Courses of uveal manifestations following surgical treatment of patients with ulcerative colitis in adults: Observation study

Abstract

Purpose This study aimed to investigate the course of uveal manifestations in a cohort of patients who underwent surgery for ulcerative colitis (UC), highlighting the diverse spectrum of associated eye disorders and alerting clinicians of their significance. Patients and methods A retrospective observational study was conducted on 40 UC patients with ocular manifestations who underwent one-stage laparoscopic restorative proctocolectomy according to the European Crohn’s and Colitis Organization (ECCO) guidelines. Ophthalmic examinations were performed preoperatively and postoperatively during the 6-month follow-up period. Anterior uveitis attacks were graded based on the presence of cells or flares, vitreous haze indicates intermediate uveitis while posterior uveitis was indicated by retinitis or choroiditis, or both. Recurrence was a Standardization of Uveitis Nomenclature (SUN) grading system score greater than or equal to 2+ for anterior chamber cells or vitreous haze. Results Postoperatively, uveitis regression was observed in ∼60% of the patients, 25% showed a stationary course, and 15% exhibited progression. After surgery, more patients had lower Standardization of Uveitis Nomenclature grades for anterior chamber cells, flares, and vitreous haze than at baseline. Conclusion Ulcerative colitis can manifest with various ophthalmic manifestations ranging from nonspecific to severe, affecting visual prognosis or remaining asymptomatic. In our study most patients who underwent colonic surgery got benefits in the form of not only decreasing the severity of disease activity but also a decrease in the recurrence rate postsurgical.

Keywords

• anterior uveitis
• episcleritis
• inflammatory bowel disease
• ocular
• scleritis
• ulcerative colitis