@article {10825, title = {Ocular Manifestations of Paediatric Inflammatory Bowel Disease: A Systematic Review and Meta-analysis.}, journal = {J Crohns Colitis}, volume = {12}, year = {2018}, month = {2018 Jun 28}, pages = {870-879}, abstract = {

Background and Aims: Ocular extraintestinal manifestations [O-EIMs] are known complications of Crohn{\textquoteright}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.

}, keywords = {Adolescent, Cataract, Child, Child, Preschool, Colitis, Ulcerative, Crohn Disease, Eye Diseases, Humans, Prevalence, Uveitis}, issn = {1876-4479}, doi = {10.1093/ecco-jcc/jjy029}, author = {Ottaviano, Giorgio and Salvatore, Silvia and Salvatoni, Alessandro and Martelossi, Stefano and Ventura, Alessandro and Naviglio, Samuele} } @article {10548, title = {Ocular Involvement in Children with Inflammatory Bowel Disease.}, journal = {Inflamm Bowel Dis}, volume = {23}, year = {2017}, month = {2017 06}, pages = {986-990}, abstract = {

BACKGROUND: Data on ocular manifestations of inflammatory bowel disease (IBD) in children are limited. Some authors have reported a high prevalence of asymptomatic uveitis, yet the significance of these observations is unknown and there are no recommendations on which ophthalmologic follow-up should be offered.

METHODS: Children with IBD seen at a single referral center for pediatric gastroenterology were offered ophthalmologic evaluation as part of routine care for their disease. Ophthalmologic evaluation included review of ocular history as well as slit-lamp and fundoscopic examination. Medical records were also reviewed for previous ophthalmologic diagnoses or complaints.

RESULTS: Data from 94 children were included (52 boys; median age 13.4 yr). Forty-six patients had a diagnosis of Crohn{\textquoteright}s disease, 46 ulcerative colitis, and 2 IBD unclassified. Intestinal disease was in clinical remission in 70\% of the patients; fecal calprotectin was elevated in 64\%. One patient with Crohn{\textquoteright}s disease had a previous diagnosis of clinically manifest uveitis (overall uveitis prevalence: 1.06\%; incidence rate: 0.3 per 100 patient-years). This patient was also the only one who was found to have asymptomatic uveitis at slit-lamp examination. A second patient had posterior subcapsular cataract associated with corticosteroid treatment. No signs of intraocular complications from previous unrecognized uveitis were observed in any patient.

CONCLUSIONS: Children with IBD may have asymptomatic uveitis, yet its prevalence seems lower than previously reported, and it was not found in children without a previous diagnosis of clinically manifest uveitis. No ocular complications from prior unrecognized uveitis were observed.

}, keywords = {Adolescent, Child, Child, Preschool, Feces, Female, Humans, Inflammatory Bowel Diseases, Italy, Leukocyte L1 Antigen Complex, Male, Remission Induction, Uveitis}, issn = {1536-4844}, doi = {10.1097/MIB.0000000000001079}, author = {Naviglio, Samuele and Parentin, Fulvio and Nider, Silvia and Rassu, Nicol{\`o} and Martelossi, Stefano and Ventura, Alessandro} }