Keratoconus in Inflammatory Bowel Disease Patients: A Cross-sectional Study.
OBJECTIVE
Increasing evidence suggests that keratoconus may have an inflammatory component. The possible association of keratoconus with inflammatory bowel disease (IBD) has yet to be determined. The aim of this study was to determine the prevalence of keratoconus and suspect keratoconus in patients with IBD.


METHODS
All consecutive adult IBD patients seen in the Department of Gastroenterology, Nancy, University Hospital, France, between March 2014 and June 2014 were included. Pregnant women, rigid lens wearers, patients with a family history of keratoconus and patients with a history of refractive surgery were excluded. A control group of healthy subjects was included. All included patients underwent a corneal topography (OPD-Scan III, Nidek) to detect keratoconus or suspect keratoconus. Rabinowitz videokeratographic indices were the basis of corneal topography interpretation.


RESULTS
Two hundred and one IBD patients were included, 150 with Crohn's disease and 51 with ulcerative colitis. Mean age was 38.7 years and 121 were women. Mean disease duration was 10.8 years. Two IBD patients were diagnosed with keratoconus (1%) and 38 with suspect keratoconus (18.9%). Overall prevalence of keratoconus and suspect keratoconus was 19.9% (95% confidence interval [CI] 17.5-22.0). None of the 100 healthy subjects had keratoconus, while three were diagnosed with suspect keratoconus (p = 0.0002 versus IBD patients). Only smoking was identified as a risk factor (p = 0.029), especially in Crohn's disease.


CONCLUSIONS
Inflammatory bowel disease patients may carry an increased risk of keratoconus and suspect keratoconus, smoking further increasing this risk. This supports the hypothesis of an inflammatory origin of keratoconus.
Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France fannytrechot@gmail.com.
Fanny
F
Tréchot
Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France.
Karine
K
Angioi
Inserm CIC-EC and Department of Epidemiology and Clinical Evaluation, Nancy, University Hospital, University of Lorraine, France.
Clothilde
C
Latarche
Inserm U 954 and Department of Gastroenterology, Nancy, University Hospital, University of Lorraine, France.
Guillaume
G
Conroy
Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France.
Pauline
P
Beaujeux
Inserm U 954 and Department of Gastroenterology, Nancy, University Hospital, University of Lorraine, France.
Charlotte
C
Andrianjafy
Inserm U 954 and Department of Gastroenterology, Nancy, University Hospital, University of Lorraine, France.
Mathilde
M
Portier
Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France.
Benjamine
B
Batta
Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France.
Jean-Baptiste
JB
Conart
Department of Ophthalmology, Nancy, University Hospital, University of Lorraine, France.
Véronique
V
Cloché
Inserm U 954 and Department of Gastroenterology, Nancy, University Hospital, University of Lorraine, France.
Laurent
L
Peyrin-Biroulet
D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D005602:France; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000150:complications*; D007640:Keratoconus / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
Keratoconus; corneal topography; inflammatory bowel disease