A morphologic study of intravitreal membranes associated with intraocular hemorrhage in the dog

Abstract We aimed to characterize intravitreal membranes in dogs and determine, if possible, associated predisposing conditions. Five globes in which intravitreal membranes were identified were evaluated. These originated from four Labrador Retrievers or Labrador-cross dogs and a Springer Spaniel. The ages of the dogs ranged from 4 to 11 years. Standard histology and immunohistochemical procedures for factor VIII-related antigen, smooth muscle actin (SMA), vimentin and glial fibrillary acidic protein (GFAP) were performed. Intravitreal membranes varied from loosely to highly organized. The extent of organization corresponded with increasing immunoreactivity for vimentin and GFAP, indicating their predominantly glial origin. They were never immunopositive for smooth muscle actin, nor were they vascularized. In all cases, they were associated with intravitreal hemorrhage. Additional common findings included epiretinal membranes, retinal neovascularization, preiridal fibrovascular membranes and glaucoma. Intravitreal membranes may be a sequelae of intravitreal hemorrhage. This in turn, may arise from new vessels associated with epiretinal or preiridial membranes, or hemorrhage associated with optic disc cupping or retinal neovascularization. All of these phenomena may accompany glaucoma.     

Ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures: 33 cases (1991–2002)

Objective: To examine ultrasonographic abnormalities in eyes with traumatic hyphema obscuring intraocular structures.
Design: Retrospective clinical study.
Setting: The ophthalmology services of a private practice and university veterinary teaching hospital.
Animals: Twenty-two dogs, 6 cats, 3 horses, and 2 birds.
Measurements and main results: Medical records were reviewed for signalment, history, ophthalmic examination, ultrasonographic findings, treatment, and outcome in all patients that presented to the ophthalmology service with trauma-induced hyphema obscuring intraocular structures. Thirty-three patients were included and there were 35 affected eyes (17 left and 18 right). Abnormalities noted on ophthalmic examination included hyphema obscuring intraocular details beyond the iris (100%), corneal laceration (23%), iris prolapse (23%), fibrin clotting within the anterior chamber (17%), and subconjunctival and periocular bruising (17%). Ocular ultrasonography revealed the presence of either vitreous hemorrhage or a retinal detachment in 32 of 35 eyes (91%) with traumatic hyphema. Of the remaining 3 eyes, ocular ultrasonography revealed a lens luxation with posterior eye wall rupture in 1 eye and collapsed globes in the other 2 eyes. Twelve eyes were enucleated and 23 were treated medically. Ten of the medically treated eyes were lost to follow-up. Blindness was noted in all the affected eyes upon their final discharge and recheck examination.
Conclusions: Ocular ultrasonography revealed vitreous hemorrhage or a retinal detachment in 32 eyes (91%) with traumatic hyphema. Blindness was noted on the last available examination of every eye. The prognosis for vision in an eye with traumatic hyphema obscuring intraocular detail is poor.     

A study of the morphology of canine eyes enucleated or eviscerated due to complications following phacoemulsification

This study was undertaken to describe the histopathologic abnormalities observed in canine eyes enucleated or eviscerated due to complications following phacoemulsification; to correlate these findings with the clinical abnormalities reported, and to suggest, if apparent, likely causes and effects of these abnormalities. Sixty-six canine globes or evisceration samples received for histopathologic interpretation over a 10-year period (1990-2000) were studied. All globes and evisceration samples were obtained from clinical patients examined by board-certified ophthalmologists. Hematoxylin and eosin (H&E) and alcian blue/periodic acid Schiff (PAS) stained sections were examined by light microscopy in every case. A tissue Gram stain was used when indicated. Clinical information obtained from the pathology submission form was reviewed in all cases, and obtained from questionnaires completed and returned by an ophthalmologist for 51 cases (77%). The most frequent histopathologic diagnoses were glaucoma (76%) and retinal detachment (64%). The most frequently reported clinical abnormalities in this series were glaucoma (86%) and uveitis (82%). Five problem areas were identified that appear to make a significant contribution to the failure of canine cataract surgery and merit further investigation: pre-iridal fibrovascular membranes; lens fiber regrowth; lens epithelial membranes; endophthalmitis, and the health of the corneal surgical incision.     

