羊膜移植在治疗猫穿孔性深层角膜溃疡中的应用

<正>角膜溃疡是犬猫最常见的眼科疾病之一。当角膜上皮以及角膜基质发生缺损或脱落即为角膜溃疡。如果得不到及时正确的治疗或治疗期间护理不当,病情可能会迅速恶化,很可能造成角膜穿孔、失明,甚至化脓性全眼球炎,最终导致眼球摘除。造成眼角膜溃疡的原因主要有:外伤性、眼睑结构异常、睫毛生长异常、干眼病、暴露性角膜炎和角膜上皮发育不良等。患角膜溃疡犬猫往往会表现出眼部疼痛的症状,     

用犬脂肪干细胞因子治疗犬角膜溃疡1例

犬角膜溃疡是临床上常见的眼科疾病,它是指由各种致病因素导致的犬角膜上皮组织的缺损.当犬发生角膜溃疡时,除有角膜溃疡症状外,还可见畏光、流泪,伴发结膜炎等.治疗时以眼睛局部的抗菌药物治疗为主,同时可应用促进角膜生长的物质.该病的病程一般较长,若治疗不及时或治疗失当,可引发角膜穿孔,若感染剧烈甚至需要摘除眼球.干细胞作为种子细胞,理论上对各种疾病均有治疗意义.     

新型人工角膜材料板层移植犬高危角膜损伤病例

为了探讨新型人工角膜治疗犬高危角膜移植病例效果,使用新型人工角膜对一例本地犬进行了高危角膜损伤的板层移植手术,对相关操作进行分析讨论,并观察术后恢复效果。结果显示,术后患眼角膜逐步恢复透明,未见明显的免疫排斥反应。表明新型人工角膜材料具有良好的组织相容性,能够提供较好的光学效果,有望在小动物临床上广泛使用,为兽医眼表移植学的发展提供有力的帮助。     

角膜结膜移植术治疗猫角膜穿孔的病例报告

<正>角膜穿孔多见于眼科急诊，常需要紧急手术治疗以保留眼球及其视觉功能。若是由于深层溃疡等原因造成的角膜穿孔面积较大，无法直接对合缝合时，通常需要进行修补性手术。在兽医临床中常用的方法包括结膜瓣遮盖术、角膜结膜移植术、全层角膜移植术等。相比较之下，角膜结膜移植术具有创口稳定性好、术后角膜透明度好、不需要异体组织移植等优势，但其对技术要求较高。现将笔者参与的1例角膜结膜移植术治疗猫角膜穿孔的病例介绍如下。     

犬穿透性角膜移植术实验

穿透性角膜移植术又称全层角膜移植术 ,是指用健康供眼的全层角膜置换患眼全层角膜的手术 ,也是人类眼科临床主要的复明手术之一。近年来随着我国宠物养殖蓬勃兴起 ,兽医临床接诊犬猫角膜损伤、溃疡或穿孔的病例增多 ,这些眼病因受动物自身特点所限 ,往往疗程很长 ,如治疗不及时或不合理 ,常常恶化并造成视力丧失。如果能够施行穿透性角膜移植术 ,不仅可以改善宠物视力 ,而且大大提高宠物的欣赏价值。目前在国内兽医临床上角膜移植术尚无开展 ,而角膜移植术属于显微眼科手术 ,在操作上与普通外科手术有很大不同 ,为便于在临床开展宠物角膜移…     

糖尿病继发犬白内障后对泪液分泌和眼表的影响

<正>糖尿病是犬临床常见的内分泌疾病之一,与糖尿病有关的眼部并发症较多,如白内障、视网膜病变,视神经病变等已被兽医广泛认识,但角膜的并发症在兽医临床报道相对较少,泪液功能的异常是导致干眼症和角膜并发症等多种眼部疾病的重要原因,为了探讨糖尿病与泪液分泌及眼表损害的关系,笔者对前来本院就诊病例进行角膜荧光素检查、泪液分泌试验(Schirmer)检查,以了解糖尿病继发犬白内障后对泪液分泌和眼表的影响。     

中西医结合治疗马属动物的白内障

正马属动物的白内障在兽医临床上是一种常见多发的眼科疾病之一,单纯采用药物治疗疗效甚微,而且在兽医临床上治疗白内障的药物较为匮乏。笔者自从事兽医工作以来,将人医眼科"白内障手术"应用到兽医临床上,采用手术与中西药物结合治疗马属动物白内障12例(马4例、骡6例和驴2例),治愈4例,有效3例。     

