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Inflammatory choroiditis and papillitis from Crohn's disease in a child

David A Kilgore1, Alice W Behrens1, Mohammad Z Siddiqui1

  • 1Jones Eye Institute, Department of Ophthalmology, University of Arkansas for Medical Sciences, Little Rock, Arkansas.

Journal of AAPOS : the Official Publication of the American Association for Pediatric Ophthalmology and Strabismus
|October 31, 2020
PubMed

Insights

A young boy experienced vision loss due to inflammatory eye conditions linked to Crohn's disease. Intravitreal corticosteroids effectively treated his optic nerve and macular swelling.

Area of Science:

  • Ophthalmology
  • Pediatric Ophthalmology
  • Inflammatory Bowel Disease

Background:

  • Crohn's disease is a chronic inflammatory condition that can affect various parts of the body, including the eyes.
  • Ocular manifestations of Crohn's disease, though rare, can lead to significant visual impairment.

Observation:

  • A 5-year-old boy presented with subacute, painless visual loss in his left eye.
  • Clinical examination revealed optic disk edema, macular edema, and choroidal thickening.

Findings:

  • The patient was diagnosed with inflammatory papillitis and choroiditis secondary to Crohn's disease.
  • Initial treatment with anti-vascular endothelial growth factor (VEGF) injections showed minimal improvement in ocular edema.
  • Intravitreal corticosteroids resulted in significant resolution of the disk and macular edema.

Implications:

  • This case highlights a rare but serious ocular complication of pediatric Crohn's disease.
  • Early diagnosis and prompt treatment with corticosteroids are crucial for managing inflammatory eye conditions associated with Crohn's disease.
  • Ophthalmologists should consider inflammatory eye disease in children with Crohn's disease presenting with visual disturbances.

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