Department of Ophthalmology, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
Department of Internal Medicine, Gastroenterology Division, Universidade Federal do Rio de Janeiro, Rio de Janeiro 21941-913, Brazil.
World J Gastroenterol. 2017 Aug 28;23(32):5836-5848. doi: 10.3748/wjg.v23.i32.5836.
Clinical manifestations of inflammatory bowel disease (IBD) are not locally restricted to the gastrointestinal tract, and a significant portion of patients have involvement of other organs and systems. The visual system is one of the most frequently affected, mainly by inflammatory disorders such as episcleritis, uveitis and scleritis. A critical review of available literature concerning ocular involvement in IBD, as it appears in PubMed, was performed. Episcleritis, the most common ocular extraintestinal manifestation (EIM), seems to be more associated with IBD activity when compared with other ocular EIMs. In IBD patients, anterior uveitis has an insidious onset, it is longstanding and bilateral, and not related to the intestinal disease activity. Systemic steroids or immunosuppressants may be necessary in severe ocular inflammation cases, and control of the underlying bowel disease is important to prevent recurrence. Our review revealed that ocular involvement is more prevalent in Crohn's disease than ulcerative colitis, in active IBD, mainly in the presence of other EIMs. The ophthalmic symptoms in IBD are mainly non-specific and their relevance may not be recognized by the clinician; most ophthalmic manifestations are treatable, and resolve without sequel upon prompt treatment. A collaborative clinical care team for management of IBD that includes ophthalmologists is central for improvement of quality care for these patients, and it is also cost-effective.
炎症性肠病（IBD）的临床表现不仅局限于胃肠道，相当一部分患者还会累及其他器官和系统。视觉系统是最常受影响的系统之一，主要由炎症性疾病引起，如表层巩膜炎、葡萄膜炎和巩膜炎。对 PubMed 上有关 IBD 眼部受累的现有文献进行了批判性回顾。表层巩膜炎是最常见的眼部肠外表现（EIM），与其他眼部 EIM 相比，它似乎与 IBD 活动更相关。在 IBD 患者中，前葡萄膜炎发病隐匿，病程长且双侧，与肠道疾病活动无关。在严重眼部炎症的情况下，可能需要全身类固醇或免疫抑制剂，控制潜在的肠道疾病对预防复发很重要。我们的综述表明，眼部受累在克罗恩病中比溃疡性结肠炎更为常见，在活动期 IBD 中，主要存在其他 EIM 时更为常见。IBD 的眼部症状主要是非特异性的，临床医生可能没有意识到其相关性；大多数眼部表现是可治疗的，及时治疗后可不留后遗症。管理 IBD 的临床护理团队包括眼科医生，这对于提高这些患者的护理质量和降低成本效益至关重要。
