Association Between Ischemic Optic Neuropathy and Inflammatory Bowel Disease: A Population-Based Cohort Study in Taiwan

Ting-Yi Lin; Yi-Fen Lai; Po-Huang Chen; Chi-Hsiang Chung; Ching-Long Chen; Yi-Hao Chen; Jiann-Torng Chen; Po-Chen Kuo; Wu-Chien Chien; Yun-Hsiu Hsieh

doi:10.3389/fmed.2021.753367

Association Between Ischemic Optic Neuropathy and Inflammatory Bowel Disease: A Population-Based Cohort Study in Taiwan

Front Med (Lausanne). 2021 Sep 28:8:753367. doi: 10.3389/fmed.2021.753367. eCollection 2021.

Authors

Ting-Yi Lin¹, Yi-Fen Lai¹, Po-Huang Chen², Chi-Hsiang Chung^{3

4

5}, Ching-Long Chen¹, Yi-Hao Chen¹, Jiann-Torng Chen¹, Po-Chen Kuo⁶, Wu-Chien Chien^{3

4

5

7}, Yun-Hsiu Hsieh¹

Affiliations

¹ Department of Ophthalmology, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
² Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
³ School of Public Health, National Defense Medical Center, Taipei City, Taiwan.
⁴ Department of Medical Research, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
⁵ Taiwanese Injury Prevention and Safety Promotion Association, Taipei City, Taiwan.
⁶ Department of Colon and Rectal Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei City, Taiwan.
⁷ Graduate Institute of Life Sciences, National Defense Medical Center, Taipei City, Taiwan.

Abstract

Background: Ischemic optic neuropathy (ION) is a possible extraintestinal manifestation (EIM) of inflammatory bowel disease (IBD). We investigate the relation between IBD and ION and possible risk factors associated with their incidence. Methods: Medical records were extracted from the National Health Insurance Research Database (NHIRD) from January 1, 2000, to December 31, 2013. The main outcome was ION development. Univariate and multivariate Cox regression analyses were performed. Results: We enrolled 22,540 individuals (4,508 with IBD, 18,032 without). The cumulative risk of developing ION was significantly greater for patients with IBD vs. patients without (Kaplan-Meier survival curve, p = 0.009; log-rank test). Seven (5%) and five (0.03%) patients developed ION in the IBD and control groups, respectively. Patients with IBD were significantly more likely to develop ION than those without IBD [adjusted hazard ratio (HR) = 4.135; 95% confidence interval: 1.312-11.246, p = 0.01]. Possible risk factors of ION development were age 30-39 years, diabetes mellitus (DM), hypertension, ischemic heart disease (IHD), atherosclerosis, and higher Charlson comorbidity index revised (CCI_R) value. Conclusion: Patients with IBD are at increased risk of subsequent ION development. Moreover, for patients with comorbidities, the risk of ION development is significantly higher in those with IBD than in those without.

Keywords: chron's disease; extraintestinal manifestation; inflammatory bowel diseases; ischemic optic neuropathy; ocular manifestation; ulcerative colitis.