Persistent fetal intraocular vasculature in the European ferret (Mustela putorius): clinical and histological aspects

Objective To describe the clinical and histological appearance of persistent fetal intraocular vasculature in a colony of ferrets.
Design Prospective study.
Animals studied Eighty-six European ferrets ( Mustela putorius ).
Procedure Both eyes of 76 genetically related progeny and 10 breeding, adult, colony-raised ferrets were studied using a slit lamp biomicroscope and an indirect ophthalmoscope. Ferret progeny were examined after eyelid opening at 5–6 weeks of age, and at 12 months of age. After euthanasia, globes were enucleated and examined histologically.
Results Persistent fetal intraocular vasculature was evident in 21 progeny ferrets at 5–6 weeks of age and in three mature progenitor ferrets. Clinical appearance of diminutive vasculature was characterized by focal remnants of the posterior tunica vasculosa lentis, muscae volitantes, and an occluded hyaloid artery extending from the optic papilla and terminating in the anterior vitreous body. Extensive persistent vasculature was characterized by a perfused hyaloid artery, vasa hyaloidea propria and posterior tunica vasculosa lentis, posterior cortical and capsular cataract, and proliferation of fibrovascular tissue along the posterior lens capsule. Fetal vasculature persisted in 7 of 21 progeny ferrets at one year of age and in three progenitor ferrets. Results of histologic examination showed persistence of the hyaloid vasculature, proliferation of retrolental fibrovascular tissue with osseous metaplasia, posterior capsular and cortical cataract, and occasional retinal detachment.
Conclusions Persistent fetal intraocular vasculature in ferrets appears similar clinically and histologically to persistent fetal intraocular vasculature reported in humans and dogs. The ferret may be a suitable animal model for vasculogenic mechanisms of persistent fetal intraocular vasculature and for evaluating vasoinhibitory growth factors and angiostatic test compounds.     

Expression of vascular endothelial growth factor receptor-1 and -2 in normal and diseased canine eyes

Objective To immunohistochemically evaluate expression of vascular endothelial growth factor receptor‐1 (VEGFR1) and ‐2 (VEGFR2) in ocular tissue of healthy dogs and dogs affected with primary glaucoma, uveitic glaucoma, and intraocular neoplasia. Sample population Enucleated globes from five dogs with primary glaucoma, five dogs with uveitic glaucoma, six dogs with intraocular neoplasms and three ophthalmically normal control dogs. Procedure Ocular tissues were obtained from enucleated globes of clinical cases or immediately following euthanasia for control dogs. Tissue sections were stained immunohistochemically for VEGFR1 and VEGFR2 via standard techniques and vascular tissue was qualitatively evaluated. Vascular endothelial VEGFR1 and VEGFR2 expression patterns are reported for normal and diseased ocular tissues. In addition, VEGFR1 and VEGFR2 expression patterns are reported for all normal ocular tissues. Results A constitutive expression pattern was detected for VEGFR1 by ocular vascular endothelial cells as well as nonvascular cells in the cornea, uvea, lens, and retina. VEGFR2 demonstrated limited expression in normal ocular tissue, but was widely expressed in vascular endothelium of diseased eyes, particularly in pre‐iridal fibrovascular membranes. Conclusions The results of this study suggest a role for VEGF receptors in both physiologic and pathologic angiogenesis in canine ocular tissue. Manipulation of this pathway may be a rational consideration for therapeutic intervention in canine ocular disease exhibiting pathologic neovascularization.     

Malignant teratoid medulloepithelioma in a llama

A lesion was identified in the eye of a juvenile llama, and preliminary clinical findings included anterior uveitis and an exudative retinal detachment suggestive of infectious disease. However, histopathologic evaluation of the enucleated globe revealed an intraocular neoplasm composed of primitive neuroepithelium forming ribbons, cords, and rosettes, heteroplastic elements including spindle cells in a loose myxomatous matrix, and islands of well-differentiated hyaline cartilage. Immunohistochemically, neoplastic cells were positive for vimentin and neuron-specific enolase. Spindle cells were multifocally positive for desmin and muscle specific actin, indicating differentiation towards myofibers. These findings are consistent with a diagnosis of malignant teratoid medulloepithelioma, an extremely rare ocular neoplasm that affects children and young animals.     

