Ophthalmologic manifestations of celiac disease

Martins, Thiago Gonçalves dos Santos; Costa, Ana Luiza Fontes de Azevedo; Oyamada, Maria Kiyoko; Schor, Paulo; Sipahi, Aytan Miranda

doi:10.18240/ijo.2016.01.26

Cited by 12 publications

(15 citation statements)

References 54 publications

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“…The manifestations related to autoimmune disorders are orbital myositis, uveitis, thyroiditis associated with orbitopathy and brain occipital calcification. [1] Similar presentations of celiac disease with acute loss of vision related optic neuropathy has been reported in literature. Boushehri et al r e p o r t e d a n a d u l t w h o r e s p o n d e d t o immunosuppressive therapy and gluten free diet.…”

supporting

confidence: 71%

Celiac Disease Presenting as Acute Unilateral Blindness

Bharadia¹,

Sharma²,

Kalla³

2022

Annals of Pediatric Gastroenterology &Amp; Hepatology

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Introduction: Celiac disease (CD) is an autoimmune condition affecting the small intestine, triggered by the ingestion of gluten, the protein fraction of wheat, barley, and rye. When patient with celiac disease ingest gluten, an immunologically mediated inflammatory response occurs that damages the mucosa of their intestines, resulting in malabsorption of food nutrients. Apart from gastrointestinal symptoms, celiac disease has extraintestinal symptoms like anemia, osteopenia, motor weakness, ataxia, seizures, peripheral neuropathy, dermatitis herpetiformis, bleeding diathesis and ophthalmic manifestations like uveitis, cataract, orbital myositis, retinopathy, occipital calcification and rarely optic neuropathy. We are reporting a case of celiac disease who presented as acute loss of vision of left eye. Case report: An eight year old boy presented with painless acute loss of vision of left eye in July 2018 which was preceded by blurring of vision for few hours. There was no history of fever, rashes, vomiting, diarrhea, constipation, seizures or headache. On examination vitals were stable, weight: 18.1 Kg (5-10th centile), Height: 114 cm (5-10th centile). There was pallor on general examination. Systemic

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supporting

confidence: 71%

Celiac Disease Presenting as Acute Unilateral Blindness

Bharadia¹,

Sharma²,

Kalla³

2022

Annals of Pediatric Gastroenterology &Amp; Hepatology

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“…Pseudotumor cerebri, malnutrition retinopathy, uveitis, and cataracts are ocular manifestations that can be seen as a result of autoantibody-related systemic inflammation or malnutrition in CD patients. [ 4 ] None of these diseases were found in the current study. In recent years, changes in choroidal thickness,[ 9 10 ] ocular surface and tear film,[ 5 ] anterior chamber features,[ 6 ] and retinal nerve fiber layer thickness[ 6 ] have been the ocular parameter differences reported in CD patients.…”

Section: Discussioncontrasting

confidence: 49%

“…In recent years, ophthalmologists have researched ocular changes in CD patients, which are caused by the extraintestinal involvement characteristic of this autoimmune disease. [ 4 5 6 7 8 9 10 ] Vascular changes and endothelial dysfunction have recently been demonstrated in CD patients. [ 11 ] However, a comprehensive literature review has found no study investigating macular perfusion parameters in CD patients.…”

mentioning

confidence: 99%

Retinal and choroidal vascular changes in newly diagnosed celiac disease: An optical coherence tomography angiography study

