P-115 Geriatric Inflammatory Bowel Disease Patients Have Increased Occurrence of Ocular Extraintestinal Manifestations

Abstract

Extraintestinal manifestations (EIMs) are common complicating sequelae of Crohn’s disease and ulcerative colitis. Ocular manifestations are seen in 4%–12% of inflammatory bowel disease (IBD) patients and include uveitis, episcleritis, conjunctivitis and blepharitis. Geriatric patients have increased ocular disorders. However, there is limited data which has specifically evaluated ophthalmologic disorders related to IBD in the older patient. This study evaluated the frequency of ocular manifestations of IBD in the geriatric patients. A retrospective medical record review of all inflammatory bowel disease patients age ≥65 at a university medical center was performed using a multispecialty electronic health record. Patient age, gender, disease type, and ophthalmologic manifestations were obtained. Maintaining patient confidentiality, a database was created. Assessment of the frequency of EIMs in patients ≥65 years was performed. Statistical analysis was performed using an unpaired t-test and chi-square test, with statistical significance set at P < 0.05. The study was approved by the university institutional review board. Twenty-four medical records were reviewed. There were 15 women and 9 men, mean age of 70.1 years, and an average duration of disease of 19.8 years. Twelve patients had Crohn’s disease and 12 had ulcerative colitis. Ocular EIMs were documented in 5 patients (21%): 1 with uveitis and blepharitis, 1 with episcleritis, and 3 with blepharitis. Four patients had documented ocular manifestations by ophthalmology. One patient had documented ocular manifestation by gastroenterology with 4 patients noted to have “no extraintestinal manifestations.” There was no significant difference in the rate of EIMs in geriatric patients based upon gender (P = 1.00) or disease type (P = 0.37). The frequency of EIMs in geriatric patients with inflammatory bowel disease is uncertain. Aging results in increased frequency of ocular manifestations in the general population. However, it is unclear if aging results in an increase in ophthalmologic disorders related to inflammatory bowel disease. This study revealed that geriatric patients had more ocular manifestations than anticipated when compared to population based statistics (21% versus 4%–12%). Notably, gastroenterologists identified only 20% of the documented ocular disorders in the geriatric IBD patients. Recognition of EIMs by gastroenterologists is important for optimal management of IBD patients. Further study is necessary to increase the knowledge about ocular manifestations of inflammatory bowel disease in the elderly patient.