Bilateral Retinal Artery Occlusions and Uveitis as the First Manifestation of Crohn’s Disease

ABSTRACT

Purpose

To present a case of newly diagnosed Crohn’s disease, in which retinal artery occlusion (RAO) with uveitis was the first clinical manifestation.

Case description

A 55-year-old man presented with bilateral blurred vision, with decreased best corrected visual acuity (BCVA) to light perception (right eye, RE) and 20/40 (left eye, LE). Ophthalmological examination revealed bilateral iritis, vitritis, disc edema, and retinal vascular occlusions. Because of concurrent fever and leukocytosis, a systemic infection was highly suspected. However, whole-body imaging was unrevealing. Subsequently, the patient presented with massive bloody stool. Histopathological specimen from emergent hemicolectomy confirmed transmural granulomatous inflammation. Crohn’s disease was finally diagnosed. Following treatment, the BCVA recovered to 20/40 (RE) and 20/22 (LE). The systemic condition remained stable after a 3-year follow-up.

Conclusion

RAO with uveitis is a possible manifestation of Crohn’s disease. In complex uveitis cases, clinicians should be aware of inflammatory bowel diseases as an important differential diagnosis.

KEYWORDS:

• Crohn’s disease
• inflammatory bowel disease
• retinal artery occlusion
• retinal vasculopathy
• uveitis

Acknowledgments

The authors thank Enago (www.enago.tw) for the formal English editing of the manuscript.

Disclosure statement

The authors have no commercial or proprietary interests in any product or instrument mentioned in the manuscript.

Ethical considerations

This study was approved by the Institutional Review Board of Far Eastern Memorial Hospital (FEMH-IRB No.: 110029-F) and was conducted following the tenets of the Declaration of Helsinki.

Additional information

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.