Ophthalmomyiasis interna anterior associated with Cuterebra spp in a cat

An 8-year-old domestic shorthair cat was examined for severe anterior uveitis of the right eye that was unresponsive to aggressive treatment with anti-inflammatory drugs and for a possible intraocular parasite or foreign body trapped within a large fibrin clot in the anterior chamber. Surgical exploration of a presumed entry site on the caudal aspect of the third eyelid led to keratotomy and removal of a larval parasite later identified as a first instar Cuterebra spp. Aggressive treatment with anti-inflammatory drugs was continued after surgery, and intraocular pressure was monitored closely to ensure that the cat did not develop glaucoma. Two weeks after surgery, the cat had vision in the affected eye, with resolving uveitis and a normal fundus. Six weeks after surgery, the uveitis continued to resolve; however, the cat did not have vision in the affected eye, and examination of the fundus revealed retinal atrophy. In contrast to the condition in humans, a Cuterebra spp larval infection within the eye of cats may cause not only an intense, acute inflammatory reaction, but also retinal degeneration and blindness despite prompt surgical removal.     

Management of bilateral uveitis in a Toxoplasma gondii-seropositive cat with histopathologic evidence of fungal panuveitis

A 5-year-old, neutered male Domestic Short-haired cat was referred with a 5-month history of anterior uveitis and cataract in the right eye. Clinical examination confirmed anterior uveitis and immature cataract in the right eye and chorioretinitis in the left eye. Ocular ultrasound showed a retinal detachment in the right eye. Diagnostic testing revealed elevated serum titers for Toxoplasma gondii. Anterior uveitis in the right eye and chorioretinitis in the left eye progressed, resulting in blindness despite a 21-day course of clindamycin and aggressive topical medical management of uveitis. The right eye was enucleated and histopathologic evaluation of the globe revealed panuveitis and multiple organisms morphologically consistent with Histoplasma capsulatum. Systemic treatment with itraconazole was initiated. Vision returned after 3 months of treatment and complete resolution of the retinal hemorrhages with formation of a flat chorioretinal scar was noted after 6 months of therapy. Itraconazole was discontinued 7 months after starting therapy, at which time the funduscopic appearance of the chorioretinal scar had remained static for 1 month. The cat has remained visual without evidence of disease progression for 6 months following discontinuation of itraconazole.     

Ophthalmomyiasis interna anterior in a cat: surgical resolution

A 4-year-old Domestic short-haired cat was presented for severe anterior uveitis in the right eye associated with a Cuterebra spp. larva in the anterior chamber. This report describes successful surgical removal of the parasite with preservation of vision.     

An unusual case of feline acute corneal hydrops: atypical disease presentation and possible in vivo detection of Descemet's membrane detachment in the cat's unaffected eye

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.     

Ocular manifestations of a metastatic pulmonary adenocarcinoma in a cat

A primary pulmonary bronchogenic adenocarcinoma originating from an intramediastinal accessory lung was diagnosed in a 14.5-year-old cat. The cat had been admitted because of a cloudy right eye. Physical examination revealed a thin cat with severe iritis, aqueous flare, and a fibrin clot in the anterior chamber of the right eye. Right fundic examination revealed bullous retinal detachment superior to the optic disc. Euthanasia and necropsy were requested when FeLV test results were positive. Metastatic neoplastic cells similar to those of the primary tumor were detected in the choroid, ciliary body, and ciliary processes of the right eye. Ciliary and iridic stromal necrosis attributable to neoplastic embolization of uveal vessels had led to severe uveitis. Foci of metastasis were also in the heart, kidney, and cerebral meninges.     

