Veterinary Ophthalmology Research Articles

Abstracts: Annual Scientific Meeting of the European Society of Veterinary Ophthalmologists, Berlin, Germany, Sept 29 - Oct 02, 2022.

Abstracts: Annual Scientific Meeting of the European Society of Veterinary Ophthalmologists, Berlin, Germany, Sept 29 - Oct 02, 2022.

Cyclosporine A Delivery Platform for Veterinary Ophthalmology-A New Concept for Advanced Ophthalmology.

Cyclosporine A (CsA) is a selective and reversible immunosuppressant agent that is widely used as a medication for a wide spectrum of diseases in humans such as graft versus host disease, non-infectious uveitis, rheumatoid arthritis, psoriasis, and atopic dermatitis. Furthermore, the CsA is used to treat keratoconjunctivitis sicca, chronic superficial keratitis, immune-mediated keratitis and equine recurrent uveitis in animals. The selective activity of Cyclosporine A (CsA) was demonstrated to be an immunomodulation characteristic of T-lymphocyte proliferation and inhibits cytokine gene expression. Moreover, the lipophilic characteristics with poor bioavailability and low solubility in water, besides the side effects, force the need to develop new formulations and devices that will provide adequate penetration into the anterior and posterior segments of the eye. This review aims to summarize the effectiveness and safety of cyclosporine A delivery platforms in veterinary ophthalmology.

Dealing with penetrating foreign bodies in the eyes of small animals

Foreign body injuries are a common reason for referral in veterinary ophthalmology and frequently cause blindness in patients with ocular trauma. Prognosis depends on the extent of the injury to intraocular structures, as well as the type and size of the foreign body. Treatment options range from conservative medical management to surgical intervention to remove the foreign body, address further ocular damage and achieve the best outcome for an animal's vision. This review summarises the types of ocular foreign bodies and their presentations in small animal practice, the role of diagnostic approaches and advanced imaging, treatment and outcomes.

Streptococcus canis sequence type 43 may be associated with treatment failure in dogs with corneal ulceration.

To profile Streptococcus canis isolates obtained from corneal ulcers in dogs. 10 dogs. Medical records were searched to identify dogs diagnosed with ulcerative keratitis by a veterinary ophthalmologist and having a positive corneal culture for S canis during the year 2020. For each case, clinical findings and outcome were determined, antimicrobial resistance and sensitivity panels were summarized, whole genome sequencing was performed, and isolates were typed using multi-locus sequence typing and genome-based proteome phylogenetic analysis. 10 S canis isolates were included from dogs diagnosed with ulcerative keratitis. Dogs were either treated surgically via keratectomy and conjunctival grafting (n = 6) or treated medically (4). Three of 10 corneas failed to heal and required enucleation (2/6 conjunctival grafts and 1/4 medically managed corneal ulcers). All three corneal ulcers that failed to heal were associated with S canis sequence type (ST) 43. Sequence types identified from successfully treated cases included ST8 (n = 1), ST50 (1), ST2 (2), ST27 (1), and ST15 (1). One ST43 isolate was obtained from a dog that healed following a conjunctival graft, however this was the only dog that received an oral antibiotic in addition to topical antibiotics. Based on this small dataset, S canis ST43 may be associated with increased virulence and contribute to conjunctival graft failure and progressive corneal collagenolysis. The postoperative administration of an oral antimicrobial may protect against conjunctival graft rejection in dogs specifically due to S canis ST43.

Prevalence of ocular lesions in cats newly diagnosed with histoplasmosis: 55 cases (2015–2022)

To describe the prevalence of ocular lesions in cats with newly diagnosed histoplasmosis. 55 client-owned domestic cats. As part of this prospective case series, cats diagnosed with histoplasmosis between the years 2015 and 2020 underwent complete ophthalmic examinations by a board-certified veterinary ophthalmologist prior to the initiation of antifungal treatment. Histoplasmosis was diagnosed by consistent clinical findings and identification of Histoplasma yeast on pathology or by the use of a commercially available enzyme immunoassay to detect Histoplasma antigen in urine. Of the 55 cats, 45 (82%; 95% CI, 72% to 92%) had signs of active anterior, posterior, or panuveitis. The most common lesions were identified in the posterior portion of the globe and included chorioretinitis and partial retinal detachments (44/55 [80%; 95% CI, 69% to 90%] cats). Detailed ophthalmic examinations should be performed on all cats with diagnosed or suspected histoplasmosis, as ocular involvement and subsequent vision loss are common.

