Kim Ji Ho, Won Yeo Kyoung, Chung Tae-Young, Lim Dong Hui
Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Renew Seoul Eye Center, Seoul, Republic of Korea.
Am J Ophthalmol Case Rep. 2024 Oct 5;36:102186. doi: 10.1016/j.ajoc.2024.102186. eCollection 2024 Dec.
This study reports a case of Crohn's disease-associated keratopathy that progressed with disease activity.
A 29-year-old man diagnosed with Crohn's disease and receiving systemic adalimumab therapy, presented with an irregular epithelial surface, superior corneal opacity, subepithelial infiltration, pannus with new vessel ingrowth, and punctate epithelial erosions in both corneas. Changes in ophthalmological findings were checked during regular outpatient follow-ups. We also compared the stool calprotectin values obtained at a gastrointestinal clinic during the course of keratopathy. By analyzing the trend of fecal calprotectin levels in this patient, we found that keratopathy worsened as fecal calprotectin levels increased. Corneal neovascularization and infiltration improved as the fecal calprotectin levels decreased.
The mechanism of Crohn's disease-associated keratopathy has not been identified but appears to be related to the autoimmune mechanism of Crohn's disease. Managing Crohn's activity by referring to the gastroenterology department should be considered to relieve Crohn's disease-associated keratopathy.
本研究报告1例与克罗恩病相关的角膜病变，该病变随疾病活动而进展。
一名29岁男性，诊断为克罗恩病并接受全身性阿达木单抗治疗，双眼角膜出现上皮表面不规则、角膜上缘混浊、上皮下浸润、伴有新生血管长入的血管翳以及点状上皮糜烂。在定期门诊随访期间检查眼科检查结果的变化。我们还比较了角膜病变过程中在胃肠科诊所获得的粪便钙卫蛋白值。通过分析该患者粪便钙卫蛋白水平的变化趋势，我们发现随着粪便钙卫蛋白水平升高，角膜病变恶化。随着粪便钙卫蛋白水平降低，角膜新生血管形成和浸润改善。
克罗恩病相关角膜病变的机制尚未明确，但似乎与克罗恩病的自身免疫机制有关。应考虑通过转诊至胃肠病科来控制克罗恩病的活动，以缓解与克罗恩病相关的角膜病变。