Intraocular ALλ amyloidoma with plasma cell neoplasia in a cat

An 11-year-old, neutered male domestic short-hair cat was presented with buphthalmos of the right eye and diagnosed with advanced glaucoma. Sonographic examination revealed an iridial thickening. Neoplasia was suspected and an enucleation was performed. Histopathology of the enucleated eye revealed abundant amyloid deposition predominantly in the anterior uveal tract accompanied by few to moderate numbers of well-differentiated plasma cells. The amyloid deposits were identified by staining with Congo red and showing green birefringence under polarized light. Immunohistochemically, amyloid and plasma cells stained intensely only with anti-ALλ antibody, supporting the amyloid tumor being an immunoglobulin-λ-light chain origin. Additional abnormalities included narrowing of the filtration angle and collapse of the ciliary cleft, and trabecular meshwork. One year post-enucleation, the cat was still healthy without signs of systemic amyloidosis or apparent metastatic disease. This is the first report of a cat with noncutaneous extramedullary plasmacytoma originating in the anterior uveal tract with resulting local amyloid.     

Actinomyces endogenous endophthalmitis in a cat following multiple dental extractions

An 8‐year‐old, brachycephalic, mixed breed cat underwent full mouth tooth extractions for the treatment of tooth root abscessation. Subsequently, the cat developed anterior uveitis refractory to topical therapy that eventually necessitated enucleation. Actinomyces species were isolated from both the tooth root abscesses and the anterior chamber after enucleation. Histopathology of the enucleated eye revealed panophthalmitis with abundant intralesional bacteria morphologically consistent with Actinomyces. Between the time of tooth root extraction and enucleation (20 weeks), the cat was diagnosed with hyperthyroidism and treated with oral steroids for inflammatory bowel syndrome. We believe this report represents a rare case of endogenous endophthalmitis secondary to dental disease, possibly precipitated by concurrent immunosuppression.     

'D-shaped' and 'reverse-D-shaped' pupil in a cat with lymphosarcoma

A 7-year-old female spayed European shorthair cat was presented because of visual reduction and a green reflex in the right eye. Examination revealed a 'D-shaped' pupil in the right eye and a 'reverse-D-shaped' pupil in the left eye. Both eyes showed fibrinous anterior uveitis with exudates in the anterior chamber and precipitates on the posterior surface of the cornea. In both eyes a chorioretinitis was diagnosed which caused partial retinal detachment and peripapillary oedema in the left eye. Histopathology revealed intestinal and ocular lymphosarcoma. The aberrant pupil shapes which persisted after death were due to infiltration of the iris stroma and were not caused neurologically. The observation that in both eyes only the medial parts of the iris were affected could not be explained.     

Ocular coccidioidomycosis in a cat

Enucleation of the right eye was performed on a 12-year-old male Persian cat when therapy for uveitis failed. Histologic examination of the anterior and posterior chambers and the vitreous led to a diagnosis of endophthalmitis caused by Coccidioides immitis infection. The primary focus of infection was not determined. Latex particle agglutination, agar gel immunodiffusion, and complement fixation gave negative results for Coccidioides immitis antibody.     

Feline glaucomas

Cats are usually presented at a very late stage in the course of glaucoma when the eye is already blind. Secondary glaucoma because of another underlying ocular lesion is the most common form of glaucoma in the cat and is frequently associated with chronic anterior uveitis or intraocular neoplasia. Chronic stages of glaucoma in the cat are characterized by buphthalmus, anterior lens luxation, and exposure keratitis secondary to the enlarged globe. Ophthalmoscopic signs of glaucomatous retinal degeneration are only noticed in very advanced stages. Treatment of glaucoma in cats is usually aimed to keep the eye comfortable and within a normal intraocular pressure range. However, many antiglaucoma medications that are successfully used in humans and dogs are not very well tolerated by cats and, therefore, the selection of recommended drugs is limited in this species.     

