Veterinary ophthalmology最新文献

Nodular granulomatous episcleritis (NGE) typically presents as an elevated mass or elevated masses at the limbus and often infiltrates the cornea (episclerokeratitis). In the current report, a granulomatous lesion was observed subretinally in the right eye (OD) of a 5-year-old male castrated American Staffordshire Terrier dog. There was concurrent retinal hemorrhage and detachment OD; the right eye was not visual. Due to poor prognosis for vision and potential for a neoplastic etiology of the mass, staging with higher imaging was recommended but declined by the owner. Therefore, an enucleation was performed. Histopathology of the globe identified a subretinal mass, marked histiocytic and lesser lymphoplasmacytic choroiditis, posterior episcleritis, and optic neuritis with retinal detachment. The subretinal mass was composed of densely packed, large, spindle histiocytes mixed with occasional lymphocytes, plasma cells, and only rare neutrophils. Regions of the mass showed lymphocytes aggregate to form nodules. This histological presentation was a type of proliferative histiocytic disease with similarities to nodular granulomatous episcleritis or granulomatous/necrotizing scleritis. This is a novel presentation of NGE-like progression to subretinal scleral, choroidal, and retinal involvement and provides a new differential possibility for posterior segment masses observed on fundic examination.

Objective: To describe ophthalmic findings in hospitalized canine and feline patients with tick paralysis (TP) and investigate possible predisposing factors.

Animals studied: Forty-seven dogs and 28 cats hospitalized with TP assessed with an ophthalmic examination performed by an ABVO resident.

Methods: Dogs and cats were hospitalized with TP from October 2021 to January 2022 and had an ophthalmic examination performed by an ABVO resident. Patient signalment data, information regarding tick number and location, hospitalization duration, medications used, and patient paralysis grades were recorded. Statistical analysis was performed to correlate findings.

Results: Corneal ulcers developed in up to 34.8% of dogs and up to 42.9% of cats hospitalized with TP. An absent palpebral reflex ipsilaterally increased the odds of a concurrent corneal ulcer being present by 14.7× in dogs and 20.1× in cats (p < .0001). Palpebral reflexes were absent in 38.3% of dogs and 35.7% of cats hospitalized with TP and were correlated with more severe gait paralysis (p = .01) and respiratory paralysis (p = .005) in dogs, and respiratory paralysis in cats (p = .041). STT-1 findings <10 mm/min were present in 27.7% of dogs and 57.1% of cats examined and were associated with increasing gait paralysis (p = .017) and respiratory paralysis (p = .007) in dogs, and increasing gait paralysis in cats (p = .017).

Conclusions: Simple corneal ulcers, loss of a complete palpebral reflex, and reduced STT-1 scores frequently occurred in dogs and cats hospitalized for TP. The frequency of these findings increased as the degree of patient paralysis increased.

Objective: To assess the accuracy of canine intraocular pressure (IOP) estimates from the eyeTelemed IOPvet indentation tonometer.

Animals studied: Part 1 included 54 eyes from 28 Beagle dogs-23 ADAMTS10-mutants with open-angle glaucoma and 5 normals. Part 2 involved five normal canine ex vivo globes.

Procedure: Part 1 (in vivo) compared IOPvet estimates in normal and glaucomatous dogs to Reichert Tono-Vera® Vet rebound tonometry. The three IOPvet estimates were green (normal; <20 mmHg, according to the manufacturer), yellow (elevated; 20-30 mmHg), and red (high; >30 mmHg). In Part 2 (ex vivo), the pressure inside freshly enucleated normal canine eyes was progressively increased from 5 to 80 mmHg and compared to IOPvet estimates. Descriptive statistics compared IOPvet estimates to rebound tonometry and direct manometry, with the threshold from normal to glaucoma set at 30 mmHg.

Results: In Part 1 (in vivo), normal pressures (≤30 mmHg) were mainly identified correctly as green or yellow-110 of 111 estimates, corresponding to a specificity of 99%. Only 16 of 125 affected estimates were correctly displayed in the >30-mmHg range; the remaining 109 showed ≤30 mmHg, corresponding to a sensitivity of 13%. In Part 2 (ex vivo), all normal pressures were correctly estimated with green, but 64 of 88 manometric IOPs >30 mmHg were falsely estimated as 20-30 mmHg.

Conclusions: The IOPvet is inaccurate in estimating canine IOP with a low sensitivity at identifying dogs with IOP > 30 mmHg. Canine-specific instrument revision is required to correctly identify elevated (yellow = 20-30 mmHg) and high (red >30 mmHg) IOPs.

Objective: To describe a novel surgical approach to conjunctivorhinostomy for feline nasolacrimal duct obstruction.