Intracapsular lensectomy and sulcus intraocular lens fixation in dogs with primary lens luxation or subluxation

Objective  To evaluate the postoperative results of lensectomy and sulcus intraocular lens fixation (SIOLF) via an ab interno approach in dogs with progressive lens subluxation or early luxation.
Study design  Retrospective study.
Animals studied  Twenty eyes from 19 dogs presented to the Animal Eye Clinic for lens luxation or subluxation between 1999 and 2006.
Methods  Medical records were reviewed to evaluate preoperative lens position, vision status, intraocular pressure (IOP), and whether surgery was performed on an emergent or elective nature. Lensectomy and SIOLF were performed and postoperative status including vision, glaucoma, and retinal detachment was assessed.
Results  Average age was 8.6 years (range 4–14 years) and 55% (11/20) were terriers. Patients were followed a mean of 29.2 months (range 1–92 months) after surgery. Retinal detachment or secondary glaucoma was observed in 1 of 20 (5%) and 5 of 20 (20%) eyes, respectively, with 1 of 20 (5%) exhibiting both. Mean preoperative IOP was 16 mmHg and preoperative lens position was equally divided between luxated and subluxated lenses. Surgery was performed more frequently as an elective procedure (18/20; 90%) due to normalized IOP vs. an emergency procedure (2/20; 10%). Vision was retained in 70% (14/20) of eyes with a mean time to vision loss of 41 months in the remaining eyes due to glaucoma, retinal detachment, or retinal degeneration.
Conclusions  Complications of glaucoma and retinal detachment after SIOLF in this study were less when compared with previously reported incidence rates in the literature for lensectomy alone which may reflect improved patient selection.     

Postoperative complications and visual outcomes of phacoemulsification in 103 dogs (179 eyes): 2006-2008

Objective To describe the postoperative complications and visual outcome after phacoemulsification in dogs and identify risk factors for complications. Animals studied One hundred and three dogs (179 eyes) that had phacoemulsification with or without intraocular lens (IOL) placement including foldable acrylic IOLs between March 2006 and March 2008 at Purdue University Veterinary Teaching Hospital. Procedure Medical records were reviewed and occurrence and dates of postoperative complications were tabulated. Visual status at the final recheck during the study period was recorded. Additional information including signalment, diabetes mellitus status, operative complications and factors, presence of prior lens induced uveitis, preoperative retinopexy, and cataract stage was collected. Results The majority of eyes were functionally visual (148 eyes, 82.7%) at the end of the study period. Blindness was seen in 18 eyes (10.0%) with reduced vision in 13 eyes (7.3%) at the final recheck. Postoperative ocular hypertension (22.9%), corneal lipid opacity (19.0%), uveitis (16.2%), intraocular hemorrhage (12.3%), retinal detachment (8.4%), and glaucoma (6.7%) were the most common postoperative complications seen in eyes. The odds of blindness were significantly greater (OR = 290.44) in the eyes of Boston terriers compared with mixed breed dogs and with each year of increasing age (OR = 2.00). Conclusion The prognosis for vision after phacoemulsification with injectable IOL placement is good. Boston terriers were at much higher risk for certain complications.     

Management of intraocular inflammatory disease

The uvea of the eye is divided into the anterior uvea (iris and ciliary body) and posterior uvea (choroid). Clinical signs of anterior uveitis include conjunctival hyperemia, corneal edema, aqueous flare, miosis, and a decrease in intraocular pressure. Inflammation of the posterior uvea often involves the retina as well resulting in a chorioretinitis. Clinical signs of chorioretinitis may include multifocal lesions in tapetal or nontapetal fundus, retinal detachment, and a decrease in vision. The etiology of uveitis is complex and includes numerous infectious, neoplastic, immune-mediated, and other diseases. Treatment is directed at the underlying systemic disease, if present, as well as symptomatic treatment for the eye. The diagnostic and therapeutic approach to a patient with uveitis is discussed.     

