Intraocular sarcoma associated with lens capsule rupture and persistent hyperplastic primary vitreous in a dog

This case report describes the clinical findings and ocular pathology in an adult Golden Retriever diagnosed with an intraocular sarcoma. Nineteen s prior to diagnosis with a lens capsule rupture and intraocular sarcoma, the dog was diagnosed with persistent hyperplastic primary vitreous and uveitis based on clinical signs and the ultrasonographic appearance of the eye. Two years after enucleation, there was no evidence of metastatic spread of the sarcoma. The immunohistochemical characteristics of the tumor as well as the limitations and supportive evidence used in attempting to identify the histogenesis of the tumor are outlined.     

Traumatic corneal laceration with associated lens capsule disruption: a retrospective study of 77 clinical cases from 1999 to 2009

Objective Examine prognostic factors that may indicate when surgical lens removal is indicated to prevent vision‐threatening complications in patients presented following traumatic perforating corneal laceration with associated lens capsule disruption. Procedures Seventy‐seven patients (10 cats and 67 dogs) were evaluated with this injury; of these, 47 were presented acutely and treated surgically and/or medically. Successful outcome was defined as functional vision in the treated eye. Results The 47 patients with acute injuries were divided into 3 treatment groups A‐C for comparison; A ‐ corneal repair/lens removal (n = 15), B ‐ corneal repair/no lens removal (n = 9), C – medical management (n = 23). Groups A and B showed a significantly greater rate of vision loss compared to Group C that was most obvious greater than 18 months post‐injury (P = 0.029 and 0.0097, respectively). Cox proportional hazards regression analysis found a significantly higher increased rate of vision loss in Group A (HR = 4.5; P = 0.023) and a higher but nonsignificant increased rate of vision loss in Group B (HR = 3.0; P = 0.23) compared to Group C after controlling for age and cause of injury. The length of the corneal laceration and time interval from injury to referral were also relevant prognostic factors. Conclusions Medical management is an appropriate therapy for patients of all ages suffering perforating corneal injuries with associated lens capsule disruption. Patients with corneal injuries requiring surgical repair or managed by lens removal following corneal repair suffered vision‐threatening complications approximately 3 to 4.5 times the rate of patients treated by medical management, respectively. Favorable prognostic signs for treatment by medical management include good corneal wound apposition and a formed anterior chamber without uveal prolapse or continued aqueous leakage.     

Uveitis and pupillary block glaucoma in an aphakic dog

Unilateral uveitis with pupillary occlusion and secondary glaucoma was treated with neodymium:YAG laser iridotomy and iridencleisis in an aphakic 2-year-old male Miniature Schnuauzer. The dog presented 4 months after bilateral phacoemulsification with a complaint of blepharospasm of the left eye. Examination revealed anterior uveitis with pupillary occlusion and iris bombé. A slit-lamp mounted Q-switched Nd:YAG laser was used to create a central iridotomy to deepen the anterior chamber and an iridencleisis was performed to recreate a pupil. The eye remained visual and normotensive over a 6-month follow-up period.     

Light-microscopy evaluation of zonular fiber morphology in dogs with glaucoma: secondary to lens displacement

Lens displacement resulting in secondary glaucoma is common in terrier breeds. This study was carried out to evaluate whether light microscopy was useful in detecting abnormal patterns in zonular fiber protein. Eyes from 63 dogs with glaucoma secondary to lens displacement were evaluated for the presence of abnormal zonular fiber morphology using the following stains: hematoxylin and eosin, periodic acid Schiff (PAS), Masson's trichrome and Verhoeff's elastin stains. Two distinct forms of abnormal zonular fiber morphology were recognized and designated as zonular fiber dysplasia (ZFD) and zonular fiber collagenization (ZFC). ZFD protein morphology was characterized by being tightly adherent to the nonpigmented ciliary body epithelium, exhibiting a distinct lamellar and cross-hatched pattern and staining strongly positive with PAS and trichrome stains, and staining negative with elastin stains. ZFD was predominant in terrier breeds (18 of 29) and Shar-Pei dogs (4 of 29). ZFC abnormality was characterized by excessive zonular fiber that was not tightly adherent to the ciliary body epithelium and staining positive with PAS, trichrome (blue for collagen) and elastin stains. Only 7 of 19 dogs with ZFC changes were terrier breeds, and there was no pattern in the breeds affected. Fifteen of the 63 dogs used in the study had normal appearing zonular fibers. The staining pattern in these dogs matched normal controls by staining positive with PAS and Verhoeff's elastin stains and had only minimal positive staining with Masson's trichrome stain. Results suggest that light microscopy is useful in detecting breed-related changes in zonular fiber morphology in cases of glaucoma secondary to lens displacement. These changes may correlate with the presence of abnormal zonular fiber proteins and might be important in the pathogenesis of primary lens displacement in terrier and Shar-Pei dogs.     

