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1.
Vet Ophthalmol ; 27(2): 191-196, 2024 Mar.
Article in English | MEDLINE | ID: mdl-38413366

ABSTRACT

OBJECTIVE: The objective of the study was to describe the optical coherence tomographic features of a cat with acute corneal hydrops. ANIMAL STUDIED: A 4-year-old castrated male domestic shorthaired showing conjunctival redness, ocular discharge, and intermittent squinting of both eyes with asymmetrical disease onset. METHODS: Complete ophthalmic examination and optical coherence tomography were performed. RESULTS: On slit-lamp biomicroscopic examination, severe intrastromal fluid pockets with profound bullae were observed in the dorsomedial region in both eyes. A diagnosis of feline acute corneal hydrops was made in both eyes. Optical coherence tomography revealed profound stromal lamellar separation representing heterogeneous reflective areas, and fluid pockets and bullae of variable size were concomitant to Descemet's membrane detachment demonstrated by a well-defined homogeneous hyporeflective area. Upon reevaluation 30 days during healing process for both eyes, the thickened epithelia and the thinning pan-stromal areas were identified as homogeneously hyper-reflective epithelia and as heterogeneous hyper-reflectivity, respectively. A thickened posterior corneal surface was shown as heterogeneous with patchy hyper-reflectivity. Additionally, Descemet's membrane detachment in the initial presentation had two distinct forms suspicious of Descemet's membrane rupture in each eye: a break with rolled ends and a break with flat ends. CONCLUSION: To the author's knowledge, this study represents the first documentation of in vivo detection of Descemet's membrane detachment and presumed rupture in a cat experiencing acute corneal hydrops. These observations strongly indicate that Descemet's membrane detachment/rupture acts as a most likely risk factor in the onset of acute corneal hydrops in cats.


Subject(s)
Cat Diseases , Corneal Edema , Cats , Male , Animals , Descemet Membrane/diagnostic imaging , Tomography, Optical Coherence/veterinary , Tomography, Optical Coherence/methods , Blister/complications , Blister/veterinary , Cornea , Corneal Edema/diagnostic imaging , Corneal Edema/veterinary , Edema/complications , Edema/veterinary , Cat Diseases/diagnostic imaging
2.
Open Vet J ; 13(5): 620-628, 2023 05.
Article in English | MEDLINE | ID: mdl-37304611

ABSTRACT

Background: Although ocular findings in diabetic patients are well described, prevalence data for those is unknown. Aim: To describe the prevalence of ocular findings and their association with glycemia in dogs with diabetes mellitus. Methods: Medical records from diabetic dogs assessed by the ophthalmology and the internal medicine services at the Veterinary Teaching Hospital of the Autonomous University of Barcelona were reviewed (2009-2019). Results: Seventy-five dogs (150 eyes) of both genders (51/75 females; 68% and 24/75 males; 32%) and a mean age of 9.37 ± 2.43 years, were included. The most common ocular findings were cataracts (146/150; 97.3%), vitreous degeneration (45/98; 45.9%), anterior uveitis (47/150; 31.3%), aqueous deficiency dry eye (ADDE) (33/150; 22%), diffuse corneal edema (31/150; 20.7%), non-proliferative retinopathy (13/98; 13.3%), and lipid keratopathy (9/150; 6%). The most prevalent type of cataracts observed (78/146; 53.4%) was intumescent, which was commonly accompanied by non-proliferative retinopathy (p = 0.003). Among the diabetic dogs, blood glucose levels were statistically higher in dogs with non-proliferative retinopathy or anterior uveitis (p < 0.005). Conclusions: Ocular complications of diabetes mellitus in dogs are numerous, being the most frequent intumescent cataracts, vitreous degeneration, anterior uveitis, ADDE, diffuse corneal edema, and non-proliferative retinopathy. This high prevalence warrants a more detailed ophthalmic evaluation in diabetic dogs especially for those undergoing cataract surgery. Furthermore, a predisposition for anterior segment inflammation and non-proliferative retinopathy is suggested when fasting plasma glucose is higher than 600 mg/dl..


Subject(s)
Cataract , Corneal Edema , Diabetes Mellitus , Dog Diseases , Retinal Diseases , Uveitis, Anterior , Female , Male , Animals , Dogs , Corneal Edema/veterinary , Hospitals, Animal , Hospitals, Teaching , Prevalence , Cataract/complications , Cataract/epidemiology , Cataract/veterinary , Diabetes Mellitus/epidemiology , Diabetes Mellitus/veterinary , Uveitis, Anterior/veterinary , Retinal Diseases/veterinary , Dog Diseases/epidemiology
3.
Vet Ophthalmol ; 26(3): 262-267, 2023 May.
Article in English | MEDLINE | ID: mdl-36999558