A keratoprosthesis prototype for the dog

Objective  To describe the technique for implantation of a novel keratoprosthesis (KP) prototype and evaluate its application for the treatment of corneal blindness in dogs.
Animals studied  Seven dogs, all of them being clinically blind before surgery as a result of severe corneal endothelial disease (5/7) or chronic superficial keratitis (2/7) that were unresponsive to prior therapy.
Procedures  A silicone KP was implanted unilaterally, just anterior to Descemet's membrane, after creating a stromal pocket by deep stromal lamellar dissection.
Results  Implantation of the KP was accomplished without complication in six of seven operated dogs. In the remaining case, an intra-operative complication (perforation of Descemet's membrane) was associated with extrusion of the KP 8 weeks postoperatively. All operated eyes regained limited vision after surgery. Three to six months after implantation purulent keratitis occurred in all five eyes with endothelial disease, necessitating surgical removal of the KP 6 months postoperatively in 5/7 eyes.
Conclusions  This KP prototype shows promise as a treatment for certain blinding corneal diseases. However, changes in the design of this KP, allowing improved stromal integration, will be necessary before its clinical application can be approved.     

Combined cycloablation and gonioimplantation for treatment of glaucoma in dogs: 18 cases (1992-1998)

OBJECTIVE: To evaluate a combined cycloablative and gonioimplantation technique for treatment of glaucoma in dogs. DESIGN: Retrospective study. ANIMALS: 18 adult dogs with glaucoma. PROCEDURE: Medical records of dogs that received a valved gonioimplant and a cyclodestructive procedure (cyclocryoablation or diode laser cyclophotocoagulation) during a 6-year period were reviewed. Retention of vision and intraocular pressure control were assessed, as well as number and nature of complications. RESULTS: 19 eyes of 18 dogs received a valved gonioimplant and either cyclocryoablation (n = 12) or diode laser cyclophotocoagulation (7). At > or = 1 year after surgery, 11 of 19 eyes had vision and 14 of 19 eyes had intraocular pressure < 25 mm Hg. Two dogs (2 eyes) were lost to follow-up 3 and 6 months after surgery. Despite the alternative route for aqueous humor flow created by the gonioimplant, 7 eyes had increased intraocular pressure (27 to 61 mm Hg) < 24 hours after surgery. Other complications included excessive intraocular fibrin, focal retinal detachment, corneal ulcer, retinal hemorrhage, cataract, and implant migration. CONCLUSIONS AND CLINICAL RELEVANCE: Combined cycloablation and gonioimplantation appears to be a promising technique for retention of vision and control of intraocular pressure in dogs with glaucoma.     

Chronic retinal detachment and giant retinal tears in 34 dogs: outcome comparison of no treatment, topical medical therapy, and retinal reattachment after vitrectomy

The outcomes of dog's eyes with chronic (> 1 month) retinal detachment and giant retinal tears without therapy were compared with those treated with topical steroids and antiglaucoma medications, and with those that received a vitrectomy, retinal reattachment, endolaser therapy, and silicone oil tamponade. Fourteen of 16 eyes that did not receive therapy developed uveitis and secondary glaucoma, and were enucleated (4) or eviscerated (6); and 2 dogs were euthanized due to blindness and uveitis. Two eyes in 2 dogs remain without treatment, 1 and 3 years later. Fifteen of 19 eyes that received topical therapy developed nonresponsive uveitis and secondary glaucoma, and were enucleated (4) or eviscerated (9), 1 dog that was affected bilaterally was euthanized; and 3 eyes remain on topical anti-inflammatory therapy and the medication has been discontinued on 1 eye. Four of 6 eyes surgically reattached remain without clinical manifestations of uveitis and secondary glaucoma and 3 of these eyes have functional vision. Light microscopic observations completed on failed globes in the 3 groups were similar.     

