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 which 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 using 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 (OR 2.70, 95% CI 1.51-4.83). Five studies (357 patients) reported data on ophthalmologic 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. Twenty-three 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 ophthalmologic referral should be maintained. Larger studies in pediatric IBD populations are needed.

Ocular Manifestations of Pediatric Inflammatory Bowel Disease: A Systematic Review and Meta-Analysis

Martelossi, Stefano;Ventura, Alessandro;Naviglio, Samuele
2018-01-01

Abstract

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 which 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 using 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 (OR 2.70, 95% CI 1.51-4.83). Five studies (357 patients) reported data on ophthalmologic 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. Twenty-three 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 ophthalmologic referral should be maintained. Larger studies in pediatric IBD populations are needed.
2018
6-mar-2018
Pubblicato
File in questo prodotto:
File Dimensione Formato  
jjy029.pdf

Open Access dal 06/03/2019

Descrizione: articolo
Tipologia: Bozza finale post-referaggio (post-print)
Licenza: Digital Rights Management non definito
Dimensione 753.12 kB
Formato Adobe PDF
753.12 kB Adobe PDF Visualizza/Apri
jjy029.pdf

Accesso chiuso

Tipologia: Documento in Versione Editoriale
Licenza: Digital Rights Management non definito
Dimensione 333.81 kB
Formato Adobe PDF
333.81 kB Adobe PDF   Visualizza/Apri   Richiedi una copia
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11368/2919169
Citazioni
  • ???jsp.display-item.citation.pmc??? 13
  • Scopus 26
  • ???jsp.display-item.citation.isi??? 22
social impact