ABSTRACT

OBJECTIVE: We hypothesized that keratouveitis still occurs despite current widespread use of Canine adenovirus (CAV)-2 vaccinations and assessed the utility of CAV-1 and CAV-2 titers in elucidation of its etiopathogenesis. ANIMALS STUDIED: Nine dogs with unexplained keratouveitis (14 eyes) and nine control dogs. PROCEDURES: The Animal Health Trust clinical database was searched between 2008 and 2018 to identify cases of keratouveitis. Inclusion criteria included known vaccination status, interval from vaccination to development of clinical signs and availability of CAV titers. Cases were excluded if they were older than 1 year of age, or other causative ocular pathology for corneal edema was identified. Nine age-matched dogs without corneal edema but with CAV titers were included as controls. RESULTS: Mean CAV-1 and CAV-2 titers were not statistically different between dogs with keratouveitis and controls (p = .16 and p = .76, respectively). Three cases had CAV-1 titers >5000 and two of these cases had rising convalescence titers (greater than an 11-fold increase) suggesting infection with wild-type CAV-1. The six other cases did not appear to be associated with CAV infection or vaccination. CONCLUSION: Keratouveitis continues to occur despite the advent of CAV-2 vaccinations. While this study found no evidence to indicate CAV-2 vaccination causes keratouveitis, the data indicates that in a proportion of cases, contemporaneous wild-type CAV-1 infection is a possible cause.


Subject(s)
Adenoviridae Infections , Adenoviruses, Canine , Corneal Edema , Dog Diseases , Keratitis , Dogs , Animals , Dog Diseases/diagnosis , Corneal Edema/veterinary , Vaccination/veterinary , Keratitis/veterinary , Adenoviridae Infections/complications , Adenoviridae Infections/diagnosis , Adenoviridae Infections/veterinary
4.
J Vet Sci ; 24(1): e16, 2023 01.
Article in English | MEDLINE | ID: mdl-36726281

ABSTRACT

BACKGROUND: Long-term comparative data of phacoemulsification combined with endoscopic cyclophotocoagulation (phaco-ECP) versus phacoemulsification (phaco) alone in dogs are rare. OBJECTIVES: To investigate the effects of ECP on postoperative intraocular pressure (IOP) and complications after phaco in dogs with normal IOP. METHODS: Medical records of IOP, conjunctival hyperemia, corneal edema, aqueous flare, posterior synechia, intraocular fibrin, and posterior capsule opacification (PCO) formation in 15 canine eyes that underwent phaco-ECP and 36 eyes that underwent phaco alone were evaluated retrospectively. ECP was applied when either the iridocorneal angle or the ciliary cleft was narrow or closed. RESULTS: The IOP of the phaco-ECP group persisted within the normal range postoperatively. The phaco-ECP group had a shorter period of dorzolamide use than did the phaco group. PCO was formed earlier in the phaco-ECP group than in the phaco group. The phaco-ECP group showed more severe corneal edema than the phaco group at every follow-up visit. Posterior synechia was more severe in the phaco-ECP group than in the phaco group from two weeks until the last follow-up. CONCLUSIONS: Although ECP might cause more postoperative complications such as corneal edema and posterior synechia, it could effectively reduce the incidence of IOP increase after phaco in dogs with a high risk of postoperative glaucoma.


Subject(s)
Corneal Edema , Dog Diseases , Glaucoma , Phacoemulsification , Dogs , Animals , Intraocular Pressure , Retrospective Studies , Phacoemulsification/adverse effects , Phacoemulsification/veterinary , Corneal Edema/complications , Corneal Edema/surgery , Corneal Edema/veterinary , Laser Coagulation/veterinary , Glaucoma/surgery , Glaucoma/veterinary , Glaucoma/complications , Treatment Outcome , Postoperative Complications/etiology , Postoperative Complications/veterinary , Postoperative Complications/surgery , Dog Diseases/etiology , Dog Diseases/surgery
5.
Vet Ophthalmol ; 26(2): 155-160, 2023 Mar.
Article in English | MEDLINE | ID: mdl-36738127

ABSTRACT

OBJECTIVE: The aim of this study was to describe placement of a nictitating membrane flap as a treatment for corneal ulceration and bullous keratopathy in two horses. ANIMALS STUDIED: A 13-year-old American Saddlebred mare presented for severe corneal edema, superficial stromal ulceration, and a central bulla of the left eye. A 4-year-old Trakhener stallion also presented with a large axial bulla of the left eye with concurrent severe corneal edema and a deep stromal ulcer. PROCEDURE: A complete ophthalmic examination was performed. Samples were obtained for corneal cytology, and both horses were started on aggressive medical therapy. Both underwent general anesthesia for placement of a nictitating membrane flap and a subpalpebral lavage system (SPLS). RESULTS: Corneal cytology for each horse revealed a mixed bacterial population. Moderate Pseudomonas aeruginosa was cultured from the mare, while Aspergillus species and a few Enterococcus gallinarum were cultured from the stallion. The bullae in both horses resolved at 3 and 4 weeks and vision returned in the affected eye 4.5 and 3 months postoperatively at the last follow-up, respectively. CONCLUSION: Aggressive medical management with concurrent placement of a nictitating membrane flap is effective to treat bullous keratopathy in two horses. The described treatments could be used to treat horses that develop severe or progressive bullous corneal lesions.