Cataracts are not associated with retinal detachment in the Bichon Frise in the UK--a retrospective study of preoperative findings and outcomes in 40 eyes

Objective The aim of this study was to evaluate whether the Bichon Frise population in the UK is at the same risk of developing retinal detachment in association with cataract formation and following phacoemulsification as described in reports from the USA. Procedures The medical records of Bichon Frises which were presented for cataract assessment and of those which were treated with phacoemulsification at Willows Referral Service between 1997 and 2009 were reviewed. Results Forty eyes (26 dogs) with unilateral or bilateral cataracts were included in the study. There was no evidence of retinal detachment associated with the cataracts at initial presentation. Phacoemulsification was performed on 34 eyes (20 dogs). Clinically evident lens‐induced uveitis was treated preoperatively in 17/34 eyes. Artificial lens implantation was carried out in 30/34 eyes; automated anterior vitrectomy was performed in 7/34 eyes. The mean follow‐up time was 16.6 months (range 1.5–73 months). At the last re‐examination, 31/34 eyes (91.2%) were visual. Three eyes (8.8%) were blind – two (in the same dog) because of presumptive bilateral optic nerve disease and one because of uveitis and secondary glaucoma. There was no evidence of retinal detachment following phacoemulsification in any of the 34 eyes. Conclusion This study suggests that the Bichon Frise population in the UK does not appear to have a predisposition for retinal detachment in association with cataract formation or following cataract surgery. Prophylactic random transscleral laser retinopexy or transscleral cryopexy cannot therefore be routinely recommended for Bichon Frises with cataracts in the UK.     

Phacoemulsification and intraocular lens implantation in a Canada lynx with phacoclastic uveitis

A 4-year-old male Canada lynx (Lynx canadensis) was referred to the ophthalmology service at the University of Saskatchewan with a 7-month history of cataract and chronic phacoclastic uveitis secondary to penetrating trauma from a lynx claw. Ophthalmic examination of the right eye revealed a corneal scar, marked aqueous flare, extensive fibrovascular membranes extending from the iris to the lens, anterior and posterior synechiae, immature cataract, and anterior vitritis; the fundus was not visible. Phacoemulsification surgery and intraocular lens implantation using a custom lens of D+46 and 14 mm (An-vision, West Jordan, Utah, USA) was performed. Post-operative medications included sub-conjunctival injections of atropine, cefazolin, and triamcinolone, and oral doxycycline and prednisolone. At the 5-month follow-up, the uveitis was controlled, and a normal fundus was visualized; at 21 mo, the eye remained comfortable and visual. This is the first case report to describe phacoemulsification in a wild felid as a treatment for a traumatic cataract and severe phacoclastic uveitis.Key clinical message:Despite chronic phacoclastic uveitis, phacoemulsification surgery can provide a positive outcome for mature wild felids with traumatic lens rupture, even when topical treatment cannot be administered.     

Ocular lesions of bovine malignant catarrhal fever

The ocular lesions of bovine malignant catarrhal fever were characterized in 15 naturally occurring and eight experimentally induced cases of the disease. Consistent findings included: lymphocytic vasculitis of retinal, scleral, posterior ciliary, and uveal vessels; uveitis, especially involving ciliary processes, ciliary body, and iris; and keratitis with corneal edema, neovascularization, and epithelial and endothelial degeneration. Lymphocytic ciliary neuritis and optic meningitis were found less frequently. Ultrastructural examination of the ciliary body and iris from one experimental calf confirmed that most infiltrating mononuclear cells were lymphocytes. The uveitis, vasculitis, and keratitis of malignant catarrhal fever were probably immune-mediated.     

Intravascular lymphoma presenting as bilateral panophthalmitis and retinal detachment in a dog

A seven-year-old, spayed female boxer was presented for sudden blindness and red eyes of one week's duration. Ophthalmic examination revealed bilateral uveitis with complete bullous retinal detachments. Initial diagnostic testing failed to reveal evidence of systemic disease. Cytopathology of subretinal aspirates confirmed the presence of macrophages with intracytoplasmic retinal pigment, epithelial and choroidal pigment, and monocytes. Tentative diagnoses were idiopathic uveitis and retinal detachment. The dog was treated with immunosuppressive doses of prednisone. The retinas reattached and vision returned. By two months, the dog became blind and systemically ill. Postmortem and histopathological examinations revealed intravascular lymphoma in multiple organs, including the eyes.     