Intraocular pressure estimates using rebound tonometry in juvenile northern bobwhite quails (Colinus virginianus).

To determine intraocular pressure (IOP) estimates using rebound tonometry in juvenile northern bobwhite quails. Eighteen, 28-day-old, wild caught, captive raised, northern bobwhite quails. Birds were manually restrained in sternal recumbency with two fingers placed below the head, applying minimal pressure. Following detailed ophthalmic examination by a board-certified veterinary ophthalmologist, IOP was obtained via rebound tonometry using the Tonovet "P" setting for undefined species in animals without obvious ocular pathology. IOPs were estimated three times on each eye. The mean result of the three estimates was recorded for further analysis. Only readings with low or no reported error were recorded. No difference was detected between the eyes; therefore, a reference interval was calculated using both eyes. The overall IOP (n=36 eyes) was 5.6 ± 1.2 mmHg (mean ± SD), the median was 6 mmHg, and the range was 2-7 mmHg. The 95% reference interval was 2.2-7.6 mmHg. All quails were ultimately released with no clinically appreciable abnormalities. This study provides information on normal IOP values for juvenile northern bobwhite quails, which can be used to evaluate the ocular health of this species. Future studies with a larger number of animals are needed, as well as validation of the rebound tonometry method using direct manometry.

Biological Compositions of Canine Amniotic Membrane and Its Extracts and the Investigation of Corneal Wound Healing Efficacy In Vitro.

The usage of canine amniotic membrane (cAM) is mainly of interest in veterinary ophthalmology. Topical formulations of cAM could deliver the beneficial properties of cAM without the need for surgical intervention. The present study aimed to investigate biological compositions of cAM and its extracts, including their corneal wound healing efficacy. In this study, canine amniotic membrane extract (cAME) and lyophilized canine amniotic membrane extract (cAMX) were developed. Bioactive molecules related to corneal wound healing, including hepatocyte growth factor, tissue inhibitor of metalloproteinase-1 and -2, Thrombospondin-1 and Interleukin-1 receptor antagonist were studied at both gene and protein expression levels. Cell viability and wound healing assays were investigated for the possibility of cAME and cAMX as topical applications. The results demonstrated that all of the relevant genes and proteins were detected in cAM, cAME and cAMX. Both cAME and cAMX showed wound healing properties in vitro and cAME at 1.0 mg/mL concentration appeared to have the best healing efficacy. In conclusion, cAME and cAMX generated for topical use provided promising results in the healing of corneal defects.

Intraocular Lymphoma in Dogs - Findings of Contrast Enhanced Ultrasound and ARFI Elastography

