Abstract

INTRODUCTION: Ophtalmic pathologies may be seen in various liver diseases related to autoimmunity, complications, drugs and other treatment modalities. In this study we aimed to assess the ophtalmic findings in autoimmune liver diseases (AILD) including Autoimmune Hepatitis (AIH), Primary Biliary Cholangitis (PBC), Overlap Syndromes and Primary Sclerosing Cholangitis (PSC). 

METHODS: Patients with AILD under follow-up in gastroenterology department in a tertiary hospital (Istanbul Medeniyet University, Goztepe Education and Research Hospital) were examined by an ophtalmologist blind to the diagnosis. A detailed ophthalmic examination, including external inspection of eye and eye lids, visual acuity, pupillary reaction, ocular movements, and ophthalmoscopy were performed. The demographic data and ocular findings were statistically analysed. 

RESULTS: The total registered patients in a single center with AILD were 111 (101 female and 10 male; 55 PBC, 44 AIH, 10 Overlap and 2 PSC) fulfilling relevant criteria for diagnosis. The mean age of the patients were 56,4±13,6 (23-84). Of these 13 patients had died related to liver problems. Ophtalmic examination could be done in 156 eyes of 78 patients. with AILD. The prominent ocular findings of 156 eyes of 78 patients were cataract (12,8%) and dry eye (11,5%). corneal sensitivity, uveitis, diabetic retinopathy (2,56% each), corneal lesions, episcleritis, macular degeneration, blepharitis, arcus senilis, conjunctival nevi and floating specks (1,28% each). xanthelasma was present on eyelids only in 3 patients (3,8%) and all were female PBC patients. All cataract patients were female and the ages were less than 60 in 5 of them and the youngest was 38 years old. Remaining 90 eyes of 45 patients (57.6%) had no distinct pathological ocular finding. Also, no glaucoma was assessed in this cohort.

CONCLUSION: In our AILD patients, ophtalmic findings were primarily cataract and dry eye. Xanthelasma which is closely related with high total cholesterol level was infrequent in our patients than some reports indicating it as 15-33% of PBC patients. Other findings were not seen in a high majority of AILD patients than other autoimmune diseases as rheumatoid arthritis, Reiters or SLE.