ocular manifestations of systemic diseases in small animals
TRANSCRIPT
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Ocular
Manifestations
of Systemic
Diseases in
Small Animals
Dennis E. Brooks DVM, PhD
University of Florida
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The eye has limited ways to react to injury.
Red
Loses transparency
Vascularizes
Pigments or depigments
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Septicemia (bacterial)
anterior uveitis to
endophthalmitis
embolization of
bacteria
circulating Ag-Ab
complexes
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Blepharitis
SLE
ZnKCS and Hypothyroidism
Immune mediated
Infectious
Hormonal
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Canine distemper virus ocular signs:
– ocular discharge, KCS
– ± corneal ulcers
– optic neuritis (blindness)
– Chorioretinitis- “gold-medallion”
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Distemper
conjunctival epithelial scrapings
– ± intracellular inclusion bodies
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Infectious canine hepatitis
canine adenovirus I (CAV-I), “blue eye”
ocular signs: 7 days PI or post vaccination– uveitis and corneal edema
– edema is due to an Arthus reaction to viral replication in the endothelium
– ocular signs often unilateral and temporary (1-2 weeks)
severe cases: Afghans!
– bullous keratopathy
– secondary glaucoma
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Feline Ocular Bartonellosis
Bartonella hensela: gram negative rods
•Iritis
•KPs
•White vitreous exudate causing
lack of tapetal reflex
5 year old Persian
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Feline Ocular Bartonellosis
Large white
fibrinous exudate in
anterior chamber
15 year old DSH
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Cryptococcus neoformans ocular signs
– cats more often affected than dogs
– optic neuritis, dilated pupils,
exudative granulomatous chorioretinitis
systemic signs
– CNS, skin and respiratory lesions
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Cryptococcosis-diagnosis
ocular extension from vascular*, respiratory, or CNS systems
may identify organism in vitreal or CSF aspirates
*most common
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Histoplasma capsulatum Uncommon; affects cats > dogs
usually ocular extension from a respiratory infection
granulomatous choroiditis with retinal detachment
Active Inactive
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Blastomyces dermatitidis
affects dogs > cats
respiratory, skin, bone, testicles, CNS lesions
~ 43% develop ocular signs
– unilateral or bilateral
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Blastomycosis ocular signs
– corneal edema/vascularization
– granulomatous chorioretinitis
– retinal detachment
– secondary glaucoma
– optic neuritis
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Ehrlichia canis
acute, subclinical, and chronic phases
replicates in mononuclears
incites a vasculitis in target tissues
tortuous vessels & grey perivascular foci
chorioretinitis & retinal vasculitis, optic neuritis, retinal detachment/hemorrhages
uveitis, hyphema
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Rocky mountain spotted fever
Rickettsia rickettsii
multifocal vasculitis
uveitis, conjunctivitis, retinal
vasculitis/perivasculitis
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Hyperlipidemia
primary
– hyperlipoproteinemia in Miniature
Schnauzers
secondary: diabetes, hypothyroidism,
pancreatitis, Cushing’s, liver disease
increased triglycerides
– lipid-laden aqueous humor
– lipemia retinalis
increased cholesterol
– lipid keratopathy
– atherosclerosis
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Hyphema and lipid in AC
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Uveodermatological syndrome
spontaneous autoimmune disease
against melanin containing tissues
Akitas, OESD, Golden Retrievers,
Samoyeds, Irish Setters
panuveitis, retinal detachments
poliosis/vitiligo- nose, muzzle
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Retinitis Healed
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GME and Reticulosis usually presents with CNS signs
acute blindness with fixed dilated pupils
optic neuritis (absent if retrobulbar)
leading to optic nerve atrophy
peripapillary retinitis with RD
Etiology: inflammation/neoplasia
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Lymphosarcoma ocular metastasis is common
uveitis, hyphema, pseudohypopyon
tortuous retinal vessels, perivascular cuffing,
retinal detachment or neoplastic infiltration
Orbital lymphoma
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Diabetes mellitus
cataracts develop in dogs>>cats
sorbitol draws water into the lens causing lens fiber swelling & rupture
early cataractous changes appear as vacuoles in the equatorial lens cortex
cataracts rapidly progress to maturity
28% lower STT; 37% lower corneal sensation; 58% lower TFBUT
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Toxoplasmosis
Retinochoroiditis
Cats with retinitis and iritis
have systemic signs more
often than cats with iritis
alone.
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Herpes
Conjunctivitis, uveitis,
keratitis
Chronic cases should be
tested for FIV
Viroptic, acyclovir,
idoxuridine
Oral lysine
Oral interferon
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FIP
Perivascular cuffing
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FIP
KP
Post TPA
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FIP
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FIV
uveitis
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FeLV
Uveitis and retinitis
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Nutritional Retinopathy
Taurine deficiency
Vit E deficiency
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Vascular Hypertension
Poor Prognosis for vision
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Vascular Hypertension
Retina HyphemaCornea
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Hyperviscosity Syndromes
Plasma cell tumors
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Ophthalmomyiasis
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Intraocular Tumors Melanomas
Adenomas
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Melanomas
The angle
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Iris melanoma
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Intraocular Cysts or Tumors??
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Dirofilaria
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Brucella canis
ocular
– corneal edema, anterior
uveitis, chorioretinitis,
glaucoma
systemic
– reproductive problems,
discospondylitis,
lymphadenopathy
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Coccidioides immitis
cats rarely affected
ocular signs-– granulomatous uveitis and retinitis, retinal detachments,
keratitis
– posterior segment lesions predominate
vitreal sample-may see endospores
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Bartonellosis Therapy
Azithromycin 5mg/kg QOD PO for 10-21 days
Rifampin 10mg/kg SID PO for 1 week
Doxycycline 5 mg/kg BID PO for 6 weeks
– Combinations of first two with doxycycline