Posterior lens luxation with associated glaucoma in a pony

Secondary lens luxation is an infrequent consequence of equine recurrent uveitis (ERU). This Case Report describes a pony with posterior lens luxation with associated glaucoma, thought to be secondary to ERU.     

Abnormal ocular pigment deposition and glaucoma in the dog

The combined occurrence of ocular pigment deposition and glaucoma has been described in Cairn Terriers. Recently, this condition was also observed in two other breeds: the Boxer (two cases) and the Labrador Retriever (one case). Six dogs were referred to the Ophthalmology section of the Department of Clinical Sciences of Companion Animals and to a private referral clinic because of glaucoma or blindness in one or both eyes. In five cases ophthalmic examination showed pigment depositions in the sclera around the entire circumference of the perilimbal zone. Eight enucleated eyes (four eyes of two Cairn Terriers, three eyes of two Boxers and one eye of a Labrador Retriever) were examined microscopically. All eyes showed the same findings: an extensive infiltration of large melanin-containing cells with an eccentric nucleus, located in the iris, ciliary body, retina, choroids and sclera. Transmission electron microscopy of two of the examined eyes revealed that the morphology of most of these cells was consistent with melanophages. While reports in the veterinary literature concerning this condition are limited the cells concerned have been described to be melanocytes. Further research is needed to conclusively identify the cell type. As described in the present report, the histologic and transmission electron microscopic findings suggest a different etiology of the ocular pigment deposition and glaucoma compared with the pigment dispersal syndrome in humans.     

The incidence of posterior capsule disruption during phacoemulsification and associated postoperative complication rates in dogs: 244 eyes (1995-2002)

OBJECTIVE: The objective of this retrospective study was to report the incidence of posterior capsule disruption during routine phacoemulsification and to document the postoperative outcomes and complications in eyes with posterior capsule disruption compared with eyes with intact posterior capsules. PROCEDURES: Records of 143 dogs (244 eyes) were reviewed. Data collected included whether the posterior capsule was disrupted, whether the disruption was planned or accidental, whether an intraocular lens was implanted, and visual outcome. Records were reviewed for postoperative complications. Intraocular lens implantation rates, complication rates, and visual outcomes were compared between intact and disrupted posterior capsule groups using Chi-square analyses. RESULTS: The posterior capsule was disrupted in 33/244 eyes (14%). Planned capsulotomies accounted for 36% of the disruptions. Intraocular lenses were implanted in 76% of eyes without a disruption of the posterior capsule and in 31% of eyes with a posterior capsule disruption. Intraocular lenses were more likely to be implanted in eyes with a planned disruption of the posterior capsule (7/12; 58%) than in eyes with an accidental disruption (3/20; 15%). There were no significant differences in postoperative complications or visual outcome between eyes with posterior capsule disruption and those without. CONCLUSIONS: The most significant complication of posterior capsule disruption during phacoemulsification is the inability to implant an intraocular lens. Intraocular lenses are more likely to be placed in eyes with intentional disruptions of the posterior capsule than those with accidental ruptures.     

Aqueous misdirection and ciliary block (malignant) glaucoma after cataract removal in a llama

Ciliary block (malignant) glaucoma is caused by the posterior flow of aqueous humor into or behind the vitreous. It is a rare complication of anterior segment surgery in humans. This is a report of ciliary block glaucoma occurring as a postoperative complication of cataract surgery in a llama. Medical management was ineffective in lowering intraocular pressure (IOP). Posterior capsulotomy and anterior hyaloid disruption with a 22-gauge needle, in addition to medical management maintained IOP in the normal range until anterior vitrectomy could be performed. After vitrectomy, glaucoma resolved and medical treatment was no longer necessary.     

