慢性肝病眼部表现介绍*

doi:10.3969/j.issn.1672-5069.2026.05.040

Abstract

Abstract: Liver diseases can lead to ocular abnormalities through diverse mechanisms, including metabolic disturbances, viral infections and immune dysregulation. These ocular manifestations are closely correlated with hepatic pathological changes and may serve as an important auxiliary indicator for early diagnosis and disease monitoring of liver diseases. This review systematically searches literature in PubMed database, with a focus on characterizing the ocular features associated with different types of liver diseases, analyzing their pathogenic mechanisms, and summarizing the clinical implication of ocular signs in hepatological diagnosis.

Key words: Liver diseases, Ocular manifestations, Diagnosis

Ruan Fang, Kong Wenjun. Ocular manifestations of chronic liver diseases[J]. Journal of Practical Hepatology, 2026, 29(5): 796-799.

References

[1] Patel R, Nair S, Choudhry H,et al. Ocular manifestations of liver disease: an important diagnostic aid. Int Ophthalmol, 2024, 44(1): 177.
[2] Chen C, Wei L, He W,et al. Associations of severe liver diseases with cataract using data from UK Biobank: a prospective cohort study. E Clin Med, 2024, 68: 102424.
[3] Vitiello L, De Bernardo M, Guercio Nuzio S,et al. Pediatric liver diseases and ocular changes: What hepatologists and ophthalmologists should know and share with each other. Dig Liver Dis, 2020, 52(1): 1-8.
[4] Humbertjean-Selton L, Selton J, Riou-Comte N,et al. Bilateral optic neuropathy related to severe anemia in a patient with alcoholic cirrhosis: a case report and review of the literature. Clin Mol Hepatol, 2018, 24(4): 417-423.
[5] Cumurcu T, Gunduz A, Cumurcu BE,et al. The changes in tear film parameters and impression cytology in heavily drinking men. Cornea, 2013, 32(3): 237-241.
[6] Ghosh AK, Čsna R, Neverauskas D,et al. Dietary alcohol consumption elicits corneal toxicity through the generation of cellular oxidative stress. J Ocul Pharmacol Ther, 2023, 39(5): 303-316.
[7] Yang YT, Ji MR, Lin ZJ,et al. Bile duct ligation impairs visual acuity in rats by ammonia- and bilirubin-induced retinal degeneration. Acta Pharmacol Sin, 2025, 46(2): 380-392.
[8] Kuo BL, Muste JC, Russell MW,et al. Evidence for the hepato-retinal axis: A systematic review. Ophthalmic Surg Lasers Imaging Retina, 2024, 55(10): 587-596.
[9] Sohal RJ, Singh P, Sandhu SS,et al. A rare cause of bilateral corneal ulcers: vitamin A deficiency in the setting of chronic alcoholism. Cureus, 2020, 12(5): e7991.
[10] Goel S, Aggarwal N, Sharma A,et al. Ocular manifestations of Wilson's disease. BMJ Case Rep, 2019, 2019: bcr2019202516.
[11] Rubio-Gozalbo ME, van der Meer S, Monnens LA, et al. The natural history of classic galactosemia: lessons from the GalNet registry. Orphanet J Rare Dis, 2019, 14(1): 86.
[12] Rajappa M, Goyal A, Kaur J. Inherited metabolic disorders involving the eye: a clinico-biochemical perspective. Eye (Lond), 2010, 24(4): 507-518.
[13] Hingorani M, Goldfarb DS, Rand EB,et al. Ocular abnormalities in Alagille syndrome. Ophthalmology, 1999, 106(2): 330-337.
[14] Folz SJ, Trobe JD. The peroxisome and the eye. Surv Ophthalmol, 1991, 35(5): 353-368.
