Ocular endothelial dysfunction in pediatric inflammatory bowel disease

Objectives To assess ocular microvasculature changes using optical coherence tomography angiography (OCTA) in pediatric patients with inflammatory bowel disease (IBD).MethodsPatients (aged 6-18 years) with IBD were recruited between September 2021 and May 2023. All eligible participants underwent comprehensive clinical assessment and laboratory investigation. Patients with functional gastrointestinal disorders served as the controls. This study assessed specific IBD phenotypes, disease duration, clinical and endoscopic activity indices, laboratory markers, and medication histories. OCTA was utilized to evaluate ocular microvasculature changes in both groups. Results A total of 63 children (mean age 12.9 +/- 3.3 years) were enrolled, comprising 38 in the IBD group (16 ulcerative colitis, 22 Crohn's disease, and 25 in the control group). Most patients in the IBD group were in remission or had mild-to-moderate disease activity at enrollment. Analysis of the OCTA results revealed significant differences in the choroidal luminal area and total choroidal area between the IBD and control groups.ConclusionsThe study identified distinct ocular microvasculature changes in pediatric IBD patients through OCTA, suggestive of potential systemic endothelial dysfunction. These findings underscore the utility of OCTA in evaluating microvascular alterations associated with pediatric IBD, offering insights into potential systemic complications linked to inflammation in IBD patients.What is Known Inflammatory bowel diseases (IBD) encompass systemic inflammation due to immune and nonimmune cell activation leading to microvascular endothelial damage. Endothelium plays a crucial role in various physiological processes like vasoconstriction/vasodilation, coagulation, and leukocyte migration. IBD patients often exhibit early endothelial dysfunction in the gut microvascular system.What is New Optical coherence tomography angiography (OCTA) has been used for the first time in children to evaluate endothelial dysfunction in pediatric IBD. The study identified distinct ocular microvasculature changes in pediatric IBD patients and a significant inverse correlation between platelet count and choroidal vasculature. The findings suggest a potential link between ocular microvascular alterations and systemic endothelial dysfunction in pediatric IBD emphasizing that IBD-related inflammation goes beyond the gut, impacting the microvasculature system of the eye.