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炎症性肠病的眼科并发症综述

A Review of Ophthalmic Complications in Inflammatory Bowel Diseases.

作者信息

Pytrus Wiktoria, Akutko Katarzyna, Pytrus Tomasz, Turno-Kręcicka Anna

机构信息

Ophthalmonology Clinical Centre SPEKTRUM, 53-334 Wroclaw, Poland.

2nd Department and Clinic of Paediatrics, Gastroenterology and Nutrition, Wroclaw Medical University, 50-369 Wroclaw, Poland.

出版信息

J Clin Med. 2022 Dec 15;11(24):7457. doi: 10.3390/jcm11247457.

Abstract

Inflammatory bowel diseases (IBD), including Crohn's disease (CD) and ulcerative colitis (UC), are chronic immune-mediated conditions caused by various polygenic and environmental factors. Clinical manifestations of IBD primarily occur in the gastrointestinal tract, but many patients are affected by extraintestinal complications, including eye diseases. Ocular disorders are the third most common extraintestinal manifestation (EIM), following musculoskeletal and mucocutaneous involvement. Episcleritis, frequently occurring in IBD patients, may be associated with exacerbation of the intestinal disease. Uveitis does not correlate with IBD activity but may be related to the presence of other EIMs, particularly erythema nodosum and peripheral arthritis. Early detection and specific therapy of ocular manifestations of IBD are fundamental to avoiding sight-threatening complications. Therefore, ophthalmic evaluation should be performed in all IBD patients. Systemic corticosteroids or immunosuppressants may be inevitable in severe cases to control ocular inflammation. Persistent and relapsing conditions usually respond well to TNF-α-inhibitors. Interdisciplinary cooperation between gastroenterologists and ophthalmologists is fundamental in initiating the appropriate treatment for patients.

摘要

炎症性肠病(IBD),包括克罗恩病(CD)和溃疡性结肠炎(UC),是由多种多基因和环境因素引起的慢性免疫介导疾病。IBD的临床表现主要发生在胃肠道,但许多患者会受到肠外并发症的影响,包括眼部疾病。眼部疾病是继肌肉骨骼和皮肤黏膜受累之后第三常见的肠外表现(EIM)。巩膜外层炎在IBD患者中经常出现,可能与肠道疾病的加重有关。葡萄膜炎与IBD活动无关,但可能与其他EIM的存在有关,特别是结节性红斑和外周关节炎。IBD眼部表现的早期检测和特异性治疗对于避免视力威胁性并发症至关重要。因此,所有IBD患者都应进行眼科评估。在严重病例中,可能不可避免地需要使用全身性皮质类固醇或免疫抑制剂来控制眼部炎症。持续性和复发性疾病通常对TNF-α抑制剂反应良好。胃肠病学家和眼科医生之间的跨学科合作对于为患者启动适当治疗至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/187b/9781961/343eda7fd2bf/jcm-11-07457-g001.jpg

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