Ahmed valve implantation to control intractable glaucoma after phacoemulsification and intraocular lens implantation in a dog

An 11-year-old spayed female Miniature Poodle presented with bilateral senile cataracts. Treatment was cataract removal by phacoemulsification and intraocular lens implantation. Five hours after surgery the operated right eye was partially closed and painful. The right pupil was fully dilated, there was generalized corneal edema, and intraocular pressure (IOP) was increased. After 12 h of medication IOP was controlled. Ten weeks after surgery the owners reported cloudiness of right eye, and the dog was again evaluated. The IOP was again increased and an Ahmed valve was implanted. This case describes describe the progression of this case and benefits of controlling postcataract surgery glaucoma by the implantation of an Ahmed valve.     

Long-term survival after combination chemotherapy for bilateral renal malignant lymphoma in a dog

CASE HISTORY: A 6-year-old, entire male Flat-coated Retriever was presented with a history of lethargy, polydipsia and seizures. Clinical chemistry had shown marked azotaemia.

CLINICAL FINDINGS AND DIAGNOSIS: Radiography and ultrasonography revealed bilateral renomegaly, and cytology of fine needle aspirates from the kidneys was diagnostic of malignant lymphoma. The dog was treated with a modified high-dose cyclophosphamide-, vincristine-, and prednisolone-based chemotherapy protocol, achieved remission, and returned to normal quality of life. Survival time was 346 days from the time of diagnosis.

CLINICAL RELEVANCE: Malignant lymphoma in the kidneys of dogs has been considered to carry a uniformly poor prognosis. Long-term remission after medical treatment has not previously been reported. The favourable outcome in this case illustrates the limitations of clinical staging in determining the outcome for individual patients.     

Multiple ciliary body cysts and secondary glaucoma in the Great Dane: a report of nine cases

Between 1989 and 1995 nine Great Danes were presented to the small animal clinic of the University of Zurich Teaching Hospital with glaucoma and multiple cysts in the anterior and posterior chamber. In four of the nine dogs cysts were present in both eyes; however, bilateral glaucoma was seen in one case only. Mean intraocular pressure (IOP) at initial presentation was 42 mmHg measured by applanation tonometry. With the exception of one dog, all animals were treated medically for a minimum of 13 days. Two animals were subsequently lost to follow up. Two dogs underwent evisceration with implantation of a silicone prosthesis. The glaucomatous globe was enucleated in three dogs. One owner declined surgery and the dog remained buphthalmic with a poorly controlled IOP. One animal remained visual after trans-scleral diode laser cyclophotocoagulation. Histopathology of the three enucleated globes showed multiple cysts originating from the ciliary body epithelium. The mechanism of IOP elevation is probably by anterior displacement of the iris with narrowing of the angle and collapse of the ciliary cleft. A delicate pre-iridal fibrovascular membrane was also seen in each case, which could have also contributed to the elevation of IOP. The high odds ratio of 2.23 (CI 95% 1.14, 3.99) for glaucoma and 37.01 (CI 95% 16.42, 77.81) for ciliary body cysts suggests they are both inherited in this breed. Pedigree analysis of the affected dogs failed to definitely reveal the mode of inheritance.     

Immunohistochemical analysis of lens epithelial-derived membranes following cataract extraction in the dog

The objective of the study was to characterize the morphologic and immunohistochemical features of lens epithelial-derived proliferative membranes from the anterior segment of canine globes. These features were correlated with those previously identified for diseases resulting from lens epithelial cell (LEC) proliferation including posterior capsular opacification, traumatic subcapsular cataract, and subcapsular plaques associated with hypermature cataracts. Sixteen canine globes were removed as a result of glaucoma or other complications following cataract extraction. Light microscopic and immunohistochemical analysis was performed on sections from formalin-fixed, paraffin-embedded globes. The tissues were stained with a variety of antibodies for cellular markers for LECs, growth factors or other cellular constituents relevant to cellular metaplasia and proliferation. The membranes were composed of monolayers or multilayers of spindle-shaped cells on the external surfaces of the anterior and posterior lens capsule, ciliary processes, iris leaflets, and iridocorneal angle, and they could be seen extending from an obvious monolayer of LEC within the capsular sac. Variably, scattered pigment cells, presumably of uveal origin, were concurrently present. Cellular components of the membranes stained positive for vimentin, transforming growth factor-beta, basic fibroblast growth factor, and smooth muscle actin. An amorphous eosinophilic extracellular matrix consisting predominately of collagen was associated with the membranes. Proliferative anterior segment membranes following cataract surgery were morphologically and immunohistochemically similar to cellular and matrix components of posterior capsular opacification and capsular plaques seen with hypermature cataracts, both of which result from metaplasia and proliferation of LEC. The presence of these LEC-derived membranes in association with secondary glaucoma suggests that exuberant proliferation of LEC outside the confines of the lens capsular sac may cause pathologic alterations in the eye following cataract surgery in the dog.     