Background: Ocular lymphoma can affect the iris, conjunctiva, choroid, and retina and is mostly associated with multicentric disease. Elastography is an ultrasound technique that provides noninvasive, pain-free assessment of tissue stiffness. It has the ability to assess subtle changes throughout the organ as well as focal lesions. Microbubble contrast ultrasound enables the detection of incipient vascular flows, which are difficult to detect using traditional ultrasound methods. This study aimed to describe acoustic radiation force impulse (ARFI) elastography and microbubble contrast ultrasound findings in the eyes of two dogs diagnosed with intraocular T-cell lymphoma. Cases: Case 1. Physical examination revealed an exophytic mass in the left eye. Schirmer test revealed a secretion of 22 mm/min. Negative threat reflex, glare, direct pupillary light reflex, and consensual response were also noted. Biomicroscopy revealed hyperplasia of the third eyelid, overlapping with the affected eye. When the membrane was removed, moderate conjunctival hyperemia, mucoid secretion, and buphthalmia were observed. In addition, significant corneal edema was present, making it impossible to visualize the anterior chamber and perform fundus examination. The intraocular pressure, as measured with a rebound tonometer, was 39 mmHg. B-mode ultrasonography identified amorphous, hyperechoic, and heterogeneous structures throughout the anterior chamber, iris, and ciliary body. The elastogram showed that the mass had greenish tones and intermediate stiffness, and the mean SWV of the ciliary body and iris was 2 m/s. Contrast-enhanced ultrasound (CEUS) revealed vascularization of the neoformation region, with wash-in, peak, and wash-out values of 9.89 s, 24.56 s, and 107.87 s, respectively. Case 2. On physical examination, a change in the shape of the right pupil was observed. Schirmer test revealed a secretion of 20 mm/min, with negative threat, glare, and pupillary reflexes to direct and consensual light. Biomicroscopy revealed neoformation from 7 am to 11 am in the sclera, retina, and choroid complex, concomitant with dyscoria and conjunctival hyperemia. The intraocular pressure, as measured by rebound tonometry, was 33 mmHg. Fundoscopy revealed a mass in the temporal region and focal retinal detachment. No changes were observed in the contralateral eye. B-mode ultrasound revealed an increase in volume in the temporal region of the iris, ciliary body, and choroid with diffuse heterogeneity and partial retinal detachment. Elastographic examination revealed shades of green and yellow compatible with increased tissue stiffness. On quantitative examination, the mean SWVs of the ciliary body and iris were 3.14 m/s. On CEUS, the neoformation region presented wash-in, peak, and wash-out values of 8.67 s, 22.33 s, and 80.20 s. Discussion: B-mode ultrasonography established the tumor extent and evaluated echogenicity, verifying the involved ocular structures. The examination played an important role in the diagnosis as well as clinical management. ARFI elastography can detect small tissue changes, helping to define nodules and masses more reliably, in addition to allowing the verification of tissue stiffness. In both dogs, it was possible to verify that the masses presented greater rigidity than the adjacent tissues both qualitatively and quantitatively. In previous studies, it was found that cutaneous and breast lymphomas in humans were more rigid than adjacent tissues on elastography. This increase in rigidity and heterogeneity observed on elastograms can be explained by the extramedullary interactions of the matrix in T-cell lymphomas. Tumor growth is dependent on the blood supply, which was evaluated using CEUS in these cases. Furthermore, the ciliary body contrast filling times were longer than those described in normal dogs. Keywords: eye, surgery, diagnostic imaging, pain, veterinary ophthalmology, neoplasia. Título: Linfoma intraocular em cães - achados da ultrassonografia contrastada e elastografia ARFI Descritores: olho, cirurgia, diagnóstico por imagem, dor, oftlamologia veterinária, neoplasia.

Veterinary Ophthalmology-Advanced Imaging Special Issue.

Veterinary Ophthalmology-Advanced Imaging Special Issue.

Abstracts: Annual Scientific Meeting of the European College of Veterinary Ophthalmologists, Online, May 20-23, 2021.

Veterinary OphthalmologyVolume 25, Issue 2 p. e1-e43 ABSTRACTS Abstracts: Annual Scientific Meeting of the European College of Veterinary Ophthalmologists, Online, May 20–23, 2021 First published: 14 March 2022 https://doi.org/10.1111/vop.12979Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume25, Issue2March 2022Pages e1-e43 RelatedInformation

Surgical treatment of limbal dermoid: Reports of cases

Ocular dermoid occur in an unusual and sporadic manner, being considered a congenital alteration, characterized by the presence of tissue of ectopic origin in ocular structures. They can develop in several places, including eyelids, conjunctiva, cornea and nictitating membrane. The objective was to report the cases of two dogs referred to the specialized service of veterinary ophthalmology, presenting tearing and ocular secretion secondary to the dermoid in the temporal limbus region, with extension to the cornea or conjunctiva. The dermoid were surgically treated by resection through conjunctivectomy combined with superficial lamellar keratectomy and corneal polishing with a diamond burr. Surgical excision of dermoid was curative.

Comparação entre o tonômetro de rebote (TD - 8000 portable) e aplanação (Tono-Pen AviaTM) manuseados por diferentes avaliadores para mensurações da pressão intraocular em coelhos