Unusual presentation of a metastatic uveal melanoma in a cat

A 10 year-old, spayed female Domestic Short-Haired (DSH) cat was diagnosed with a large primary uveal melanoma and exenteration was recommended. Thoracic radiographs, abdominal ultrasonography, and complete blood count and serum biochemistry panel did not reveal any abnormality compatible with metastatic disease and surgery was performed. Histopathologic study of the eye confirmed a diffuse iris melanoma. Five months later, the cat presented with a lameness of the right anterior extremity. On physical exam the right elbow was swollen and painful. Radiographs showed a severe osteolysis of the radial head and proximal diaphysis. Fine needle aspiration of the radius head identified a round cell neoplasm with scattered cells containing intracytoplasmatic pigmented granules, compatible with metastatic melanoma. The owners decided not to treat the patient with chemotherapy and declined a biopsy. Two months later, the cat died and necropsy was performed confirming bone metastasis of the uveal melanoma. A diagnosis of generalized metastasis from primary diffuse iris melanoma was made. This report describes, for the first time, long bone metastasis from an uveal melanoma in a cat.     

Excision of a feline limbal melanoma and use of nictitans cartilage to repair the resulting corneoscleral defect

A limbal melanoma was surgically removed from a 12-year-old castrated male black domestic shorthair (DSH) cat. The resulting full-thickness eye wall defect was repaired using the autologous third eyelid cartilage. The patient was followed for 85 days postoperatively, during which time there was no recurrence. Other than a small amount of fibrin and blood at the anterior lens capsule, no significant complications were seen. Use of the third eyelid cartilage as graft material following resection of a feline limbal melanoma can be effective for repairing large eye wall defects and preserving ocular function. The third eyelid proved to be a convenient source of graft material. In addition, autologous grafting can reduce the potential for iatrogenic spread of infectious agents such as feline herpes virus.     

Tissue distribution of dexamethasone in feline ocular structures following single topical application of dexamethasone as an ointment or suspension

Objective To compare the dexamethasone concentration in various structures of the feline eye following a single topical application of dexamethasone as an ophthalmic ointment or suspension. Animals studied Nineteen cats, euthanized due to reasons not related to this study, were selected and their ocular health status evaluated. Selected animals were treated with dexamethasone ointment or suspension. Procedure The concentration of dexamethasone was determined in the following structures of the eye: third eyelid, cornea, aqueous humor, iris, lens, vitreous body, and choroid/retina. The dexamethasone concentration in the eye was measured by radioimmunoassay. The applied amount of dexamethasone was 0.05 mg in 0.05 mL Isopto Dex^® ophthalmic suspension and 0.05 mL Isopto Dex^® ophthalmic ointment, respectively. Cats were treated once with ointment or suspension and were euthanized 3 h or 6 h after treatment. Results At 3 h after topical administration the highest concentrations of dexamethasone were measured in the anterior structures of the eye. The concentrations after application of ointment and suspension were comparable. However, 6 h after administration, the concentrations decreased after administration of suspension and increased further after administration of the ointment, leading to significantly higher concentrations of dexamethasone in the third eyelid, cornea and choroid/retina after treatment with ointment. Conclusion Therapeutically relevant concentrations of dexamethasone after a single topical administration were only achieved in the anterior structures of the eye. Six hours after application there was a substantially higher amount of dexamethasone in the anterior structures of cat eyes treated with ophthalmic ointment compared to ophthalmic suspension.     

Ophthalmomyiasis (interna posterior) of the posterior segment and central nervous system myiasis: Cuterebra spp. in a cat

A unilateral ophthalmomyiasis posterior in a 5-year-old female spayed Domestic Long-haired cat of a third or fourth stage instar Cuterebra spp. larvae is reported. The cat was presented for depression and anorexia. The organism was found on physical examination at presentation. The cat was euthanized because of the worsening systemic condition. The larva was demonstrated by histopathology with coagulation necrosis and hemorrhage of the optic nerve, retina and choroid, and anterior uveitis. No significant cerebrum and anterior brain stem lesions were found.     