Subject(s)
Corneal Edema , Corneal Ulcer , Horses , Animals , Male , Female , Corneal Edema/veterinary , Nictitating Membrane/pathology , Blister/pathology , Blister/veterinary , Cornea/pathology , Corneal Ulcer/surgery , Corneal Ulcer/veterinary , Corneal Ulcer/pathology
6.
Vet Ophthalmol ; 25(4): 307-311, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35727165

ABSTRACT

A fledgling feral pigeon with systemic protozoal infection was referred with corneal protrusion in the right eye after being treated for a corneal ulcer for 12 days. Ophthalmic examination revealed a corneal bulla covering almost the entire central cornea and preventing the eyelids from closing. Gelatinous corneal stroma with numerous heterophils surrounding the corneal bulla was also detected on cytologic examination. Bullous keratopathy and melting keratitis in the right eye were diagnosed. Temporary tarsorrhaphy with topical eye drops was prescribed for a week; however, the bulla persisted. A modified nictitating membrane flap was created under general anesthesia and maintained for 2 weeks. The corneal bulla resolved, and corneal thickness was restored. The pigeon was presented again with recurrence of the corneal bulla in the right eye after 45 days. Alternative surgical options were recommended; however, the pigeon was euthanized because the protozoa-induced intra-oral and intra-aural masses caused malformation of the beaks, which made voluntary feeding impossible.


Subject(s)
Columbidae , Corneal Edema , Animals , Blister/veterinary , Cornea , Corneal Edema/veterinary , Nictitating Membrane
7.
J Vet Emerg Crit Care (San Antonio) ; 32(4): 507-511, 2022 Jul.
Article in English | MEDLINE | ID: mdl-35001484

ABSTRACT

PURPOSE: To describe the treatment of an acidic chemical corneal ulceration in a puppy secondary to nail polish spilling on and adhering to the cornea. CASE SUMMARY: A 12-week-old neutered male Australian Shepherd mix dog was presented to Colorado State University Veterinary Teaching Hospital's (CSU-VTH) Emergency and Urgent Care service acutely after exposure to nail polish spilling on the left eye (OS). Initial ophthalmic examination revealed nail polish adhered to approximately 80% of the cornea with moderate diffuse corneal edema and chemosis, and green nail polish adhered to the skin and fur of the periocular area. Copious flushing with eye wash was performed, but no areas of reduced nail polish adherence were noted. The patient was treated with 1 drop of topical ofloxacin 0.3% ophthalmic solution OS and hospitalized overnight, receiving hyaluronic acid ophthalmic lubrication every hour OS. The treatment plan was carried out for 6 h until time of transfer. In the morning, CSU-VTH's Ophthalmology service removed a nonadhered nail polish plaque in 1 piece using Bishop-Harmon tissue forceps. Following removal, a superficial ulcer secondary to an acidic chemical burn covering 100% of the corneal surface was noted, as well as moderate diffuse corneal edema. Following topical treatment for 8 days, the superficial ulcer healed completely, with no significant long-term consequences. UNIQUE INFORMATION PROVIDED: This is the first report of management of an acidic chemical corneal ulceration secondary to nail polish spill in a puppy. Early assessment and vigilance in treatment was essential for a good prognosis and outcome.


Subject(s)
Corneal Edema , Corneal Ulcer , Dog Diseases , Animals , Australia , Cornea , Corneal Edema/veterinary , Corneal Ulcer/chemically induced , Corneal Ulcer/veterinary , Dog Diseases/chemically induced , Dogs , Hospitals, Animal , Hospitals, Teaching , Humans , Male , Poland , Ulcer/veterinary
8.
Vet Ophthalmol ; 25 Suppl 1: 185-192, 2022 May.
Article in English | MEDLINE | ID: mdl-34971485

ABSTRACT

OBJECTIVE: To describe the clinical findings, multimodal corneal imaging features and treatment in canine patients diagnosed with endotheliitis. ANIMALS STUDIED: Four canine patients met inclusion criteria for bilateral corneal disease with endothelial inflammation and secondary corneal edema that responded to topical anti-inflammatory treatment. METHODS: The patients selected underwent a complete ophthalmic examination with emphasis on the cornea including ultrasound pachymetry (USP), Fourier-domain optical coherence tomography (FD-OCT), in vivo confocal microscopy (IVCM), and digital slit lamp photography. RESULTS: All patients in this study demonstrated thickened corneas due to edema with USP and FD-OCT. With IVCM, mild to severe polymegathism and pleomorphism of corneal endothelial cells, reduced endothelial cell density, hyperreflective keratic precipitates (KPs), and extracellular debris as well as hyporeflective pseudoguttata were observed. With FD-OCT, hyperreflective KPs were commonly observed on the inferior cornea. Clinical examination and advanced imaging results were consistent with a diagnosis of endotheliitis. All patients initially responded to topical anti-inflammatory treatment and required continued therapy; two patients also received topical netarsudil, a rho-associated coiled-coil kinase inhibitor. CONCLUSION: Endotheliitis should be considered for canine patients with bilateral edema that is most severe in the inferior cornea. Careful inspection of Descemet's membrane-endothelial complex should be performed for KPs or inflammatory debris. Chronic administration of topical anti-inflammatories may be necessary to prevent flare-ups of endotheliitis.


