Inflamm Bowel Dis. 2024 Jul 24:izae160. doi: 10.1093/ibd/izae160. Online ahead of print.

Amir Ben-Tov ^1 2 3, Tomer Achler ³, Tal Patalon ¹, Sivan Gazit ¹, Henit Yanai ^3 4, Shiri Shulman ^5 6, Amit Assa ⁷

Author information

¹Kahn Sagol Maccabi (KSM) Research & Innovation Center, Maccabi Healthcare Services, Tel Aviv, Israel.

²Pediatric Gastroenterology Institute, Dana-Dwek Children's Hospital, Tel Aviv, Israel.

³Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.

⁴IBD Center, Division of Gastroenterology, Rabin Medical Center, Petah Tikva, Israel.

⁵Ophthalmology Institute, Assuta Medical Center, Tel Aviv, Israel.

⁶Faculty of health sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel.

⁷The Juliet Keidan IInstitute of Pediatric Gastroenterology and Nutrition, Shaare Zedek Medical Center, The Hebrew University, Jerusalem, Israel.

Abstract

Background: Ocular manifestations (OMs) in patients with inflammatory bowel disease (IBD) are uncommon, particularly in children. We aimed to explore the prevalence and characteristics of IBD-associated OM in a large cohort study.

Methods: A cross-sectional study was performed using the Maccabi Healthcare Services (MHS) database. The eligible population included all patients diagnosed with IBD as children (<18 years) between January 2005 and July 2023.

Results: Out of 2567 children with IBD (males 55%, Crohn's disease 64%), 78 (3%) were diagnosed with OM at any time during the disease course. In 54 patients (69%), the ocular disease occurred after IBD diagnosis with a median time of 2.6 (0.47-7) years between the 2 events, whereas in 24 patients (31%), ocular involvement preceded IBD diagnosis with a median time of 2.1 (0.6-5.7) years. The presence of ocular involvement was associated with increased usage of systemic corticosteroids (P < .001) and biologic agents (P = .04). There were 55 patients with ocular involvement during childhood who were ever diagnosed with IBD. In this population, ocular involvement was also associated with increased usage of systemic corticosteroids (P < .001). The prevalence of OM among patients with IBD did not change significantly over time (P = .75), with a prevalence of 2.3% at the end of the study period.

Conclusions: The prevalence of ocular involvement in children with IBD is rare and steady; it is also associated with a greater usage of systemic corticosteroids and biologic agents, potentially representing a more severe disease course.