Ophthalmological and extraintestinal manifestations of Crohn's disease (Atena Editora)

Abstract

Crohn's disease is a chronic inflammatory disease that affects the gastrointestinal tract, causing symptoms such as abdominal pain, diarrhea, fever and weight loss. In addition to intestinal manifestations, Crohn's disease can present extraintestinal complications, which involve several organs and systems, such as the skin, joints, liver and eyes. The ophthalmological manifestations of Crohn's disease are varied and may include uveitis, episcleritis, scleritis, keratitis, conjunctivitis, blepharitis and xerophthalmia. These eye changes can cause discomfort, reduced visual acuity and even blindness if not treated properly. Therefore, it is important to recognize and manage the ophthalmological manifestations of Crohn's disease, as well as assess the relationship between them and intestinal disease activity. Objective: to analyze the scientific evidence on the ophthalmological and extraintestinal manifestations of Crohn's disease, as well as the factors associated with its occurrence and severity. Methodology: followed the PRISMA checklist, searches were carried out in the PubMed, Scielo and Web of Science databases, using the following descriptors: “Crohn’s disease”, “ocular manifestations”, “extraintestinal manifestations”, “uveitis” and “episcleritis”. Articles published in the last 10 years (from 2013 to 2023) that addressed the ophthalmological and extraintestinal manifestations of Crohn's disease in adults or children, in any language, were included. Articles that were not original (reviews, editorials, letters to the editor), that did not have sufficient data for extraction or that had low methodological quality were excluded. Results: 16 studies were selected. The prevalence of ophthalmological manifestations in Crohn's disease varies from 0.3% to 11%, depending on the diagnostic criteria used. The most common ophthalmological manifestations of Crohn's disease are uveitis (inflammation of the uvea) and episcleritis (inflammation of the episclera). Ophthalmological manifestations may occur before, during or after the diagnosis of intestinal disease. Ophthalmological manifestations may be related to the activity of the intestinal disease, the presence of other extraintestinal complications or the drug therapy used. The treatment of ophthalmological manifestations in Crohn's disease depends on the severity and type of ocular change, and may involve anything from anti-inflammatory eye drops to systemic immunosuppressants. Conclusion: ophthalmological manifestations in Crohn's disease are frequent and potentially serious, requiring regular ophthalmological monitoring and a multidisciplinary approach. Furthermore, the need for further studies on the pathophysiological mechanisms involved in the relationship between intestinal and ocular inflammation was highlighted, as well as on the best therapeutic strategies to prevent and treat ocular complications in Crohn's disease.