Septic lens implantation syndrome in a cat

A 13-year-old female spayed domestic shorthair cat was presented initially for a change in the appearance of the left eye. On initial examination, a small penetrating wound was suspected as the cause for a corneal scar, an anterior cortical incipient cataract and mild iritis. The cat was not re-presented until 1 year later at which time ocular pain was marked. Severe anterior uveitis and glaucoma were diagnosed and the eye enucleated. Histopathology documented intralenticular coccoid bacteria and septic lens implantation syndrome.     

Golden Retriever uveitis: 75 cases (1994-1999)

OBJECTIVE: To document the presenting ocular signs and the clinical course of Golden Retriever dogs with a progressive anterior uveitis, often associated with the histologic presence of iridociliary cysts. Animals studied Seventy-five Golden Retriever dogs (142 affected eyes) referred to a private practice referral ophthalmology clinic between 1994 and 1999. Procedures Complete ophthalmic evaluation with slit-lamp biomicroscopy, indirect ophthalmoscopy, applanation tonometry, and gonioscopy. Hematology, serum biochemical evaluations, and serologic titers for endemic infectious agents were also used in selected cases. RESULTS: The age range of affected dogs was 4.5-14.5 years, with a mean age of 8.6 +/- 2.1 years. The majority of the dogs (n = 66) were affected in both eyes at first presentation. The sex distribution included 4 intact males, 32 neutered males, and 39 spayed females. Hematology, serum biochemical evaluations, and serologic titers for endemic infectious agents failed to demonstrate any underlying disorder. The ophthalmic hallmark of this syndrome was the appearance of pigment on the anterior lens capsule, often in a radial orientation. This capsular pigment was seen both with and without associated uveal cysts. Although single to multiple iridociliary cysts were noted clinically in only 13.3% of the cases, cysts were common on histopathology of advanced glaucomatous, blind eyes. Fibrin was observed in the anterior chamber of 37% of the cases, and often was a precursor for glaucoma. Cataract formation (37%) and glaucoma (46%) were frequent sequelae to the uveitis. Posterior synechiae formation occurred in 50% of the cases. Histopathologic analysis of four enucleated eyes and the eviscerated specimens from 14 glaucomatous eyes demonstrated thin-walled iridociliary epithelial cysts in 3/4 and 12/14 cases, respectively. Microscopically, little to no uveal inflammatory infiltration was commonly noted. Conclusion The overall prognosis for this progressive uveitis in Golden Retriever dogs is guarded, with 46% of the eyes becoming blind due to glaucoma. Iridociliary cysts in Golden Retriever dogs may lead to the development of glaucoma in this breed.     

Orbitotomy for retrobulbar malignant fibrous histiocytoma in a dog

A retrobulbar malignant fibrous histiocytoma was diagnosed in a 12-year-old castrated male Keeshond dog. The mass was excised with a lateral orbitotomy and zygomatic arch resection. Vision was preserved in the affected eye, and no recurrence was noted up to 10 months postoperatively. Malignant fibrous histiocytoma originates from primitive mesenchymal stem cells. The malignant fibrous histiocytoma seen in our patient was most consistent with the storiform-pleomorphic variant, given the storiform arrangement of spindle cells, the presence of histiocytoid cells, and a mixed inflammatory infiltrate, without giant cells. The metastatic potential of malignant fibrous histiocytoma in general, and the storiform variant in particular, is unknown. Seventeen months later the dog was presented to the referring veterinarian with anorexia, diarrhea, weight loss and bilateral purulent nasal exudates. The dog was euthanized without necropsy.