Título

EVALUATION OF OCULAR SURFACE AND CHOROIDAL THICKNESS IN PATIENTS WITH INFLAMMATORY BOWEL DISEASE: ULCERATIVE COLITIS AND CROHN’S DISEASE

Objetivo

To assess ocular surface disease (OSD) and choroidal thickness in patients with inflammatory bowel disease (IBD) and compare to a healthy control group.

Método

A comparative cross-sectional study was carried out in which patients with ulcerative colitis (UC) or Crohn’s disease (CD) and healthy subjects (control group) were enrolled. It was performed a detailed ophthalmological examination, ocular surface evaluation using tear break-up time test , Schirmer test and the Ocular Surface Disease Index (OSDI) questionnaire and Keratograph analysis. In addition, subfoveal choroidal thickness (SCT) of all patients was measured by Topcon OCT (Swept Source OCT) and it was compared with disease activity and its treatment. Different clinical findings, keratograph parameters and OCT measures were also compared between groups.

Resultado

A total of 62 eyes of 31 patients with IBD (16 CD and 15 UC) and 12 controls were included. Eyes with CD presented significantly increased SCT followed by UC and control group (p=0.012). However, it does not seem to be related with disease's activity. There were significant differences regarding clinical OSD evaluation, with worse Schirmer test, in eyes with UC (p=0.020). According to OSDI questionnaire, the overall OSD prevalence rate was 42%, 69% and 60% in the control, CD and UC group, respectively (p<0.05). However, considering severe OSD symptoms most patients had ulcerative colitis (33%) compared to Crohn and control group (25% and 17%, respectively). For the objective keratograph assessment, patients with UC had significant worse hyperemia indexes compared to controls (2.26±0.49 vs. 1.71±0.13; p=0.009). Non-invasive keratograph BUT index was worse (10.19±6.93 vs. 16.81±7.50; p=0.036), in eyes with UC.

Conclusão

Our findings not only confirm high prevalence of clinical findings of OSD in patients with Inflammatory Bowel Disease, but also reveals new objective parameters measured by keratograph analysis. In addition, patients with Crohn’s disease had thicker choroidal thickness.