Subject(s)
Corneal Diseases , Corneal Edema , Dog Diseases , Animals , Cornea , Corneal Diseases/veterinary , Corneal Edema/diagnostic imaging , Corneal Edema/drug therapy , Corneal Edema/veterinary , Corneal Pachymetry , Dog Diseases/diagnostic imaging , Dog Diseases/drug therapy , Dogs , Endothelial Cells , Endothelium, Corneal , Microscopy, Confocal/veterinary
9.
Cornea ; 40(5): 578-583, 2021 May 01.
Article in English | MEDLINE | ID: mdl-32947393

ABSTRACT

PURPOSE: To retrospectively evaluate the clinical data, diagnostic tests, treatments, and outcomes for dogs with corneal endothelial dystrophy (CED) and determine risk factors for CED when compared with a canine reference population. METHODS: Medical records of 99 dogs (1991-2014) diagnosed with CED at the University of California Davis Veterinary Medical Teaching Hospital were reviewed and compared with 458,680 dogs comprising the general hospital population during the study period. Retrieved data included signalment, examination findings, diagnoses, treatments, and outcomes associated with CED. The exact Pearson χ2 test or exact Kruskal-Wallis test was used to compare parameters between the groups. Progression of corneal edema was assessed using 3 independent Kaplan-Meier curves, identifying clinically significant changes in corneal opacity. RESULTS: Boston terriers, German wirehaired pointers, and Dachshunds were overrepresented in the CED-affected group, whereas Labradors were underrepresented. Dogs older than 11 years were overrepresented in the CED-affected group, whereas intact dogs were underrepresented. Surgical intervention was performed (n = 11) based on the severity of disease and secondary complications from CED. Median time to progression of corneal edema was 1) 368 days when an at-risk eye initially without edema developed edema at a subsequent visit, 2) 701 days when there was progression from mild to marked corneal edema, and 3) 340 days when there was progression from focal to diffuse corneal edema. CONCLUSIONS: Many CED-affected dogs progress over months to years without surgical intervention, making dogs with CED a useful model for studying genetic predispositions and development of novel therapeutics for Fuchs endothelial corneal dystrophy.


Subject(s)
Corneal Dystrophies, Hereditary/veterinary , Corneal Edema/veterinary , Dog Diseases/diagnosis , Animals , Anti-Bacterial Agents/therapeutic use , Anti-Inflammatory Agents/therapeutic use , Corneal Dystrophies, Hereditary/diagnosis , Corneal Dystrophies, Hereditary/drug therapy , Corneal Edema/diagnosis , Corneal Edema/drug therapy , Corneal Pachymetry/veterinary , Diagnostic Techniques, Ophthalmological/veterinary , Dog Diseases/drug therapy , Dogs , Female , Male , Microscopy, Confocal/veterinary , Mydriatics/therapeutic use , Ointments/administration & dosage , Retrospective Studies
10.
Vet Ophthalmol ; 23(6): 930-942, 2020 Nov.
Article in English | MEDLINE | ID: mdl-32893460

ABSTRACT

PURPOSE: To describe a modified keratoleptynsis procedure, as a method of preserving central corneal function, and evaluate the outcome in vision, reduction of corneal thickness and treatment of epithelial corneal ulcers in cases with endothelial cell dysfunction. METHODS: Forty-four dogs (72 eyes) were affected by progressive corneal edema, with or without ulcerative keratitis. All patients were treated with a dorsal and ventral superficial keratectomy followed by conjunctival flaps, maintaining a clear central cornea. Corneal thickness measurements were obtained via ultrasound biomicroscopy. RESULTS: All eyes showed resolution of ocular discomfort postoperatively, with a median time to resolution of 35 days. Two years post-surgery, vision had been lost in 2 of 29 eyes (7%). From the initial population, 23 dogs (39 eyes) had follow-up evaluations of corneal thickness. The mean central corneal thickness was 1359 ± 251 µm prior to surgery. Thickening of the central cornea was observed one week after surgery to 1559 ± 263 µm. Decreased corneal thickness was reported, at 1 month, 4 months, 10 months and 2 years postoperatively (1285 ± 267 µm, 1102 ± 150 µm, 1121 ± 288 µm, 1193 ± 283 µm, respectively). All eyes showed a similar trend of increasing and then decreasing corneal thickness. CONCLUSIONS: This surgical technique provided statistically significant reduction in central corneal thickness and sustained relief of ocular pain. Reduction in corneal thickness appeared to be maintained 2 years post-surgery, and all patients remained comfortable. Superficial corneal pigmentation and fibrosis resulted in vision loss in two eyes.


