%0 Journal Article %J J Crohns Colitis %D 2018 %T Ocular Manifestations of Paediatric Inflammatory Bowel Disease: A Systematic Review and Meta-analysis. %A Ottaviano, Giorgio %A Salvatore, Silvia %A Salvatoni, Alessandro %A Martelossi, Stefano %A Ventura, Alessandro %A Naviglio, Samuele %K Adolescent %K Cataract %K Child %K Child, Preschool %K Colitis, Ulcerative %K Crohn Disease %K Eye Diseases %K Humans %K Prevalence %K Uveitis %X

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.

%B J Crohns Colitis %V 12 %P 870-879 %8 2018 Jun 28 %G eng %N 7 %1 http://www.ncbi.nlm.nih.gov/pubmed/29518184?dopt=Abstract %R 10.1093/ecco-jcc/jjy029 %0 Journal Article %J Inflamm Bowel Dis %D 2017 %T Ocular Involvement in Children with Inflammatory Bowel Disease. %A Naviglio, Samuele %A Parentin, Fulvio %A Nider, Silvia %A Rassu, Nicolò %A Martelossi, Stefano %A Ventura, Alessandro %K Adolescent %K Child %K Child, Preschool %K Feces %K Female %K Humans %K Inflammatory Bowel Diseases %K Italy %K Leukocyte L1 Antigen Complex %K Male %K Remission Induction %K Uveitis %X

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'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'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.

%B Inflamm Bowel Dis %V 23 %P 986-990 %8 2017 06 %G eng %N 6 %1 http://www.ncbi.nlm.nih.gov/pubmed/28328621?dopt=Abstract %R 10.1097/MIB.0000000000001079