Ophthalmological Findings in Cases of Autoimmune Pancreatitis: Changes in Long-term Corticosteroid Therapy

Patients with autoimmune pancreatitis (AIP) sometimes show characteristic ophthalmologic findings, such as dacryoadenitis and dry eye. However, the ocular findings in AIP patients thus far have not fully been analyzed, especially in patients treated long term with corticosteroids (CS). We aimed to study the current and previous history of ocular diseases in AIP patients and changes of the common ophthalmologic findings during the CS treatment.

We retrospectively analyzed the history of ophthalmologic diseases in 105 AIP patients and further examined the changes in the ophthalmologic findings and associated factors occurring during CS treatment in 63 patients.

Several common ophthalmic diseases, including cataract (33.3%) and glaucoma (6.3%), were recognized in approximately one-third of the AIP patients at their initial diagnosis. Behcet uveitis was seen in the past histories of two AIP patients. During 70 months of CS treatment, exacerbation of cataract was recognized in 31.7%, and new onset of glaucoma in 7.9%. Univariate and multivariate analyses demonstrated the cumulative CS amount as a significant risk of cataract exacerbation (p<0.05) and diffuse pancreatic swelling at the initial diagnosis as a risk of Mikulicz's disease (p<0.01).

An ophthalmologic check at the initial diagnosis and monitoring during CS treatment is required for patients with AIP. Promising steroid-sparing agents are expected to lessen the adverse ophthalmologic events caused by CS.