Animal studied: A client-owned 4-year-old female spayed domestic shorthair cat presented with chronic unilateral nasolacrimal duct obstruction of the right eye.

Methods: Following obstruction confirmation via complete ophthalmic examination and dacryocystorhinography, conjunctivorhinostomy was performed under general anesthesia, and an indwelling sub-palpebral lavage (SPL) line was placed to facilitate the formation of a new pathway for tear drainage. Specifically, the SPL footplate was sutured to the ventral conjunctival fornix with 5-0 nylon and 6-0 vicryl while the tubing was passed through the new pathway and the distal end of the tubing trimmed and tucked into a perinasal subcutaneous pocket. Two skin sutures closed the perinasal pocket and were removed 2 weeks postoperatively.

Results: No immediate postoperative complications occurred. At 6 weeks and 6 months postoperatively, the distal SPL tubing was dislodged and visible out of the right nostril. This was uneventfully trimmed shorter, and no further complications occurred. The SPL component was easily removed 11 months postoperatively without complication. The patient's clinical signs dramatically improved; she was comfortable over 2 years after surgery.

Conclusion: To the authors' knowledge, this is the first report of using an SPL as an indwelling catheter for nasolacrimal duct surgery via conjunctivorhinostomy in a cat. This technique eliminated external stent sites for the patient, which was associated with a short use of an e-collar, and utilized materials readily available in a specialty hospital.

Objective: Prospective observational study with preregistered study protocol to assess interexaminer agreement using the 2022 European College of Veterinary Ophthalmologists Hereditary Eye Disease (ECVO-HED) gonioscopy grading scheme.

Animals studied: Sixty client-owned dogs presented for gonioscopy as part of the required certification process prior to breeding.

Procedure: Two ECVO diplomates with comparable clinical experience performed gonioscopy with a Koeppe gonioscopy lens and slit-lamp biomicroscope at 10x magnification on all eyes in a randomized fashion.

Results: One hundred and eighteen of 120 eyes (60 dogs) were included. In 110/118 eyes (93%), both examiners provided the same breeding recommendation (yes/no). This translated into an agreement on the final breeding recommendation in 58/60 dogs (97%). Examiners disagreed on pectinate ligament abnormality (PLA) grading in 19/118 eyes and iridocorneal angle width (ICAW) grading in 9/118 eyes. PLA grading disagreement was mostly observed between neighboring grades. Disagreement between PLA and ICAW grading sometimes occurred within the same eye accounting for an observed disagreement in iridocorneal angle abnormality (ICAA) grading in 19/118 eyes in total. Cohen's kappa was Κ = 0.62 (95% TI 0.34-0.89), whereas maximum kappa was maxΚ = 0.82 (95% TI 0.59-1). Mixed model analysis suggested no significant examiner influence on breeding recommendations (OR 0.17; 95% CI 0.02-1.12, p = .09).

Conclusions: Although examiners disagreed on ICAA grading in 19/118 eyes, this resulted in a different breeding recommendation (yes/no) in eight eyes and in two dogs only. Therefore, the use of the 2022 ECVO-HED gonioscopy grading scheme seems to result in examiners providing the same breeding recommendations in most cases.

Objective: To describe a case of presumed band keratopathy in a young cat with no known history of corneal disease who was not receiving topical phosphate-based steroids.

Animal studied: A 10-month-old domestic shorthair cat was evaluated for severe ocular discomfort that did not improve despite the initiation of topical antibiotic treatment.

Methods: A complete ophthalmic examination and ancillary tests such as biomicroscopy and corneal cytology were performed at the time of presentation. A superficial lamellar keratectomy was excised, and the corneal button was sent for histopathology. In addition to routine hematoxylin-eosin staining, sections were stained with Gram, PAS, von Kossa, and trichrome stains.

Results: Biomicroscopic examination revealed an extensive corneal epithelial ulcer with a hard white plaque in the central area of the right cornea with associated superficial neovascularization. Ultrasound biomicroscopy showed a 0.63 mm, slightly hyperechoic band in the anterior corneal stroma. Corneal cytology evidenced numerous neutrophils with toxic changes and few macrophages. Histopathologic analysis excluded corneal sequestration as a differential diagnosis and confirmed superficial corneal mineralization. At the last follow-up, 16 months after surgery, corneal transparency had returned, and visual acuity was good with some corneal conjunctivalization.

Conclusions: In this case report, the presumptive diagnosis is calcific band keratopathy. To the best of the author's knowledge, this is the first presumed case in a cat not receiving topical phosphate-based steroids and without previous corneal damage. Lamellar keratectomy represents a curative approach that successfully resolved the clinical signs, with no reported recurrence.

