Abstract
To retrospectively evaluate the clinical signs, imaging findings, and outcome of feline internal ophthalmoparesis/ophthalmoplegia. Medical records were reviewed from 2008 to 2015. Inclusion criteria included cats that presented with internal ophthalmoparesis/ophthalmoplegia, underwent diagnostic imaging, and had follow-up information available. Twelve cases of feline internal ophthalmoparesis/ophthalmoplegia were identified. Nine cats were unilaterally affected, and three cats were bilaterally affected. Affected cats had a median age of 10.54years (range 5.75 to 13.17), and both sexes of varying breeds were affected (nine males; three females). Clinical signs including abnormal mental status (n=9; 75%) and additional neurologic abnormalities (n=10; 83%) were observed. Magnetic resonance imaging and/or computed tomography (MRI/CT) of the head were performed in ten cats, revealing a mass lesion in all cases with varying locations. Multicentric lymphoma was diagnosed in two cats via abdominal ultrasound and cytology. All twelve cats were euthanized due to deterioration of clinical signs and/or quality-of-life concerns. Median time from diagnosis to euthanasia was 3.5days (range 0 to 80days). Feline internal ophthalmoparesis/ophthalmoplegia rarely presents as the sole clinical sign in a referral hospital. Advanced imaging (MRI/CT) may be necessary to reach a definitive diagnosis in these cases. However, abdominal ultrasound would be advocated in cats with systemic clinical signs as a less expensive and less invasive diagnostic test to further investigate the possible etiology of internal ophthalmoparesis/ophthalmoplegia prior to advanced imaging. Feline cases with internal ophthalmoparesis/ophthalmoplegia associated with other intracranial signs and/or systemic clinical signs have a poor prognosis.
Highlights
Internal ophthalmoparesis/ophthalmoplegia is characterized by decreased or absent motor function of the iris sphincter and ciliary body muscle. This is due to loss of parasympathetic innervation from the oculomotor nerve [cranial nerve (CN)
Most of the literature in dogs and cats with internal ophthalmoparesis/ophthalmoplegia are case reports with middle cranial fossa syndrome.[2,3,4,5,6,7,8,9,10,11]
Inclusion criteria were as follows: (1) cats that presented with internal ophthalmoparesis/ophthalmoplegia; (2) had complete medical records; (3) underwent diagnostic imaging; and (4) had follow-up information available
Summary
Internal ophthalmoparesis/ophthalmoplegia is characterized by decreased (ophthalmoparesis) or absent (ophthalmoplegia) motor function of the iris sphincter and ciliary body muscle. This is due to loss of parasympathetic innervation from the oculomotor nerve [cranial nerve (CN). Most of the literature in dogs and cats with internal ophthalmoparesis/ophthalmoplegia are case reports with middle cranial fossa syndrome ( known as cavernous sinus syndrome).[2,3,4,5,6,7,8,9,10,11] Middle cranial fossa syndrome is a clinical disorder characterized by ipsilateral internal ophthalmoparesis/ophthalmoplegia, paresis or plegia of the extra-ocular muscles ( known as external ophthalmoparesis/ophthalmoplegia) and decreased to absent facial and corneal sensation.[12,13] These clinical signs are due to a dysfunction of several cranial nerves that course at the level of the middle cranial fossa.[12,13]
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