Subject(s)
Corneal Edema/veterinary , Corneal Ulcer/veterinary , Dog Diseases/surgery , Keratectomy/veterinary , Animals , Corneal Edema/surgery , Corneal Pachymetry/veterinary , Corneal Ulcer/surgery , Dogs , Female , Male , Retrospective Studies , Treatment Outcome
11.
Vet Ophthalmol ; 23(1): 181-189, 2020 Jan.
Article in English | MEDLINE | ID: mdl-31544302

ABSTRACT

OBJECTIVE: To describe ultrasonography as a diagnostic method of in vivo Descemet's membrane detachment (DMD) in horses. ANIMALS STUDIED: Seven horses (three Icelandic horses, two Dutch Warmblood horses, one Appaloosa, and one Welsh Pony), presenting with moderate-to-severe focal or diffuse corneal edema, in whom DMD was suspected on ultrasonographic examination and confirmed with histopathology, were studied. PROCEDURE: A retrospective analysis of case records of horses with suspected DMD was performed. RESULTS: Median age at presentation was 14 years (range 11-24). Clinical signs in eyes with DMD were unilateral in all horses and included blepharospasm and epiphora (6/7), buphthalmos (5/7), moderate-to-severe focal or diffuse corneal edema (7/7), corneal epithelial bullae (4/7), corneal neovascularization (4/7), Haab's striae (2/7), corneal endothelial precipitates (1/7), fibrin in the anterior chamber (1/7), focal cataract (2/7), and pigment deposits on the anterior lens capsule (1/7). During transpalpebral ultrasonography, a distinct linear echogenic structure was noted in the anterior chamber, initially diverging from, and later running parallel to, the posterior lining of the cornea in all eyes studied. In all cases, the cornea was severely thickened and echogenic, consistent with edema, and DMD was suspected. In all horses, the clinical signs progressed and the affected eye was eventually enucleated. Histopathology revealed DMD (7/7), spindle cell proliferation (4/7), Descemet's membrane reformation (3/7), and inflammation of the anterior uvea (5/7). Overall incidence was 1.04%. CONCLUSIONS: Ultrasonography is an adequate tool in diagnosing DMD in horses. Descemet's membrane detachment should be included in the differential diagnosis in horses with dense focal or diffuse corneal edema.


Subject(s)
Corneal Edema/veterinary , Descemet Membrane/diagnostic imaging , Horse Diseases/diagnostic imaging , Ultrasonography/veterinary , Animals , Corneal Edema/diagnostic imaging , Corneal Edema/pathology , Descemet Membrane/pathology , Female , Horse Diseases/pathology , Horses , Male , Retrospective Studies , Ultrasonography/methods
12.
Vet Ophthalmol ; 21(4): 426-431, 2018 Jul.
Article in English | MEDLINE | ID: mdl-29111586

ABSTRACT

A 1-year-old, female spayed, domestic shorthair cat presented for blepharospasm of the right eye. Slit-lamp biomicroscopic examination showed focal corneal ulceration and presumptive keratomalacia of the right eye. Examination of the left eye was normal apart from a focal endothelial opacity. Within the first 24 h of medical management, the right eye developed marked corneal edema and globular anterior protrusion of the corneal surface consistent with feline acute corneal hydrops (FACH). Surgical management consisted of a bridge conjunctival graft, nictitating membrane flap, and temporary tarsorrhaphy. Resolution of corneal edema and pain occurred in the right eye within 24 days. Spectral domain optical coherence tomography (SD-OCT) of the anterior segment was performed in both eyes. Conjunctival tissue from the bridge graft precluded examination of deeper corneal structures in the right eye. The left eye displayed a focal separation of the corneal endothelium and Descemet's membrane from the overlying stroma. These SD-OCT findings are similar to the analogous syndrome found in humans and represent a potential etiology for FACH of the right eye in the case presented here. Unfortunately, the cat was lost to follow-up and the progression of this lesion to FACH in the left eye could not be determined.