犬角膜神经染色及形态分析

角膜是动物机体神经末梢分布密度最高的区域之一,承担着营养角膜、维持角膜知觉等功能。当角膜神经出现异常时,易继发角膜水肿、角膜溃疡、干眼症等眼科疾病。在兽医临床实践中,白内障手术及周边虹膜切除术等治疗青光眼的术式,常进行角巩膜缘切口。这必然会对从角膜缘进入角膜的神经根造成损伤,引起一系列并发症。本试验将采用改良后的氯化金染色方法对犬角膜神经进行染色,模拟手术切口,并分析其对角膜神经的损伤。     

兽医眼科学与比较眼科学的近代进展(上)

《兽医科学进展》1959年第五卷发表了Uberreiter 的一篇关于眼病诊断程序和眼科手术原理的综述。从此,兽医眼科学和比较眼科学就有了显著的进展。1959至1971年各国发表的有关动物眼科病和眼科手术研究的文献已达八百多篇。作者从中选出其主要部份,作一简要的综述。其中特着重干眼球和眼眶疾病,以     

青光眼治疗药物在兽医眼科应用研究进展

青光眼是动物眼科中常见的疾病，其对动物的眼部安全危害极大。在临床上，经常使用药物对动物青光眼进行治疗且效果极佳。本文就兽医上常用的治疗青光眼五种药物的原理以及使用方法进行综述。这些药物的适应症、禁忌症以及如何合理地使用成为了新的研究方向。     

Nonsteroidal anti-inflammatory drugs in veterinary ophthalmology.

Uveitis is a common sequela to many ocular diseases. Primary treatment goals for uveitis should be to halt inflammation, prevent or control complications caused by inflammation, relieve pain, and preserve vision.Systemic and topical NSAIDs are essential components of the pharmaceutic armamentarium currently employed in the management of ocular inflammation by general practitioners and veterinary ophthalmologists worldwide. NSAIDs effectively prevent intraoperative miosis; control postoperative pain and inflammation after intraocular procedures, thus optimizing surgical outcome; control symptoms of allergic conjunctivitis;alleviate pain from various causes of uveitis; and circumvent some of the unwanted side effects that occur with corticosteroid treatment. Systemic NSAID therapy is necessary to treat posterior uveitis, because therapeutic concentrations cannot be attained in the retina and choroid with topical administration alone, and is warranted when diseases, such as diabetes mellitus or systemic infection, preclude the use of systemic corticosteroids.Risk factors have been identified with systemic and topical administration of NSAIDs. In general, ophthalmic NSAIDs may be used safely with other ophthalmic pharmaceutics; however, concurrent use of drugs known to affect the corneal epithelium adversely, such as gentamicin, may lead to increased corneal penetration of the NSAID. The concurrent use of NSAIDs with topical corticosteroids in the face of significant preexisting corneal inflammation has been identified as a risk factor in precipitating corneal erosions and melts in people and should be undertaken with caution[8]. Clinicians should remain vigilant in their screening of ophthalmic and systemic complications secondary to drug therapy and educate owners accordingly. If a sudden increase in patient ocular pain (as manifested by an increase in blepharospasm, photophobia, ocular discharge, or rubbing)is noted, owners should be instructed to contact their veterinarian promptly.     

Control of ocular inflammation

Although both topical and systemic anti-inflammatory agents have a place in veterinary ophthalmology, they play only a small role in overall patient management. They must be used appropriately to prevent ocular damage and loss of vision from inflammation and are not a replacement for a complete ophthalmic examination and specific treatment directed at the etiology of the problem. If used indiscriminately, they can result in local or systemic side effects or toxicities, many of which are worse than the initial problem for which they were selected. Just as topical corticosteroids are contraindicated with infectious keratitis, so are systemic corticosteroids contraindicated in patients with ocular inflammation resulting from a systemic infectious process. Anti-inflammatories must be used at the appropriate dosage and frequency. Use of corticosteroids that have low intraocular penetration for intraocular disease or corticosteroids with low potency is a waste of time and money. The most expensive medication is one that does not work. Avoid combination therapies when only a single medication is required. These do not save time or money and have the potential to result in the development of drug-related diseases. Diseases for which anti-inflammatory therapy has little or no indication include corneal scars, corneal edema, corneal pigmentation, corneal dystrophy, cataracts without inflammation, glaucoma, and retinal atrophy and degeneration. Last, remember that all commercially available ophthalmic medications are specifically formulated for use in the eye. Their pH, concentration, osmolality, and melting temperature all are designed to facilitate penetration. The use of dermal and otic preparations to treat ophthalmic problems is contraindicated.     

