The eyes of children with celiac disease

J AAPOS. 2017 Feb;21(1):48-51. doi: 10.1016/j.jaapos.2016.09.025. Epub 2017 Jan 10.

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 abnormality.

MeSH terms

  • 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*
  • Photography
  • Prospective Studies
  • Retinal Ganglion Cells / pathology*
  • Tears / metabolism*
  • Tomography, Optical Coherence