Crohn's disease-associated keratopathy: A case report

Abstract

Purpose: This study reports a case of Crohn's disease-associated keratopathy that progressed with disease activity. Observations: A 29-year-old man diagnosed with Crohn's disease and receiving systemic adalimumab therapy, presented with an irregular epithelial surface, superior corneal opacity, subepithelial infiltration, pannus with new vessel ingrowth, and punctate epithelial erosions in both corneas. Changes in ophthalmological findings were checked during regular outpatient follow-ups. We also compared the stool calprotectin values obtained at a gastrointestinal clinic during the course of keratopathy. By analyzing the trend of fecal calprotectin levels in this patient, we found that keratopathy worsened as fecal calprotectin levels increased. Corneal neovascularization and infiltration improved as the fecal calprotectin levels decreased. Conclusions and importance: The mechanism of Crohn's disease-associated keratopathy has not been identified but appears to be related to the autoimmune mechanism of Crohn's disease. Managing Crohn's activity by referring to the gastroenterology department should be considered to relieve Crohn's disease-associated keratopathy.

Keywords

• Crohn's disease
• Tacrolimus
• Keratopathy
• Adalimumab
• Calprotectin
• Inflammatory bowel disease