{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T05:10:36Z","timestamp":1788844236291,"version":"build-2803163510"},"reference-count":27,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Celiac disease (CD) is an autoimmune enteropathy affecting approximately 0.7\u20131.4% of the global population. However, extraintestinal manifestations of CD, particularly ophthalmic conditions, remain underrecognized. This study aims to describe the spectrum and frequency of ophthalmic manifestations among a cohort of patients with CD in Tabuk, Saudi Arabia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This 5-year retrospective observational study was conducted at a tertiary care center and included 83 patients with CD, with no age restrictions. Patients were identified through the hospital\u2019s electronic medical records using a diagnosis of CD established by a gastroenterologist based on standard clinical, serological, and\/or histopathological criteria. Ophthalmic manifestations were retrieved from comprehensive ophthalmic examinations documented by ophthalmologists. For analysis, participants were stratified into pediatric (\u226414\u202fyears) and adult (&amp;gt;14\u202fyears) groups based on their age at the time of data collection.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Ophthalmic manifestations were identified in 37.3% (95% CI: 27.0 to 48.7%) of the reviewed patient records. The most common ocular manifestations included refractive errors (12, 95% CI: 5.9 to 21.0%), followed by allergic conjunctivitis and dry eye disease (each 4.8, 95% CI: 1.3 to 11.9%). No significant associations were observed between age groups or diabetes mellitus and the prevalence of individual ophthalmic diagnoses. However, when ophthalmic involvement was analyzed as a composite outcome (defined by the presence of any ophthalmic disorder), a multivariable logistic regression analysis demonstrated that older age (adjusted OR: 3.25, 95% CI: 1.09 to 9.66,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.034) and diabetes mellitus (adjusted OR: 3.32, 95% CI: 1.17 to 9.44,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.024) were independently associated with increased odds of having ophthalmic involvement.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In this cohort, ophthalmic findings were documented in over one-third of patients with CD. However, the prevalence of refractive errors was comparable to that reported in the general population, and due to the absence of a control group, a disease-specific association between CD and ophthalmic manifestations could not be established. Nevertheless, adults and patients with co-occurring diabetes demonstrated a higher likelihood of ocular involvement. These results highlight the need to raise awareness of ocular findings in patients with CD among healthcare professionals. Future controlled studies, particularly matched case\u2013control or prospective cohort designs, are recommended to better assess these potential associations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1801404","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T04:26:27Z","timestamp":1788841587000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Ophthalmic manifestations of celiac disease in Tabuk City, Saudi Arabia"],"prefix":"10.3389","volume":"13","author":[{"given":"Seham S.","family":"Alhemaidi","sequence":"first","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Omnia S.","family":"Elseifi","sequence":"additional","affiliation":[{"name":"Department of Family and Community Medicine, Faculty of Medicine, University of Tabuk","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faris","family":"Hashem","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maisa","family":"Elhalabi","sequence":"additional","affiliation":[{"name":"Pediatrics Department, King Salman Armed Forces Hospital in Northwestern Region","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naif M.","family":"Alali","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hani B.","family":"ALBalawi","sequence":"additional","affiliation":[{"name":"Division of Ophthalmology, Department of Surgery, Faculty of Medicine, University of Tabuk","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maher F.","family":"Al-Juhani","sequence":"additional","affiliation":[{"name":"Ophthalmology Department, King Salman Armed Forces Hospital in Northwestern Region","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sumayah A.","family":"Alzahrani","sequence":"additional","affiliation":[{"name":"Pediatrics Department, King Salman Armed Forces Hospital in Northwestern Region","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Albaraa A.","family":"Altowijri","sequence":"additional","affiliation":[{"name":"Department of Surgery, Faculty of Medicine, University of Tabuk","place":["Tabuk, Saudi Arabia"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"159","DOI":"10.18240\/ijo.2016.01.26","article-title":"Ophthalmologic manifestations of celiac disease","volume":"9","author":"Martins","year":"2016","journal-title":"Int J Ophthalmol"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1016\/j.cgh.2017.06.037","article-title":"Global prevalence of celiac disease: systematic review and Meta-analysis","volume":"16","author":"Singh","year":"2018","journal-title":"Clin Gastroenterol Hepatol"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"6865917","DOI":"10.1155\/2020\/6865917","article-title":"The epidemiology of celiac disease in the general population and high-risk groups in Arab countries: a systematic review","volume":"2020","author":"El-Metwally","year":"2020","journal-title":"Biomed Res 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