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Optic disc swelling in Crohn's disease

J C Walker1, D Selva, G Pietris

  • 1Royal Adelaide Hospital, South Australia, Australia. jwalker@medicine.adelaide.edu.au

Australian and New Zealand Journal of Ophthalmology
|December 8, 1998
PubMed
Summary

Optic disc swelling is a rare complication of inflammatory bowel disease (IBD). Causes include inflammation, ischemia, or intracranial hypertension, with venous sinus thrombosis needing exclusion.

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Area of Science:

  • Ophthalmology
  • Gastroenterology
  • Neurology

Background:

  • Inflammatory bowel disease (IBD) encompasses Crohn's disease and ulcerative colitis.
  • Optic disc swelling, or papilledema, can manifest in various neurological and systemic conditions.
  • Understanding the link between IBD and optic disc swelling is crucial for accurate diagnosis and management.

Observation:

  • Two cases of bilateral optic disc swelling in IBD patients are presented.
  • One patient had known Crohn's disease; the other was diagnosed during investigations.
  • These cases highlight the varied presentations of optic nerve complications in IBD.

Findings:

  • Optic disc swelling in IBD is rare, with reported causes including peripapillary inflammation, optic disc ischemia, and intracranial hypertension.

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  • Optic nerve ischemia may stem from local vasculitis or systemic hypercoagulability.
  • Intracranial hypertension causes are often unclear, but corticosteroid use, iron deficiency anemia, and dural venous sinus thrombosis are considered.

    • Implications:

    • This review emphasizes the importance of considering optic disc swelling in IBD patients presenting with visual disturbances.
    • Differential diagnosis should include IBD-related etiologies alongside more common causes of papilledema.
    • Further research into the pathogenesis and optimal management strategies for optic nerve complications in IBD is warranted.