P0208 Can we predict inflammatory activity of Ulcerative Colitis by just looking into eyes?
Authors: Tagluk B , Kav T , Keskin O , Kadayifcilar S 
Published: January 2025

Background

With the introduction of Optical Coherence Tomography-Angiography(OCT-A) in ophthalmology it has been suggested that the true prevalence of posterior segment manifestations in patients with Inflammatory Bowel Diseases(IBD) may be higher than previously thought and OCT-A findings would correlate with the inflammatory burden of the IBD[1-4].

In this prospective study, the relationship with retinal vascular structures and choroidal changes in patients with Ulcerative Colitis(UC) were investigated.

Methods

47 UC patients and 42 healthy volunteers with a similar age-sex distribution were employed in this study. Epidemiological, clinical and biochemical data were recorded and patients were grouped as active (55%, n=26) and remission (45%, n=21) according to Mayo Scores. All participants underwent right-left eye anterior and posterior segment examinations, but only right eye data were used. Retinal vascular structures were evaluated on 6x6 mm sections with OCT-A, while choroidal thickness was assessed using the EDI mode of the spectral-domain Optical Coherence Tomography. All measurements were made at similar times of the day to avoid changes due to diurnal rhythm.

Results

No evidence of past or active uveitis was detected in all participants. It is found that the foveal avascular zone area was enlarged and the subfoveal choroidal thickness was increased in UC patients, compared to the findings of healthy participants(p&lt;0.05). In addition, serum CRP, ESR and fibrinogen levels were generally increased in the active group compared to the remission group and had significant linear relationships with disease activity(p&lt;0.05). No significant relationship was found between the obtained posterior segment eye findings and disease activity, serum CRP, ESR and fibrinogen(p&gt;0.05).

Conclusion

Retinal vascular structure changes in UC patients compared to healthy participants were associated with systemic inflammation leading to ischemic damage. While choroidal atrophy and thinning were expected with ischemia in UC patients, an increase in subfoveal choroidal thickness was observed in our patients.

Furthermore, the study showed that posterior segment eye findings were not superior to traditional biomarkers routinely used in clinical practice in assessing disease activity.

References

1-Yilmaz S, Aydemir E, Maden A, Unsal B. The prevalence of ocular involvement in patients with inflammatory bowel disease. Int J Colorectal Dis. 2007;22(9):1027-1030. doi:10.1007/s00384-007-0275-1

2-Felekis T, Katsanos K, Kitsanou M, et al. Spectrum and frequency of ophthalmologic manifestations in patients with inflammatory bowel disease: a prospective single-center study. Inflamm Bowel Dis. 2009;15(1):29-34. doi:10.1002/ibd.20584

3-Nakayama LF, Bergamo VC, Conti ML, et al. The retinal foveal avascular zone as a systemic biomarker to evaluate inflammatory bowel disease control. Int J Retina Vitreous. 2019;5:16. Published 2019 Aug 6. doi:10.1186/s40942-019-0168-9

4-Debourdeau E, Charmard C, Carriere I, et al. Retinal Microcirculation Changes in Crohn’s Disease Patients under Biologics, a Potential Biomarker of Severity: A Pilot Study. J Pers Med. 2022;12(2):230. Published 2022 Feb 7. doi:10.3390/jpm12020230