Abstract This study aimed to compare values of intraocular pressure (IOP) by different tonometers and evaluators (veterinary ophthalmologist specialist and veterinary not a specialist). For this, 30 rabbits were used, and in all (n = 60 eyes), the IOP was initially measured with a rebound tonometer (model TD - 8000 portable, Apramed Indústria e Comércio de Equipamentos Médicos Ltda) and, subsequently, with an applanation tonometer (portable model Tono-Pen AviaTM®, Reichert Technologies®, USA). With the two devices, the measurements in mmHg were performed in the central region of the corneas, always performed in the same period, by a professional veterinary ophthalmologist (specialist) and a professional veterinary (not a specialist). Data were statistically compared using the simple analysis of variance test. With the rebound tonometer, IOP ranged from 7 to 14 mmHg when measured by both evaluators; while with the applanation tonometer, from 9 to 15 mmHg by the specialist and from 8 to 16 mmHg by the non-specialist. In the right eyes, the IOP measured by the applanation tonometer by the non-experienced evaluator was statistically lower than the specialist's values; yet, the results of the two evaluators were higher in these same eyes when compared with those of the rebound tonometer. In the left eyes, the IOP measured by the applanation tonometer by the non-experienced evaluator was statistically higher than the specialist's values with the rebound tonometer. Thus, it was possible to infer that, regardless of experience in the area, the applanation tonometer indicated higher mean values of IOP in both eyes and, about the evaluators, the means of the measurements performed by the specialist were higher compared to the non-professional specialist.

Оценка иридокорнеального угла глаза у кошек с различным строением черепа

The study of the structure of the drainage system of the eye in small domestic animals today is one of the priorities for modern veterinary ophthalmology. Along with the clinical assessment of changes in the eyeball with a decrease or increase in intraocular pressure, it is important to identify fundamental aspects in the structure of the iridocorneal angle and its changes depending on the shape of the skull. Nowadays, there is a large amount of information in which the authors focus on changes in the comb ligament and the trabecular meshwork. However, there is no data on the difference in the size of the iridocorneal angle depending on the shape of the skull. The authors of the article present morphometric criteria of the iridocorneal angle in cats with brachycephalic and mesocephalic skull shapes, establish differences in size, and give practical recommendations for using the results of the research. It is shown that cats with different skull shapes have no pronounced deviations in the size of the hyridocorneal angle, while the average size of the angle in brachycephals is on average 20° larger than the size of the angle in mesocephals, which creates prerequisites for the development of secondary glaucoma.

Ophthalmic disorders in a referral population of seven breeds of brachycephalic dogs: 970 cases (2008-2017).

To evaluate the frequency of ophthalmic disorders in 7 brachycephalic dog breeds referred to an academic veterinary ophthalmology service. 970 client-owned dogs of 7 brachycephalic breeds that were evaluated by the ophthalmology service in a veterinary teaching hospital from January 2008 through December 2017. Medical records of 7 brachycephalic breeds (ie, Boston Terriers, English Bulldogs, French Bulldogs, Lhasa Apsos, Pekingese, Pugs, and Shih Tzus) were reviewed to collect data regarding patient signalment, ophthalmic diagnoses, affected eyes, and number and dates of visits. Median age at the first examination was 7 years (range, 23 days to 22 years). The number of dogs seen for a first examination increased with age. Corneal ulcers, keratoconjunctivitis sicca, corneal pigmentation, immature cataracts, and uveitis were each diagnosed in ≥ 100 dogs and represented 40.4% (1,161/2,873) of all diagnoses. On the basis of anatomic location, 66.3% (1,905/2,873) of all disorders were located in either the cornea (1,014/2,873 [35.2%]) or adnexa (891/2,873 [31%]). There was a significant difference in breed proportion in the study population; of the 7 breeds studied, Shih Tzus (34.3% [333/970]), Pugs (20.8% [202/970]), and Boston Terriers (16.6% [161/970]) were the most prevalent breeds. The frequency of some diseases within the referral population was associated with breed. Findings suggested that the most prevalent disorders for the brachycephalic breeds in this ophthalmic referral population were corneal ulcers, keratoconjunctivitis sicca, corneal pigmentation, immature cataracts, and uveitis. Although all dogs shared brachycephalic features, the frequency of specific ophthalmic diseases varied between breeds.

Corneal Surgery in the Cat: Diseases, considerations and techniques.