Feline ocular emergencies

Feline ocular emergencies include any ophthalmic condition that has rapidly developed or is the result of trauma to the eye or periocular structures. Common feline emergencies include proptosis, lid lacerations, corneal ulcers, and foreign bodies. Complete ophthalmic examination including procurement of the minimal ophthalmic database (Schirmer tear test, fluorescein stain, and intraocular pressure measurement) should be obtained whenever possible to ensure that the complete and correct diagnosis is made. Concern for the patient's vision and ocular comfort should guide the practioner's diagnostic and therapeutic plan. This article reviews some of the more common feline ocular emergencies, including conditions affecting the orbit and globe, adnexa, conjunctiva, and cornea. Feline uveitis, glaucoma, and lenticular diseases are covered more thoroughly elsewhere in this issue.     

Bacterial corneal diseases in dogs and cats

Corneal diseases are very common in small animals. Corneal disease associated with bacterial agents is frequent in the dog and maybe less frequent in the cat. The medical history, important steps of the ophthalmic examination, and the ophthalmic diagnostic tests that are relevant in such corneal conditions are outlined. Bacterial corneal diseases in dogs and cats are most commonly considered in one of two categories--bacterial ulcerative keratitis and corneal abscesses. The clinical aspects of these two entities as well as the therapeutic strategies available for general practitioners and ophthalmologists are discussed. Ulcerative keratitis is frequent; it represents the most common ocular diseases in dogs and cats. Because some of these corneal ulcers can be very severe, progress rapidly, and therefore are sight threatening, the crucial steps of their diagnosis and management are stressed. The use of a magnification system, fluorescein dye, and corneal cytology and culture, if indicated, is necessary for diagnosis at an early stage of the disease. The treatment of bacterial ulcerative keratitis should eradicate the infection, reduce or stop the corneal destruction and support the corneal structures, control the uveal reaction and the pain associated with it, and minimize the scarring. The prognosis depends on the stage and the severity of the corneal ulceration, the etiology of the condition, and the therapeutic choice. A close follow-up of animals with corneal ulceration is highly recommended because corneal ulcers can progress rapidly.     

Veterinary ocular microbiome: Lessons learned beyond the culture

Ocular pathogens cause many painful and vision‐threatening diseases such as infectious keratitis, uveitis, and endophthalmitis. While virulent pathogens and pathobionts play important roles in disease pathogenesis, the scientific community has long assumed disruption of the ocular surface occurs prior to microbial colonization and subsequent infection. While nonpathogenic bacteria are often detected in corneal and conjunctival cultures from healthy eyes, cultures also frequently fail to yield growth of common ocular pathogens or nonpathogenic bacteria. This prompts the following question: Is the ocular surface populated by a stable microbial population that cannot be detected using standard culture techniques? The study of the microbiome has recently become a widespread focus in physician and veterinary medicine. Research suggests a pivotal symbiotic relationship with these microbes to maintain healthy host tissues, and when altered is associated with various disease states (“dysbiosis”). The microbiota that lives within and on mammalian bodies have long been known to influence health and susceptibility to infection. However, limitations of traditional culture methods have resulted in an incomplete understanding of what many now call the “forgotten organ,” that is, the microbiome. With the introduction of high‐throughput sequencing, physician ophthalmology has recognized an ocular surface with much more diverse microbial communities than suspected based on traditional culture. This article reviews the salient features of the ocular surface microbiome and highlights important future applications following the advent of molecular techniques for microbial identification, including characterizing ocular surface microbiomes in our veterinary species and their potential role in management of infectious and inflammatory ocular diseases.     