[15] Colburn JD, Skelo AS, Donahue SP. Corneal ulceration due to vitamin A deficiency in Zellweger syndrome. J AAPOS, 2009, 13(3): 289-291.
[16] Ajzensztejn MJ, Hulton SA, Gill D, et al. Primary hyperoxaluria type 1. Arch Dis Child, 2007, 92(3): 197.
[17] Del Longo A, Piozzi E, Schweizer F. Ocular features in mucopolysaccharidosis: diagnosis and treatment. Ital J Pediatr, 2018, 44(Suppl 2): 125.
[18] Ashworth JL, Clarke AJ, Hollingsworth DR,et al. Mucopolysaccharidoses and the eye. Surv Ophthalmol, 2006, 51(1): 1-17.
[19] Libert J, Toussaint D, Guiselings R. Ocular findings in Niemann-Pick disease. Am J Ophthalmol, 1975, 80(6): 991-1002.
[20] Tsoumani A, Theopistos V, Katsanos A, et al. Treatment and non-treatment related ocular manifestations in patients with chronic hepatitis B or C. Eur Rev Med Pharmacol Sci, 2013, 17(8): 1123-1131.
[21] d'Alteroche L, Majzoub S, Lecuyer AI,et al. Posterior segment complications in patients with hepatitis C treated with interferon and ribavirin. J Hepatol, 2004, 40(4): 706-707.
[22] Raza A, Mittal S, Sood GK. Interferon-associated retinopathy during the treatment of chronic hepatitis C: a systematic review. J Viral Hepat, 2013, 20(9): 593-599.
[23] Hayasaka S, Nagaki Y, Matsumoto M, Sato S. Ophthalmologic side effects during alpha-interferon therapy for viral hepatitis. J Interferon Cytokine Res, 1998, 18(8): 569-572.
[24] Bertrand RHC, de Oliveira DM, de Freitas MR,et al. An eye on hepatitis C: a review. Arq Bras Oftalmol, 2019, 82(2): 161-167.
[25] Zeni LP, Viera SM, Mello FC,et al. Hepatitis C virus induces abnormalities in surface and intraocular pressure: a comparative study. Eur J Gastroenterol Hepatol, 2013, 25(4): 411-415.
[26] Gumus K, Erden A, Yilmaz O,et al. Evaluation of ocular surface damage and dry eye status in chronic hepatitis C at different stages of hepatic fibrosis. Cornea, 2009, 28(9): 997-1002.
[27] Wilson SE, Foster CS, Azar DT,et al. Mooren-type hepatitis C virus-associated corneal ulceration. Ophthalmology, 1994, 101(4): 736-745.
[28] Yeh CC, Chen YC, Yang YH, et al. Association of SjÏgrens syndrome in patients with chronic hepatitis virus infection: a population-based analysis. PLoS One, 2016, 11(8): e0161958.
[29] Citirik M, Erdem E, Gurel S,et al. Ocular findings in patients with autoimmune liver disease. Ocul Immunol Inflamm, 2012, 20(6): 438-442.
[30] Eshraghi H, Mahtabfar A, Dastjerdi MH. A case of peripheral ulcerative keratitis associated with autoimmune hepatitis. Case Rep Med, 2017, 2017: 3939413.
[31] Romanelli RG, Bianchi FB, de Souza AP,et al. Uveitis in autoimmune hepatitis: a case report. World J Gastroenterol, 2006, 12(10): 1637-1640.
[32] Liang Y, Li J, Wang Y, et al. Extrahepatic conditions of primary biliary cholangitis: a systematic review and meta-analysis of prevalence and risk. Clin Res Hepatol Gastroenterol, 2024, 48(5): 102321.
[33] Deng X, Li J, Hou M, et al. Prevalence and impact of SjÏgren's syndrome in primary biliary cholangitis: a systematic review and meta-analysis. Ann Hepatol, 2022, 27(6): 100746.
[34] Li S, Li A, Zhu Y, et al. Evaluation of the clinical characteristics of dry eye secondary to different types of liver diseases. Ophthalmol Ther, 2023, 12(5): 2493-2503.
[35] Dogra S, Jindal R. Cutaneous manifestations of common liver diseases. J Clin Exp Hepatol, 2011, 1(3): 177-184.