Immunohistochemical and histomorphometric evaluation of vascular distribution in intact canine cranial cruciate ligament

Objectives: To (1) describe vascular distribution in the grossly intact canine cranial cruciate ligament (CCL) using immunohistochemical techniques specific to 2 components of blood vessels (factor VIII for endothelial cells, laminin for basement membrane); and (2) compare the vascularity in different areas of interest (craniomedial versus caudolateral bands; core versus epiligamentous regions; and proximal versus middle versus distal portions) in the intact normal canine CCL. Study Design: In vitro study. Animals: Large, mature dogs (n=7) of breeds prone to CCL disease that were euthanatized for nonorthopedic conditions. Methods: Intact CCL were collected from fresh canine cadavers free from stifle pathology. CCL tissue was processed for immunohistochemistry and stained for factor VIII and laminin. Vascular density was determined by histomorphometric analysis. Results: Specific vascular staining was sparsely identified throughout the CCL; however, the proximal portion of the CCL appears to have a greater number of vessels than the middle or distal portion of the ligament. Conclusions: The CCL is a hypovascular tissue and its vascular distribution is not homogeneous.     

DNA measurement and immunohistochemical characterization of epithelial and mesenchymal cells in canine mixed mammary tumours: putative evidence for a common histogenesis.

DNA measurement by image cytometry, and a detailed immunohistochemical study using monoclonal antibodies directed against different human cytokeratin types, muscle-specific actin, vimentin and S100 protein were carried out on normal canine mammary tissue (n =4), benign canine mammary mixed tumours (n =20) and malignant canine mammary mixed tumours (n =13). The results showed that ductal and alveolar luminal cells in normal and neoplastic tissue were immunoreactive with CAM5.2 and AE1/AE3 antibodies recognizing human keratins.Basal/myoepithelial cells were clearly differentiated from ductal and alveolar epithelial cells, since the latter only expressed cytokeratins, whereas the former also expressed vimentin and muscle-specific actin. This immunohistochemical study showed that there is loss of expression of muscle-specific actin and cytokeratins in areas of myoepithelial proliferation, and enhanced expression of vimentin and S100 protein in proliferative areas with osseous and/or chondroid metaplasia. The ploidy studies revealed that 20% (4/20) of benign and 54% (7/13) of malignant mixed tumours of canine mammary gland were aneuploid and that the epithelial and myoepithelial components of the mixed tumours had identical DNA content.Our results reinforce the role of myoepithelial cells in mesenchymal metaplasia in mixed mammary tumours and suggest the possibility of a common origin of both components from a totipotential stem cell with capacity for divergent differentiation.     

An Immunohistochemical Study of the Oviduct in the Domestic Fowl (Gallus domesticus)

This study describes the distribution of vimentin, desmin, smooth muscle actin (SMA) and laminin in the oviduct of the laying domestic fowl. Vimentin immunostaining was localised in the luminal epithelium of the infundibulum, magnum, magnum–isthmus junction and isthmus. The luminal epithelium of the shell gland regions displayed weak vimentin immunostaining. Vimentin immunostaining was demonstrated in the glandular grooves of the tubular infundibular region. In contrast, gland cells in the magnum, isthmus and shell gland regions were vimentin immunonegative. Fibroblasts and vascular endothelial cells in the lamina propria of the oviductal regions studied exhibited vimentin immunostaining. Strong desmin and SMA immunostaining were present in the smooth muscle cells of the tunica muscularis and vascular tunica media. In this study, basement membranes underlying the luminal and glandular epithelia were immunopositive for laminin. In addition, basement membranes associated with smooth muscle cells exhibited laminin immunostaining. The results of the study indicate that the immunolocalisation of desmin, SMA and laminin in the oviduct of the domestic fowl is similar to that in the mammalian uterus. The immunolocalisation of vimentin in the domestic fowl varies depending on the oviductal region.