Ocular manifestations of paediatric inflammatory bowel disease: A systematic review and meta-analysis

Giorgio Ottaviano, Silvia Salvatore, Alessandro Salvatoni, Stefano Martelossi, Alessandro Ventura, Samuele Naviglio

Research output: Contribution to journalReview articlepeer-review

Abstract

Background and Aims: Ocular extraintestinal manifestations [O-EIMs] are known complications of Crohn's disease [CD], ulcerative colitis [UC], and inflammatory bowel disease unclassified [IBD-U]. However, data on their prevalence in children are scarce and there are no clear recommendations on what follow-up should be offered. We aimed to review available data on O-EIMs in children. Methods: In January 2018, we performed a systematic review of published English literature using PubMed and EMBASE databases and disease-specific queries. Results: Fifteen studies [7467 patients] reported data on O-EIMs prevalence in children. Overall prevalence of O-EIMs was 0.62-1.82%. Uveitis was the most common O-EIM. Meta-analysis showed that children with CD are at increased risk of O-EIMs as compared with children with UC and IBD-U (odds ratio [OR] 2.70, 95% confidence interval [CI] 1.51-4.83). Five studies [357 patients] reported data on ophthalmological screening in asymptomatic children: mild asymptomatic uveitis was identified in a variable proportion of patients [1.06-23.1%], more frequently in male patients with CD and colonic involvement. No evidence of ocular complications from untreated uveitis was detected. A total of 23 case reports [24 patients] were identified. Conclusions: Data on O-EIMs in children are scarce. Prevalence of O-EIMs is lower than in adults but may be underestimated because of the possibility of asymptomatic uveitis; however, the long-term significance of this condition is unknown. Children with CD may be at increased risk of O-EIMs. No recommendations on routine ophthalmological examination can be made, but a low threshold for ophthalmological referral should be maintained. Larger studies in paediatric IBD populations are needed.

Original languageEnglish
Pages (from-to)870-879
Number of pages10
JournalJournal of Crohn's and Colitis
Volume12
Issue number7
DOIs
Publication statusPublished - Jun 28 2018

Keywords

  • Children
  • Extraintestinal manifestations
  • Eye
  • IBD
  • Ocular

ASJC Scopus subject areas

  • Gastroenterology

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