Ocular manifestations of chronic liver diseases

PDF (PC)

Knowledge

Abstract

Cite this article

share this article

References

Related Articles 15

Recommended Articles

Metrics

Comments

[1]	Han Min, He Mingling, Zhang Dongbang, et al. Prediction of significant liver fibrosis by FibroTouch detection in combination with APRI score in patients with primary biliary cholangitis [J]. Journal of Practical Hepatology, 2026, 29(5): 681-684.
[2]	Wang Haiyu, Zhang Zhibo, Wang Qian, et al. Ultrasound attenuation coefficient imaging in the assessment of liver damage in children and adolescents with hepatolenticular degeneration [J]. Journal of Practical Hepatology, 2026, 29(5): 697-700.
[3]	Wen Ting, Jia Yuyang, Feng Liuping. Application of liver DWI parameters in predicting patients with liver cirrhosis and high-risk esophageal varices [J]. Journal of Practical Hepatology, 2026, 29(5): 709-712.
[4]	Wang Wenxuan, Li Jie, Wang Xinrui, et al. Classification of cholangiocarcinoma staging by CT and MRI enhanced scans [J]. Journal of Practical Hepatology, 2026, 29(5): 781-784.
[5]	Ma Guangjun, Zhu Qingsong, Meng Xianghua. Bismuth-Corlette typing of patients with hilar cholangiocarcinoma by CT multimodal reconstruction [J]. Journal of Practical Hepatology, 2026, 29(5): 785-788.
[6]	Wu Pengxuan, Liu Hui, Zheng Sujun. Inherited metabolic liver diseases that may present with hepatic steatosis: current state of the art [J]. Journal of Practical Hepatology, 2026, 29(4): 481-484.
[7]	Liu Ying, Ma Xiaohong, Sun Changjiang, et al. Evaluation of hepatic steatosis by ultrasound-derived fat fraction in combination with RC/HDL-C ratio in patients with MAFLD [J]. Journal of Practical Hepatology, 2026, 29(4): 513-516.
[8]	Guo Hongyan, Wang Rui, Sun Qian. Impact of poorly-controlled blood glucose on oxidative stress and liver fibrosis in patients with type 2 diabetes mellitus and non-alcoholic fatty liver diseases [J]. Journal of Practical Hepatology, 2026, 29(4): 521-524.
[9]	Peng Yanxia, Zhai Meng. Liver ultrasound attenuation coefficient and body mass index in predicting metabolic dysfunction-associated steatohepatitis in obese children [J]. Journal of Practical Hepatology, 2026, 29(4): 525-528.
[10]	Zhu Chenchen, Zhuang Xiaochen, Yang Lingfei, et al. Diagnostic efficacy of QUS technology in predicting hepatic steatosis in patients with non-alcoholic fatty liver disease [J]. Journal of Practical Hepatology, 2026, 29(4): 529-532.
[11]	Yang Hong, Lai Huijun, Ma Lei, et al. Evaluation of liver fibrosis by ultrasound elastography and serum liver fibrosis indexes in patients with schistosomiasis liver disease [J]. Journal of Practical Hepatology, 2026, 29(4): 561-564.
[12]	Lai Zhenhui, Cai Yinlian, Cui Dong, et al. Prediction of esophageal gastric varices by abdominal CT scan parameters in patients with liver cirrhosis and portal hypertension [J]. Journal of Practical Hepatology, 2026, 29(4): 565-568.
[13]	Li Lifang, Wang Chaoyang, Li Zexin. Efficacy of liver stiffness measurement in combination with FIB-4 index and serum CHI3L1 levels in predicting esophageal varices in patients with hepatitis B-induced liver cirrhosis [J]. Journal of Practical Hepatology, 2026, 29(4): 569-572.
[14]	Shi Lu, Wu Xiaoyu, Shou Mengyuan, et al. China disease burden of liver diseases from 1990 to 2021 and prediction of future trend [J]. Journal of Practical Hepatology, 2026, 29(4): 581-584.
[15]	Wang Guanhua, Wang Ping, Yang Jinjun, et al. Application of contrast-enhanced ultrasound in the diagnosis and treatment of patients with early bacterial liver abscess [J]. Journal of Practical Hepatology, 2026, 29(4): 601-604.