Subject(s)
Cat Diseases/diagnosis , Corneal Edema/veterinary , Descemet Membrane/pathology , Animals , Cat Diseases/pathology , Cats , Cornea/pathology , Corneal Edema/diagnosis , Corneal Edema/pathology , Female , Nictitating Membrane/pathology , Slit Lamp/veterinary , Tomography, Optical Coherence/veterinary
13.
Vet Ophthalmol ; 20(1): 65-72, 2017 Jan.
Article in English | MEDLINE | ID: mdl-26778407

ABSTRACT

OBJECTIVE: To describe the clinical presentation, treatment, and outcome of four horses with severe corneal edema caused by suspected endothelial disease treated with a superficial keratectomy and Gundersen inlay flap and to determine whether this procedure (i) reduces corneal edema, (ii) reduces ocular pain, (iii) eliminates recurrent corneal ulceration, and (iv) improves vision in these horses. ANIMALS STUDIED: Four horses met inclusion criterion of (i) diagnosis with endothelial disease by a board-certified veterinary ophthalmologist and (ii) surgical treatment with a superficial keratectomy and Gundersen inlay flap. PROCEDURE: Retrospective medical record review of included horses was used to determine breed, age and sex of included horses, as well as details of medical and surgical therapy, and visual outcome. RESULTS: Four horses were presented with a complaint of focal corneal edema that progressed to diffuse corneal edema. Epithelial bullae and ulceration were present in all cases. The disease process was unresponsive to standard medical treatment with a hyperosmotic agent and topical and systemic anti-inflammatories. However, treatment with a superficial keratectomy and Gundersen inlay flap performed under general anesthesia was associated with (i) a significant decrease in corneal edema, (ii) increased comfort, (iii) elimination of corneal ulceration, and (iv) retention of vision postoperatively with little to no need for medical therapy. Follow-up time was 15, 12, 6, and 3 months. CONCLUSIONS: The superficial keratectomy and Gundersen inlay flap may provide a surgical alternative to chronic medical treatment of severe corneal edema in horses.


Subject(s)
Corneal Edema/veterinary , Horse Diseases/surgery , Keratectomy/veterinary , Animals , Cornea/surgery , Corneal Edema/surgery , Female , Horses , Keratectomy/methods , Male , Surgical Flaps/surgery , Surgical Flaps/veterinary
14.
Vet Ophthalmol ; 20(3): 273-279, 2017 May.
Article in English | MEDLINE | ID: mdl-27191927

ABSTRACT

PURPOSE: To describe the clinical and histopathologic features of glaucoma associated with Descemet's membrane (DM) detachment in five horses without prior history of intraocular surgery. ANIMALS STUDIED: Three Appaloosa horses and two Thoroughbreds were included in this study. The affected horses ranged in age from 16 to 27 years and presented with severe diffuse corneal edema. PROCEDURE: Five eyes were enucleated due to intraocular hypertension and/or chronic corneal ulceration. The enucleated globes were evaluated by the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW). Each globe was routinely processed for histopathology and analyzed by light microscopy. A histologic diagnosis of glaucoma was reached by demonstrating a loss of optic nerve axonal tissue by measuring neurofilament-immunopositive axons with automated image analysis software. RESULTS: All five horses presented with unilateral severe diffuse corneal edema that had developed between 2 and 16 weeks prior to enucleation. Intraocular pressures for the affected eyes were between 9 and 87 mmHg prior to enucleation. Descemet's membrane detachment was identified histopathologically in all five globes (5/5, 100%). All five eyes had an avascular spindle cell proliferation filling the space between the displaced peripheral DM and the corneal stroma. Neurofilament immunostaining revealed axonal loss consistent with glaucoma. CONCLUSION: Equine glaucoma may be associated with Descemet's membrane detachment. This detachment and glaucoma is a possible differential diagnosis for severe equine corneal edema. In this case series, an eye with a DM detachment had a poor prognosis for retention.


Subject(s)
Descemet Membrane/injuries , Glaucoma/veterinary , Horse Diseases/diagnosis , Animals , Corneal Edema/diagnosis , Corneal Edema/veterinary , Eye Enucleation/veterinary , Female , Glaucoma/diagnosis , Horses , Male
15.
Cornea ; 35(10): 1295-304, 2016 Oct.
Article in English | MEDLINE | ID: mdl-27538190

ABSTRACT

PURPOSE: To evaluate the efficacy of superficial keratectomy and conjunctival advancement hood flap (SKCAHF) for the treatment of bullous keratopathy in canine patients. METHODS: Nine dogs (12 eyes) diagnosed with progressive corneal edema underwent superficial keratectomy followed by placement of conjunctival advancement hood flaps. The canine patients were examined pre- and postoperatively using in vivo confocal microscopy, ultrasonic pachymetry (USP), and Fourier-domain optical coherence tomography (FD-OCT). All owners responded to a survey regarding treatment outcomes. RESULTS: Mean central corneal thickness (CCT) as measured by FD-OCT was 1163 ± 290 µm preoperatively and significantly decreased postoperatively to 795 ± 197 µm (P = 0.001), 869 ± 190 µm (P = 0.005), and 969 ± 162 µm (P = 0.033) at median postoperative evaluations occurring at 2.2, 6.8, and 12.3 months, respectively. Owners reported significant improvement (P < 0.05) in vision and corneal cloudiness at 6.8 and 12.3 months postoperatively. The percentage of cornea covered by the conjunctival flap was correlated (P = 0.0159) with a reduction in CCT by USP at 12.3 months postoperatively. All canine patients were comfortable pre- and postoperatively. CONCLUSIONS: SKCAHF results in a reduction of corneal thickness in canine patients with bullous keratopathy. The increase in corneal thickness over time, after performing SKCAHF, is likely because of progressive endothelial decompensation. This surgery is a potentially effective intervention for progressive corneal edema in dogs that may have value in treatment of human patients with bullous keratopathy.


