The eyes of children with celiac disease

• Published in: Journal of AAPOS Vol. 21; no. 1; pp. 48 - 51
• Main Authors: Karatepe Hashas, Arzu Seyhan, MD, Altunel, Orhan, MD, Sevınc, Eylem, MD, Duru, Necati, MD, Alabay, Bedirhan, MD, Torun, Yasemin Altuner, MD
• Format: Journal Article
• Language: English
• Published: United States 01.02.2017
• Subjects: Adolescent; Anterior Chamber - pathology; Celiac Disease - complications; Celiac Disease - diagnosis; Celiac Disease - metabolism; Child; Child, Preschool; Diagnostic Techniques, Ophthalmological; Eye Diseases - diagnosis; Eye Diseases - etiology; Eye Diseases - metabolism; Female; Humans; Male; Nerve Fibers - pathology; Ophthalmology; Photography; Prospective Studies; Retinal Ganglion Cells - pathology; Tears - metabolism; Tomography, Optical Coherence
• ISSN: 1091-8531; 1528-3933
• DOI: 10.1016/j.jaapos.2016.09.025

Abstract Purpose To determine possible eye involvement in pediatric patients with celiac disease. Methods Children (aged 5-18 years) with classic celiac disease and sex- and age-matched controls were included. In addition to a complete ophthalmologic examination, all patients were scanned by a Scheimpflug camera and spectral domain optical coherence tomography, and Schirmer and break-up time (BUT) tests were performed. Data were evaluated by paired t test, with a P value of <0.05 considered statistically significant. Results A total of 31 celiac patients (19 females [61%]) and 34 controls (20 females [59%]) were included. Mean age of the celiac patients was 11.0 ± 4.4 years (range, 4-18 years); of the controls, 10.4 ± 2.6 years (range, 5-15 years; P = 0.473). Mean follow-up of patients was 5.4 ± 1.7 years (range, 3-7.2 years). The eyes of children with celiac disease, compared to controls, did show decreased anterior chamber depth (3.5 ± 0.2 vs 3.7 ± 0.2, resp.; P < 0.001), decreased anterior chamber volume (170.8 ± 25.5 vs 190.7 ± 27.4; P < 0.001), lower Schirmer (17.9 ± 9.1 vs 21.6 ± 4.1; P = 0.038), and lower BUT (10.8 ± 3.8 vs 12.1 ± 1.7; P = 0.046), as well as lower retinal nerve fiber layer (general 102.8 ± 8.2 vs 108.9 ± 10.1; P < 0.001). Conclusions Decreases in retinal nerve fiber, anterior chamber shallowing, and qualitative and quantitative reduction in tears can occur in celiac patients, even if routine ocular examination reveals no pathology.