The ability to recognize, diagnose and treat corneal disease is essential for maintaining vision and comfort in feline patients. Being able to correctly identify appropriate techniques for surgical cases is of particular importance for success when performing corneal surgery. Many different corneal diseases present with similar clinical signs, and it can be hard to determine the appropriate treatment for individual patients. It is essential for the clinician to understand the indications for corneal surgery, instrumentation needed and microsurgical principles prior to attempting these procedures. The prognosis following surgery and potential complications should be discussed with the client. This review article aims to assist in decision-making and to provide detailed guidance for primary care clinicians considering referral of cats for corneal surgery. The review outlines common feline corneal diseases and associated surgical therapies performed by veterinary ophthalmologists, highlighting appropriate instrumentation and case selection. Some surgeries are explained in depth for ophthalmologists and residents in training. Although some procedures may be performed with common surgical equipment and supplies, most require specialized ophthalmic instrumentation and expertise, which entails significant microsurgical training and practice, as well as financial investment. Most of the procedures require an operating microscope for the best surgical outcomes; however, surgical loupes may be sufficient in some cases. Evidence base: This review article compiles information from many published references on feline corneal diseases and surgeries, complemented by the experience of the authors.

Abstracts: Annual Virtual Scientific Meeting of the European Society of Veterinary Ophthalmologists, Oct 2-3, 2021.

Veterinary OphthalmologyVolume 24, Issue 6 p. e48-e59 ABSTRACTS Abstracts: Annual Virtual Scientific Meeting of the European Society of Veterinary Ophthalmologists, Oct 2–3, 2021 First published: 16 November 2021 https://doi.org/10.1111/vop.12946Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat Volume24, Issue6November 2021Pages e48-e59 RelatedInformation

Abstracts: The 52nd Annual Scientific Meeting of the American College of Veterinary Ophthalmologists, Indianapolis, IN Sept 29-Oct 2, 2021.

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Applications of in vivo confocal microscopy in the management of infectious keratitis in veterinary ophthalmology.

In vivo confocal microscopy (IVCM) is a relatively new ocular imaging technique that permits morphological and quantitative assessment of the living cornea on the cellular level. The applications for IVCM in clinical ophthalmology are numerous and diverse. There are several advantages inherent to IVCM over standard diagnostic techniques currently used to confirm a diagnosis of infectious keratitis in veterinary ophthalmology. With IVCM, images can be viewed in real-time providing immediate diagnostic information. Traumatic corneal sampling techniques are avoided, and the procedure can be repeated as frequently as is clinically indicated without risk of corneal tissue damage. Both superficial and deep corneal lesions can be evaluated by IVCM in an atraumatic fashion. Microorganism viability is not required for their detection and specialized diagnostic laboratory assay procedures are not necessary. Many larger infectious agents can be directly identified within corneal lesions by IVCM, including fungi and parasites such as Acanthamoeba spp. In other situations, such as bacterial infectious crystalline keratopathy, the biological systems associated with the microorganism can be detected within the cornea. The current resolution of IVCM is inadequate to directly visualize some corneal infectious agents, such as herpesviruses, but host responses and virus-infected epithelial cells can be identified. This review summarizes the current knowledge and applications of IVCM in the management of infectious keratitis in veterinary ophthalmology, including its use in animals with bacterial, fungal, parasitic, and viral keratitis.

The Efficacy of Online Case-Based Assignments in Teaching Veterinary Ophthalmology.

Veterinarians are required to use clinical reasoning skills to successfully manage their patients with eye diseases. Case-based assignments can be an effective tool for teaching problem-solving skills. Very few models or online modules exist to deepen the instruction of veterinary ophthalmic clinical reasoning skills. The current study aims to assess the value of online case-based assignments given to students during the Ontario Veterinary College's Phase 4 ophthalmology rotation over a 4-year period. Nine case-based assignments were developed as an online module and provided signalment, history, ophthalmic database, and clinical photography. For each case, students were required to describe the ocular lesions, provide a diagnosis, and develop a short-term and long-term treatment plan. A grading rubric was created, and student feedback was collected using an online survey. A frequency analysis was conducted to evaluate final grades across each case. This analysis was also completed for grades of each question across all cases. A total of 285 students were graded individually. Students' grades were normally distributed across each assignment. Students performed better on lower-order cognitive skills (description of ocular lesions) but poorer on high-order cognitive skills (therapeutic plans). These results suggest that students tend to have difficulty with the analysis and interpretation of these cases. Student feedback reported case-based assignments were useful. Online case-based assignments may be a useful adjunctive teaching tool for students rotating through ophthalmology in their clinical year, and this tool could be considered for other specialized rotations.

Notes on…

Abstract Mike Rhodes, European and RCVS Recognized Specialist in Veterinary Ophthalmology, provides an overview for the first-opinion clinician, highlighting which ocular drugs to stock and use in practice.*