Subject(s)
Blister/veterinary , Conjunctiva/surgery , Cornea/surgery , Corneal Edema/veterinary , Dog Diseases/surgery , Surgical Flaps , Animals , Blister/diagnostic imaging , Blister/surgery , Conjunctiva/diagnostic imaging , Conjunctiva/pathology , Cornea/diagnostic imaging , Cornea/pathology , Corneal Edema/diagnostic imaging , Corneal Edema/surgery , Corneal Pachymetry/veterinary , Disease Models, Animal , Dog Diseases/diagnostic imaging , Dogs , Female , Fourier Analysis , Male , Microscopy, Confocal/veterinary , Tomography, Optical Coherence/veterinary
16.
Vet Ophthalmol ; 19 Suppl 1: 61-8, 2016 Jul.
Article in English | MEDLINE | ID: mdl-26868329

ABSTRACT

OBJECTIVE: To evaluate the effectiveness of the use of a nictitating membrane flap (NMF) as therapy in 19 cats (21 eyes) affected with feline acute corneal hydrops (FACH). METHODS: Medical records from 19 cats diagnosed with FACH and treated with a NMF were retrospectively evaluated. Information was collected from multiple veterinary hospitals and included signalment, medical history, therapy, and ocular outcome. RESULTS: Breeds included 13 Domestic Shorthairs, 2 Exotic Shorthairs, 2 Maine Coons, 1 Persian, and 1 Domestic Medium Hair. Two cats were bilaterally affected. Median age of cats was 3.2 years (range 0.26-15 years). Eleven patients were spayed females, 6 were neutered males, and 2 were intact males. Topical steroids were previously administered in 5 (23.8%) eyes; oral steroids were previously administered in 7 cats (36.8% of patients); three patients received both oral and topical steroids. Thirteen of 21 (61.9%) eyes had a history of ocular disease including ulcerative and nonulcerative keratitis, anterior uveitis, corneal sequestrum, conjunctivitis, and glaucoma. Median duration of NMF was 15 days (range 6-30 days). Follow-up ranged from 12 to 1601 days (median 169 days). Corneal perforation occurred in 1 (4.7%) eye and was successfully repaired. One lesion (4.7%) in a diabetic patient did not resolve. Nineteen of the treated eyes (90.5%) resolved with no complications. CONCLUSIONS: A nictitating membrane flap successfully treated 90.5% of FACH eyes (89.5% of patients).


Subject(s)
Cat Diseases/surgery , Corneal Edema/veterinary , Nictitating Membrane/surgery , Surgical Flaps/veterinary , Animals , Cats , Corneal Edema/surgery , Female , Male , Retrospective Studies , Treatment Outcome
17.
Vet Ophthalmol ; 19 Suppl 1: 77-85, 2016 Jul.
Article in English | MEDLINE | ID: mdl-26880480

ABSTRACT

OBJECTIVE: To determine whether any association exists between the onset of feline acute bullous keratopathy (ABK) and administration of systemic corticosteroid or immunosuppressive therapy. ANIMALS STUDIED: Medical records of cats diagnosed with ABK between the years of 2000 and 2008 were retrospectively reviewed. Breed, age at diagnosis, weight, systemic disease status, eye affected, ophthalmic examination findings, systemic and topical therapy instituted, dosage and duration of therapy, visual outcome and histopathological analyses were recorded in cases meeting the inclusion criteria. RESULTS: A total of 12 cats of a surveyed population of 70 167 met the inclusion criteria with 17/24 eyes affected by ABK. Medical and/or surgical therapy was utilized for management of ABK with 13/17 eyes remaining sighted at the time of last follow-up. In a subset of cases corneal cytology, aerobic bacterial culture, FHV-1 PCR, virus isolation and/or histopathology were performed; no infectious organisms were identified. A rupture in Descemet's membrane of the cornea was identified histologically in two globes. A total of 10 of 12 cats had been previously diagnosed with ongoing systemic disease. A total of 10 of 12 cats were receiving systemic therapy, and a significant association (P < 0.001) was noted between systemic administration of corticosteroids and/or cyclosporine A and the development of ABK. A total of 8 of 10 cats were administered oral prednisolone at doses between 1-2 mg/kg every 12-24 h. A total of 5 of 8 cats receiving oral prednisolone were concurrently administered oral cyclosporine at doses of 1.5-7 mg/kg every 12-24 h. Systemic cyclosporine therapy was found to be a significant risk factor (P < 0.001) for ABK development, while systemic prednisolone was not significant (P = 0.10). CONCLUSIONS: Systemic cyclosporine administration appears to be a risk factor for development of ABK in the population of cats studied.


