4.7 Article

Association between Optic Neuritis and Inflammatory Bowel Disease: A Population-Based Study

Journal

JOURNAL OF CLINICAL MEDICINE
Volume 10, Issue 4, Pages -

Publisher

MDPI
DOI: 10.3390/jcm10040688

Keywords

Crohn’ s disease; extraintestinal manifestation; inflammatory bowel disease; optic neuritis; ocular manifestation; ulcerative colitis

Funding

  1. Tri-Service General Hospital Research Foundation [TSGH-B-110012, TSGH-D-110112, TSGH-D-110109]
  2. Ministry of National Defense [MNDMAB-110-084, MAB-E-110001]

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Patients with inflammatory bowel disease (IBD) have a higher risk of developing optic neuritis (ON) compared to those without IBD. ON occurs more frequently in IBD patients aged between 30 and 39 years, with comorbidities including neuromyelitis optica (NMO), acute disseminated encephalomyelitis (ADEM) and systemic lupus erythematosus (SLE). Other factors besides anti-tumor necrosis factor alpha treatment for IBD are more likely associated with the development of ON.
Extraintestinal manifestations are common in patients with inflammatory bowel disease (IBD), and optic neuritis (ON) is a rare but severe one. This study aimed to evaluate possible factors associated with ON in patients with IBD. Adult patients with IBD who were not with concomitant ON on the index date identified from the Taiwan National Health Insurance Research Database (NHIRD) from the years 2000 to 2013 were included. A four-fold matched group was selected using age, sex and year of index date for comparison. All the patients were followed up until the development of ON or the end of the study period. Data of included patients were extracted and analyzed statistically. The mean follow-up time for all patients was 7.13 +/- 5.21 years. At the study period conclusion, eight (0.18%) and five (0.003%) patients with and without IBD, respectively, had developed ON (p = 0.001). Adjusted HRs showed that patients with IBD aged between 30 and 39 years, with comorbidities including neuromyelitis optica (NMO), acute disseminated encephalomyelitis (ADEM), systemic lupus erythematosus (SLE) and with a higher Charlson Comorbidity Index, had a significantly higher risk of developing ON (all p < 0.005). Among the eight IBD patients who developed ON, only one patient was diagnosed with Crohn's disease, the male gender was slightly dominant, and two (25%) patients received antitumor necrosis factor alpha (anti-TNF alpha) treatment for IBD. Patients with IBD have a higher risk of developing ON compared to patients without IBD. ON occurs more frequently in IBD patients aged between 30 and 39 years, with comorbidities including NMO, ADEM and SLE. Other factors besides anti-TNF alpha treatment for IBD are more likely associated with the development of ON.

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