Hemangiosarcoma of the third eyelid in a cat

A case of hemangiosarcoma of the third eyelid in a 15-year-old Domestic Short-haired cat is reported. A small red mass protruding from the anterior surface of the third eyelid in the left eye was present. Only mild bilateral conjunctivitis and nuclear sclerosis were revealed on initial ophthalmic examination. After anti-inflammatory treatment, surgery and cryotherapy were performed. On histopathologic examination the mass was located just beneath the conjunctival epithelium, suggesting that the conjunctiva was the tissue of origin. The tumor showed high cellularity and was composed of pleomorphic spindle and polygonal cells arranged in interlacing bundles and solid sheets. The presence of slit-like spaces between tumor cells containing erythrocytes demonstrated the vascular differentiation. Mitotic activity was moderate, but atypical mitoses were detected. The surgical area healed uneventfully and after 7 months there was no recurrence. To the authors' knowledge, this is the first report of conjunctival hemangiosarcoma of the third eyelid in a cat.     

Orbito-nasal cyst in a young European short-haired cat

Purpose To describe a case of an orbito‐nasal cyst in a cat. Procedure An 18‐month‐old male European short‐haired cat was presented to the Ophthalmology service of the Vetsuisse Faculty, University of Zurich for a subcutaneous swelling in the medial canthal region of the right eye (OD). Ophthalmologic, ultrasound and CT examinations, and fine needle aspiration were performed. After lesion excision, the removed tissue was submitted for histopathology. CT examination was repeated 5 months after removal of the cyst. Results Ophthalmologic examination revealed a large fluctuant swelling inferonasal to OD. Despite patent lacrimal puncta, only the first few mm of the lacrimal canaliculi could be cannulated. A normal globe with moderate enophthalmos was present. Ultrasound examination showed a well‐defined lobulated cyst‐like structure in the right orbit, inferonasal and anterior to the eye. CT examination revealed extension of this lesion through the medial orbital wall into the right nasal cavity. Fine needle aspiration confirmed the cystic nature of the lesion. An orbito‐nasal cyst was diagnosed. The orbital part of the cyst was dissected from the surrounding tissue and excised from the periosteum in the medial orbital wall defect. Part of the maxillary bone was removed to allow removal of the cyst from the nasal cavity. Histologically, the cyst wall consisted of a single to multilayered, mostly cuboidal epithelium and surrounding connective tissue. Follow‐up revealed a good functional result and no recurrence 7 months after cyst removal. Conclusions Similar orbito‐nasal cystic structures were reported in dogs but not in cats.     

Choroidal melanocytoma in a cat

An 11-year-old male, neutered European cat was presented for anisocoria due to pupillary dilation in the right eye. Ophthalmic findings were restricted to this eye and consisted of a raised, darkly pigmented, retrolental mass associated with retinal detachment. Ultrasonography identified the mass lesion protruding into the vitreous cavity from the posterior pole of the eyeball and confirmed the detachment of the retina. A tentative diagnosis of an intraocular tumor was made. Radiographic evaluation and retromandibular lymph node cytology did not reveal evidence of distant metastasis. Orbital exenteration of the affected eye was performed and the tumor was diagnosed as a choroidal melanocytic tumor with no criteria of malignancy (melanocytoma). The cat died 5 months later from renal lymphoma, and necropsy did not detect metastasis of the melanocytic tumor. To our knowledge this is the first reported case of feline choroidal melanocytoma.     

Prolapse of the gland of the third eyelid in a cat: a case report and literature review.

A one-year-old, castrated male, domestic shorthair was presented with a prolapse of the gland of the third eyelid. Similar to the dog, this cat did not appear to suffer from this eye condition. The prolapse was unilateral on the left eye. The right eye was normal. No accompanying eye diseases were found. Treatment consisted of a surgical pocket technique similar to the technique used in dogs.     

Retrobulbar lymphoma associated with a ballistic foreign body in a cat

A seven‐year‐old domestic shorthair cat, adopted 5 years previously with a corneal perforation of the left eye, was presented for investigation of a left orbital mass. Computed tomography revealed a metallic foreign body within a contrast‐enhancing, heterogeneous orbital mass. Large cell lymphoma was diagnosed from a fine needle aspirate. The cat staged negatively and was treated with l‐asparaginase, prednisolone and three fractions of radiation therapy. A rapid clinical remission was obtained and the cat remained in remission for 3 years after therapy. This is the first report of large cell lymphoma likely occurring secondary to a foreign body.