This study demonstrated the prevalence of the spectrum of ophthalmologic manifestations in the IBD population, including some rare and silent findings that may merit consideration and early intervention.
Screening for these polymorphisms would probably constitute a valuable procedure in N-AION patients, as they may have an important contribution to the pathogenesis of the disease.
A relationship between inflammatory bowel disease and multiple sclerosis is supported by a higher than expected coexistence of these diseases among families and individuals. A 32 year-old male with Crohn's disease of the terminal ileum diagnosed 4 years ago and HLA-B27 negative bilateral sacroiliitis diagnosed 2 years ago, was admitted in our hospital because of an acute episode of blurred vision. In addition the patient complained for urine incontinence. Before this admission the patient was administered methylprednisolone and Infliximab induction treatment. During admission the diagnosis of multiple sclerosis-associated bilateral optic neuritis was made and Infliximab was discontinued. The patient was started on therapy with interferon-beta for multiple sclerosis, prednizolone and azathioprine for Crohn's disease and oxybutynin hydrochloride for urine incontinence. After 8 weeks of Infliximab discontinuation patient recovered totally from optic neuritis. This is a rare case of totally reversible bilateral optic neuritis associated with multiple sclerosis in a patient with Crohn's disease and sacroiliitis receiving also Infliximab induction therapy.
Large spectrums of ophthalmic manifestations from the anterior to the posterior segment have been so far reported in patients with inflammatory bowel disease. Anterior ischemic optic neuropathy is caused by acute ischemic infarction of the optic nerve head and is distinguished in two different types, non-arteritic anterior ischemic optic neuroparhy (NAION) which is the most frequent type and arteritic anterior ischemic optic neuropathy. Non-arteritic anterior ischemic optic neuroparhy may result in severe visual field loss. We present the case of a 69 year-old man with known history of Crohn's disease that was referred to the Department of Ophthalmology after noticing sudden blurred vision of his left eye. Ophthalmologic examination revealed a corrected visual acuity of 8/10 OS and 10/10 OD. Pupil examination showed a relative afferent pupillary defect of the left pupil and fluoroangiography revealed hyperfluorescence of the left optic disc, indicating edema and NAION attack on his left eye. Genetic analysis showed that the patient was homozygous for MTHFR C677T genetic polymorphism and A1/A2 heterozygous for GPIIIa polymorphism.
A 51-year-old male was referred to the University Eye Clinic of Ioannina with nonarteritic anterior ischemic optic neuropathy (NAION) 12 hours after receiving sildenafil citrate (Viagra®). Examination for possible risk factors revealed mild hypercholesterolemia. Family history showed that his father had suffered from bilateral NAION. Although a cause-and-effect relationship is difficult to prove, there are reports indicating an association between the use of erectile dysfunction agents and the development of NAION. Physicians might need to investigate the presence of family history of NAION among systemic or vascular predisposing risk factors before prescribing erectile dysfunction drugs.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.