Conjunctival Impression Cytology and Tear-Film Changes in Patients With Inflammatory Bowel Disease

Purpose: To evaluate the ocular surface changes and tear-film functions in patients with inflammatory bowel disease (IBD). Methods: The IBD group included 57 patients, and the control group included 29 healthy individuals. The Schirmer I test, tear breakup time (TBUT), corneal and conjunctiva fluorescent staining, and conjunctival impression cytology tests were performed to both groups. Results: The rate of dry eye was 56.1% and 10.3% in the IBD and control groups, respectively, as assessed by the Schirmer I test (P<0.001). The rate of dry eye was 52.6% and 20.8% in the IBD and control groups, respectively through TBUT (P=0.004). The Ocular Surface Disease Index scores of the IBD group (15.25 +/- 7.31) were significantly higher than the control group (11.75 +/- 7.33) (P=0.039). According to the Oxford scheme, mild-tomoderate staining was 54.4% in the IBD group and 6.9% in the control group (P<0.001). Nelson Staging System showed that 69% of the IBD group had stage 2 or 3 impression cytology, whereas none of the control group had stage 2 or 3 impression cytology (P<0.001). Using the Schirmer I test, the rate of dry eye was 55.8% of the patients with IBD receiving 5-aminosalicylic acid (5-ASA) and 61.5% of the patients with IBD receiving both 5-ASA and azathioprine (P=0.485). Conclusions: Our study results showed that dry eye was 3 times higher in the IBD group than the control group. But, the duration of disease seems not to have effect on dry eye.