Central Retinal Vein Occlusion Rarely Complicates Ulcerative Colitis

By Reuters Staff

May 22, 2019

NEW YORK (Reuters Health) - Central retinal vein occlusion (CRVO) can rarely complicate the course of inflammatory bowel disease (IBD), according to a case series.

As many as 11.8% of patients with IBD can develop ophthalmological complications, including episcleritis, scleritis, and uveitis.

Dr. Carine Bou-Abboud Matta from Case Western Reserve University School of Medicine, Cleveland, Ohio and colleagues report the occurrence of an even rarer complication, CRVO, in three patients with ulcerative colitis, in a paper online April 26th in Inflammatory Bowel Diseases.

The first patient was a 64-year-old woman with newly diagnosed ulcerative colitis who was diagnosed with nonischemic CRVO and papillitis. Treatment with vedolizumab and azathioprine, along with tapering of empiric high-dose corticosteroids, resulted in clinical and endoscopic remission of ulcerative colitis, and her papillitis improved with intraocular injection of bevacizumab.

A 45-year-old previously healthy man presented with CRVO approximately a year and a half after being diagnosed with ulcerative colitis. He was treated with adalimumab to prevent the progression of his disease and has not had any exacerbation of his ocular symptoms.

Finally, a 37-year-old man with a six-year history of ulcerative colitis was diagnosed with CRVO and papillitis following three months of unilateral vision impairment and two days of acute visual loss. He was treated with high-dose intravenous methylprednisolone, and his vision in the affected eye remained stable three years later.

"Delayed diagnosis and management of CRVO can result in permanent vision loss," the researchers note. "Knowledge of ophthalmologic manifestations and a thorough eye evaluation should be an important component of care in patients with IBD."

"These cases stress the importance of early ophthalmic examination and interdisciplinary care in patients with IBD," they conclude.

Since 1990, there have been 10 other cases of CRVO in association with inflammatory bowel disease, most often ulcerative colitis, reported in the medical literature. The mean annual incidence of CRVO in the general population appears to be about 2/10,000 for persons aged over 40 years and as high as 7/10,000 for those 85 years and older.

Dr. Bou-Abboud Matta did not respond to a request for comments.

SOURCE: http://bit.ly/2HDHLMH

Inflamm Bowel Dis 2019.