Ophthalmic Disorders Observed in Pet Chinchillas (Chinchilla lanigera)

This article presents a retrospective analysis of ocular disorders observed in outpatient pet chinchillas examined in a veterinary clinic between 2000 and 2010. The most common ophthalmic conditions diagnosed during this time period was alteration of the lens (15 eyes, 10 chinchillas), followed by abnormalities of the cornea (14 eyes, 13 chinchillas), and conjunctival disease (10 eyes, 9 chinchillas). The predominant lens disorder was cataracts, whereas the main alteration of the cornea was fluorescein-positive corneal substance loss. Subtle ocular changes appear to be common in the chinchilla. The data gathered within this study indicate that a thorough ophthalmic evaluation is warranted during routine physical examinations for this species.     

Reference values for selected ophthalmic diagnostic tests of the ferret (Mustela putorius furo)

PURPOSE: To perform selected ophthalmic diagnostic tests in healthy ferrets with the aim of establishing normal physiological reference values for this species. METHOD: A total of 15 healthy, unrelated ferrets were used to test most of the parameters in this investigation. Eight of the 15 ferrets were used for central corneal thickness evaluation. Ages varied from 1.5 to 6 years of age. Selected diagnostic ocular tests were performed including Schirmer tear test, tonometry using an applanation tonometer (Tonopen), central corneal thickness using an ultrasonic pachymeter (Sonomed, Micropach, Model 200P +) and culture of the normal conjunctival bacterial flora. RESULTS AND DISCUSSION: Staphylococcus sp. and Corynebacterium sp. were isolated from healthy conjunctival and eyelid margins, suggesting they are normal constituents of the conjunctival flora of the ferret. Results for selected ocular diagnostic tests investigated here for the ferret eye were as follows: intraocular pressure: 14.50 +/- 3.27 mmHg; Schirmer tear test: 5.31 +/- 1.32 mm/min; central corneal thickness: 0.337 +/- 0.020 mm. No statistically significant differences between ages or genders were found for any of the results. The reference data for the ocular tests obtained in this investigation will help veterinary ophthalmologists to more accurately diagnose ocular diseases in the ferret. Knowledge of these reference values will be particularly useful to diagnose discrete or unusual pathological changes of the ferret eye.     

Laser applications for corneal disease

The clinical use of the carbon dioxide (CO2) laser and diode laser is increasing in veterinary medicine. New applications for their use are being explored, including ophthalmic applications. The use of lasers for small-animal corneal disease is fairly limited due to several factors. The ideal laser for corneal use is the excimer laser due to its extremely precise photoablative capability. However, the excimer laser is unlikely ever to become practical for veterinary use. The frequency of corneal disease in small animals in which tissue ablation is indicated is relatively low. And for most of these diseases, routine surgical techniques work as well or better than laser ablation. The CO2 laser can be used on corneal tissue, but must be used very cautiously so as not to ablate too deeply, creating serious scarring or perforation. There are also concerns regarding its effect on corneal nerves, stromal collagen, and corneal endothelium. The CO2 laser can be very effective in ablating limbal tumors with corneal extension. The use of the laser is less invasive, technically less difficult, and faster because of excellent hemostasis. The diode laser, due to its high melanin absorption, can be used effectively to ablate epibulbar melanomas with corneal stromal invasion.     

Ocular disease in rats: a review

The rat Rattus norvegicus is widely used in experimental work, both providing a rodent model for human ocular disease and as a species for toxicologic screening. In addition, the rat is more and more widely kept as a pet, being both friendly and intelligent. Diagnosis and treatment of ocular disease is important for the welfare of individual animals and whole colonies, but also to ensure that spontaneous disease is not compromising experimental work. Here, ophthalmic conditions are reviewed in order to provide a survey of ocular disease in the rat both for veterinary ophthalmologists and for laboratory animal veterinarians and research workers.     

Nonhypotensive autonomic agents in veterinary ophthalmology.

The parasympathetic and sympathetic divisions of the autonomic nervous system are involved in homeostatic control of a wide variety of ocular functions, including accommodation, pupillomotor control, lacrimation, eyelid position, and aqueous humor production. Familiarity with the functional anatomy of the autonomic nervous system is paramount to the understanding and application of the large number of autonomic drugs used in veterinary ophthalmology. The cholinergic and adrenergic agents discussed in this article are commonly employed to facilitate routine ophthalmic examination, in the diagnosis of autonomic dysfunction, and in the treatment of a variety of ocular diseases.