GÜMÜŞ

Eker

Karaküçük

et al. 2022

Indian Journal of Ophthalmology

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Purpose: To investigate the retinal and choroidal microcirculation changes in celiac disease (CD) patients via optical coherence tomography angiography (OCT-A). Methods: This cross-sectional study included 44 pediatric patients with newly diagnosed CD and 44 healthy pediatric subjects. The vascular densities (VD) of the superficial, deep, and choriocapillar plexuses (VDs, VDd, and VDcc, respectively) (%), the superficial and deep foveal avascular zones (FAZs and FAZd) (%), the central macular thickness (CMT) (mm), and the subfoveal choroidal thickness (SFCT) (mm) were measured with swept-source OCT-A in addition to a complete ophthalmological examination. Results: Mean ages of the CD patients and the healthy participants were 12.02 ± 2.9 and 13.6 ± 2.3 years, respectively. The central sectors of the VDs and VDd measurements were found to be significantly higher in the study group compared to the control group (p = 0.006; P = 0.001, respectively), and the temporal and nasal values of the VDcc measurements were significantly lower in the study group than in the control group (p < 0.05 for both values). CMT and FAZ metrics did not differ between the groups (p > 0.05). SFCT was significantly reduced (p = 0.001), and choroidal thinning was more considerable in female CD patients (p = 0.045). Conclusion: CD seems to affect macular and choroidal microcirculation. The reduced choriocapillaris plexus parameters and choroidal thickness may provide disease activity information.

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“…In addition, the higher risk specifcally of the microvascular complication of retinopathy, as demonstrated here in youth with potentially undiagnosed CD and in adults with CD and type 1 diabetes [11,35], remains undetermined. A potential contributing factor specifcally for retinopathy, however, may be reduced vitamin A levels secondary to malabsorption in the setting of CD [39]. Vitamin A plays an important role in the retina [40] and malnutrition retinopathy has been described in CD [39], although this warrants further investigation.…”

Section: Discussionmentioning

confidence: 97%

The Frequency of Undiagnosed Celiac Disease in Youth with Type 1 Diabetes and Its Association with Diabetic Retinopathy: The SEARCH for Diabetes in Youth Study

et al. 2023

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Aims. Celiac disease (CD) in adults with type 1 diabetes has been associated with increased cardiovascular risk and the earlier occurrence of diabetes-associated complications. In the Search for Diabetes in Youth study, we aimed to assess the frequency of CD and the potential for undiagnosed CD among youth with childhood onset type 1 diabetes. In addition, we assessed the burden of cardiovascular risk factors and diabetes-associated complications in youth with type 1 diabetes by CD status and IgA tissue transglutaminase autoantibody (tTGA) levels. Methods. 2,444 youths with type 1 diabetes completed a CD questionnaire and underwent tTGA testing. Integrating the celiac disease questionnaire and tTGA results for this cross-sectional analysis, participants were categorized as follows: (1) reported CD; (2) seropositive for CD (no reported CD and seropositive tTGA); and (3) type 1 diabetes only (comparison group: no reported CD and seronegative tTGA). Subanalyses were performed on those with no reported CD and tTGA ≥10x ULN, designated potentially undiagnosed CD. Cardiovascular risk factors and diabetes-associated complications were evaluated by CD status and tTGA levels utilizing a Poisson model to estimate relative risk. Results. Reported CD in youths with type 1 diabetes was 7%. Seropositivity for tTGA with no reported CD was present in 4%, and 1.2% had potentially undiagnosed CD. Youths with potentially undiagnosed CD had a 2.69x higher risk of diabetic retinopathy than comparison group. In addition, CD with tTGA <0.05 (controlled CD) was associated with lower HbA1c. Conclusions. Undiagnosed CD is likely present in youths with type 1 diabetes and potentially undiagnosed CD is associated with a higher risk of diabetic retinopathy. These findings indicate the importance of routine screening for CD in type 1 diabetes in youths.

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Ophthalmologic manifestations of celiac disease

Cited by 12 publications

References 54 publications

Celiac Disease Presenting as Acute Unilateral Blindness

Celiac Disease Presenting as Acute Unilateral Blindness

Retinal and choroidal vascular changes in newly diagnosed celiac disease: An optical coherence tomography angiography study

The Frequency of Undiagnosed Celiac Disease in Youth with Type 1 Diabetes and Its Association with Diabetic Retinopathy: The SEARCH for Diabetes in Youth Study

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