Subject(s)
Anti-Inflammatory Agents/adverse effects , Cat Diseases/chemically induced , Corneal Edema/veterinary , Cyclosporine/adverse effects , Immunosuppressive Agents/adverse effects , Prednisolone/adverse effects , Animals , Cat Diseases/pathology , Cats , Corneal Edema/chemically induced , Corneal Edema/pathology , Female , Male , Retrospective Studies
19.
Vet Ophthalmol ; 15(1): 46-52, 2012 Jan.
Article in English | MEDLINE | ID: mdl-22051372

ABSTRACT

OBJECTIVE: To describe the ocular clinical signs in a group of cows diagnosed with sheep associated malignant catarrhal fever (MCF), and to investigate a possible correlation between the severity and progression of certain typical clinical signs and disease outcome. PROCEDURE: This prospective study involved cows diagnosed with MCF between 2007 and 2010, and included cows enrolled in a larger clinical trial. Signalment of affected cows, presence and progression of ocular lesions, as well as disease outcome were recorded. Cows were divided into two groups based on the disease outcome: (1) survival and (2) nonsurvival. The degree of corneal edema at first examination was statistically compared between groups. The progression of corneal edema, uveitis and the examining ophthalmologists' subjective assessment of disease progression between the first and last examination were also compared between groups. RESULTS: Twenty-five cows (22 F, 3 M) of six different breeds and one mixed breed were included. Median age was 21 months (range 8-113). Ten cows survived, 13 cows were euthanized, and two died. No statistical association was identified between the degree of corneal edema at the first examination and the disease outcome. Deterioration of corneal edema was not noticed in any of the surviving animals. Anterior uveitis improved in all 10 surviving cows. CONCLUSIONS: The degree of corneal edema at first examination had no prognostic value for the disease outcome. The results of this study suggest that the progression of corneal edema correlates well with disease outcome, and that nonimprovement of uveitis is a bad prognostic sign.


Subject(s)
Corneal Edema/veterinary , Malignant Catarrh/pathology , Animals , Cattle , Cornea/pathology , Corneal Edema/pathology , Female
20.
Am J Vet Res ; 71(12): 1475-83, 2010 Dec.
Article in English | MEDLINE | ID: mdl-21118000

ABSTRACT

OBJECTIVE: To assess the intraoperative and postoperative clinical effects and histologic effects of intracameral administration of α-chymotrypsin in clinically normal dogs undergoing standard intracapsular lens extraction (ICLE). ANIMALS: 6 young adult male dogs without evidence of systemic or ocular disease. PROCEDURES: All dogs underwent bilateral ICLE 7 minutes following injection of 75 U of α-chymotrypsin or an identical volume (0.5 mL) of a commercially available balanced saline solution (BSS) into the posterior chamber of the eye. Ease of lens extraction was subjectively assessed and intraoperative intraocular hemorrhage and fibrin accumulation scored. For 27 days after surgery, ocular hyperemia and discharge, chemosis, corneal edema, hyphema, and aqueous flare were scored, and intraocular pressure (IOP) was measured. Thirty days after surgery, histologic evidence of anterior synechia, collapse of and inflammation within the iridocorneal angle, and iritis were scored. RESULTS: In 5 of 6 dogs, the surgeon was able to correctly identify the eye treated with α-chymotrypsin on the basis of ease of lens extraction. Mean intraoperative intraocular hemorrhage and fibrin scores for BSS-treated eyes were significantly higher than for α-chymotrypsin-treated eyes. Postoperatively, there were no significant differences between treatments for any clinical variables, including IOP Histologic scores were not significantly different between treatments for any variable. Vision was lost as a result of glaucoma in 1 α-chymotrypsin-treated eye and 1 BSS-treated eye. CONCLUSIONS AND CLINICAL RELEVANCE: Intracameral administration of 75 U of α-chymotrypsin 7 minutes before ICLE facilitated lensectomy without apparent adverse effects in clinically normal dogs.


Subject(s)
Cataract Extraction/veterinary , Chymotrypsin/pharmacology , Dog Diseases/surgery , Animals , Anterior Chamber/drug effects , Anterior Chamber/surgery , Cataract Extraction/methods , Chymotrypsin/administration & dosage , Corneal Edema/epidemiology , Corneal Edema/veterinary , Dogs , Euthanasia , Eye/pathology , Eye Diseases/surgery , Eye Diseases/veterinary , Glaucoma/surgery , Glaucoma/veterinary , Hyperemia/epidemiology , Hyperemia/veterinary , Hyphema/epidemiology , Hyphema/veterinary , Intraocular Pressure , Lens Capsule, Crystalline/drug effects , Male
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