflamm Bowel Dis. 2017 Jun;23(6):986-990. doi: 10.1097/MIB.0000000000001079.
Data on ocular manifestations of inflammatory bowel disease (IBD) in children are limited. Some authors have reported a high prevalence of asymptomatic uveitis, yet the significance of these observations is unknown and there are no recommendations on which ophthalmologic follow-up should be offered.
Children with IBD seen at a single referral center for pediatric gastroenterology were offered ophthalmologic evaluation as part of routine care for their disease. Ophthalmologic evaluation included review of ocular history as well as slit-lamp and fundoscopic examination. Medical records were also reviewed for previous ophthalmologic diagnoses or complaints.
Data from 94 children were included (52 boys; median age 13.4 yr). Forty-six patients had a diagnosis of Crohn's disease, 46 ulcerative colitis, and 2 IBD unclassified. Intestinal disease was in clinical remission in 70% of the patients; fecal calprotectin was elevated in 64%. One patient with Crohn's disease had a previous diagnosis of clinically manifest uveitis (overall uveitis prevalence: 1.06%; incidence rate: 0.3 per 100 patient-years). This patient was also the only one who was found to have asymptomatic uveitis at slit-lamp examination. A second patient had posterior subcapsular cataract associated with corticosteroid treatment. No signs of intraocular complications from previous unrecognized uveitis were observed in any patient.
Children with IBD may have asymptomatic uveitis, yet its prevalence seems lower than previously reported, and it was not found in children without a previous diagnosis of clinically manifest uveitis. No ocular complications from prior unrecognized uveitis were observed.
关于儿童炎症性肠病（IBD）眼部表现的数据有限。一些作者报告无症状葡萄膜炎的患病率很高，但这些观察结果的意义尚不清楚，对于应提供何种眼科随访也没有相关建议。
在一家儿科胃肠病转诊中心就诊的IBD患儿作为其疾病常规护理的一部分接受了眼科评估。眼科评估包括眼部病史回顾以及裂隙灯和眼底镜检查。还查阅了病历以了解先前的眼科诊断或主诉。
纳入了94名儿童的数据（52名男孩；中位年龄13.4岁）。46例患者诊断为克罗恩病，46例为溃疡性结肠炎，2例为未分类的IBD。70%的患者肠道疾病处于临床缓解期；64%的患者粪便钙卫蛋白升高。1例克罗恩病患者先前诊断为有临床表现的葡萄膜炎（总体葡萄膜炎患病率：1.06%；发病率：每100患者年0.3例）。该患者也是裂隙灯检查中唯一被发现有无症状葡萄膜炎的患者。另1例患者有与皮质类固醇治疗相关的后囊下白内障。在任何患者中均未观察到先前未被识别的葡萄膜炎引起的眼内并发症迹象。
IBD患儿可能有无症状葡萄膜炎，但其患病率似乎低于先前报道，且在先前未诊断为有临床表现的葡萄膜炎的儿童中未发现。未观察到先前未被识别的葡萄膜炎引起的眼部并发症。