Objective: To evaluate the success and failure rate of photoactivated chromophore for keratitis-corneal cross-linking (PACK-CXL) therapy in a single population of dogs and cats. To identify the usefulness of the PACK-CXL based on ulcer depth and establish a cutoff at which this procedure could be recommended. To analyze the influence of the different variables in corneal healing time and to report the presence of secondary endothelial damage and cataract formation.

Materials and methods: Medical records of dogs and cats with presumptive infectious keratitis which underwent accelerated epithelium-off PACK-CXL between 2016 and 2023 were reviewed and analyzed.

Results: Records for 369 animals were included, and the overall success rate for healing was 97% (range 4-74 days and no rescue procedure). The second success (re-epithelialization <30 days and no rescue procedure) rate was 86%, and a total of 40 eyes needed more than 1 month for the corneal repair. Corneal ulcers were classified in three categories based on the depth: 0%-33% (46%), 34%-66% (37.4%), and 67%-100% (16.5%). The cutoff at which PACK-CXL had a higher probability of failure was with ulcer depth >66.5%. Animals who suffered from keratomalacia and hypopyon at presentation, or were treated with topical serum or gentamicin after PACK-CXL showed an increase in epithelial healing time (EHT). Increasing age, brachycephalic conformation, keratomalacia alone, and deeper ulcers were identified as risk factors for the treatment outcome. Secondary endothelial injury or cataract formation was not noted in this study.

Conclusions: Accelerated PACK-CXL is a non-invasive, adjunctive treatment to medical therapy, which can be used in presumed infectious keratitis with a high probability of success. However, it is important to take in consideration the patient age, skull conformation, presence of keratomalacia, and the ulcer depth.

Objective: To map the disease locus for familial ocular melanosis (OM) in the Cairn Terrier.

Animals studied: Cairn Terriers with OM and normal control dogs.

Procedure: A genome-wide association study (GWAS) was performed using 63 OM-affected and 31 control Cairn Terriers, followed by haplotype analysis. A significantly associated single-nucleotide polymorphism was genotyped in a larger group of OM-affected and control Cairn Terriers. The coding and splice-site regions of genes mapping within the confidence interval were sequenced.

Results: A ~9.2 Mb region of chromosome 11 was significantly associated with OM. Haplotype analysis narrowed the region to 1.49 Mb. Genotyping of a SNP within the region showed 86% of OM-affected dogs were homozygous or heterozygous for the risk allele, whereas 78% of unaffected dogs were homozygous for the nonrisk allele. Sequencing of the coding regions and splice sites of four genes (c9orf72, IFNK, the 5' end of MOB3B, and the 3' end of LINGO2) and of a microRNA (MIR876) did not detect any genetic variants unique to OM-affected dogs.

Conclusion: OM in Cairn Terriers maps to a 1.49 Mb region of chromosome 11. This accounts for 86% of OM cases in our DNA bank. A second locus may account for the OM phenotype in the remaining 14% of cases. Sequencing of coding regions and splice sites of positional candidate genes and a microRNA did not reveal any genetic variants unique to affected dogs. Further studies are required to elucidate the DNA variant causal for OM in Cairn Terriers and to understand the disease mechanism.

Purpose: The purpose of this study is to describe modification of the lateral enucleation technique without ligation or clamping of the optic nerve, document the incidence of complications, estimate intraoperative blood loss and identify possible risk factors for the developments of complications.

Methods: Medical records of dogs, cats, and rabbits undergoing lateral enucleation without clamping of the optic nerve were identified and retrospectively reviewed for post-operative complications (2000-2022). The significance of possible risk factors for the development of complications, including species, sex, age, eye, surgeon, presumed ocular surface infection, cultures, follow-up, antibiotics, NSAIDs, complications and diabetes mellitus was examined in a subset of these patients (2019-2022). As a prospective study, intraoperative blood loss was estimated by gravimetric analysis in an additional subset.

Results: Records of 1296 enucleations were retrospectively reviewed and detailed evaluation regarding potential risk factors was performed in 446 enucleations. The overall complication rate and surgical site infection rate was 2.31% and 2.08% respectively. Only Pseudomonas spp. bacterial culture was associated with development of complications. Estimated relative intraoperative blood loss was 2.2% and 4.1% in 43 dogs and 29 cats respectively.

Conclusions: The modified lateral enucleation technique is a safe and fast procedure with minimal risk of postoperative complications in dogs, cats, and rabbits. Based on the anatomy of the orbital vasculature ligation or clamping of the optic nerve and surrounding tissue is contraindicated.