Phacofragmentation for morgagnian cataract in a horse

A 3‐year‐old Paint gelding was presented for sudden onset of cataract affecting the right eye. Ophthalmic examination revealed subtle to mild microphthalmia and a mature cataract affecting the right globe. The right eye was treated with an antibiotic‐corticosteroid ophthalmic ointment and phacofragmentation was recommended. On re‐examination 5 months later, resorption of the cortex of the right lens and a morgagnian cataract were evident. The nucleus was positioned ventronasally in the lens capsule. The right eye had light perception, and a menace response was present. Examination of the right fundus via binocular indirect ophthalmoscopy was not possible. Ophthalmic ultrasonography revealed that the right globe was 4 mm shorter in axial length when compared with the left globe. There was a marked reduction in the size of the right lens vs. the left lens, and the presence of a moderate amount of hyperechoic debris was identified within the vitreal compartment of the right globe. Phacofragmentation, irrigation and aspiration of the morgagnian cataract and an anterior vitrectomy were performed. On postoperative examination, the eye was comfortable and a menace response was present. The horse regained useful vision and continues to have a comfortable, visual eye 7 months postoperatively.     

Cataract in the UK Leonberger population

OBJECTIVE: To survey the Leonberger, a numerically small breed in the UK, for the presence of cataract and find statistical support for the possible presence of inherited forms of cataract. METHODS: Ocular examinations were carried out by the first author between September 1996 and September 1998 on 211 Leonbergers; results of the ocular examination of further 228 Leonbergers examined between January 1990 and September 1998 by members of the British Veterinary Association/KC/ISDS eye scheme (BVA/KC/ISDS eye scheme) panel were analyzed. Data from all dogs examined were pooled in a composite database of 365 Leonbergers and the relationships between offspring and parents for the identified forms of cataract were examined with appropriate statistical methods. RESULTS: Cataracts were diagnosed in 90 Leonbergers, the majority being nuclear (40) or posterior polar subcapsular (31). A subgroup of nuclear cataracts, diagnosed in 11 dogs, is described and named as 'posterior nuclear cataract.' For posterior polar cataract, a positive association between offspring and parents was made in the logistic regression model, supporting the suggestion of inheritance. CONCLUSIONS: The presence of several types of cataract in the UK Leonberger population is described. Statistical support for the inheritance of posterior polar subcapsular cataract is given.     

The relationship of cataract maturity to intraocular pressure in dogs

Objective To determine the distribution of intraocular pressure, as measured by applanation tonometry, in dogs with cataracts, and compare these tonometric results to the different stages of cataract formation (incipient, immature, mature, and hypermature). Animals studied Retrospection study of canine clinical patients (86 dogs). Procedures All records of dogs presented from 1991 to 1996 to the university veterinary medical teaching hospital for diagnosis of cataracts and evaluation for cataract surgery were reviewed. The tonometric measurements from the initial ophthalmic examination were selected in cataractous and nonglaucomatous eyes either receiving no topical or no systemic medications. The stage of cataracts was based on the degree of opacification, tapetal reflection, clinical vision, and visibility of the ocular fundus by indirect ophthalmoscopy. The distribution of tonometric results were grouped by the cataract maturity, and compared by anova and Tukey’s general linear tests. Results Intraocular pressure with incipient cataracts ranged from 9 to 17 mmHg (mean 12.7 ± 1.2 mmHg). Intraocular pressure with immature cataracts ranged from 3 to 27 mmHg (mean 13.6 ± 0.6 mmHg). For the mature cataracts, IOP ranged from 5 to 22 mmHg (mean 11.9 ± 0.7 mmHg). For the hypermature cataract group, IOP ranged from 4 to 23 mmHg (mean 10.8 ± 0.6 mmHg). Comparison of the tonometric results among the different stages of cataract formation indicated a significant difference (P = 0.0086) between only the immature and hypermature groups. Conclusions Intraocular pressure in lens‐induced uveitis (LIU) is lowered but the relationship to the stage of cataract maturity is less clear. Significant tonometric differences were present between the immature and hypermature cataract groups, but these differences are too small to be clinically useful. Decreased intraocular pressure of dogs with all stages of cataract formation suggests concurrent LIU during all stages of cataract formation, especially with the mature and hypermature stages. The average tonometric measurements in dogs with these cataracts were about two standard deviations below the mean IOP reported in normal dogs.     

The effect of a topical antioxidant formulation including N-acetyl carnosine on canine cataract: a preliminary study

OBJECTIVE: To determine the efficacy of a topical antioxidant formulation including N-acetyl carnosine in the treatment of canine cataract in a preliminary nonplacebo, controlled, unmasked study. ANIMALS STUDIED: Thirty dogs of varying breeds and ages with a spectrum of lens opacities ranging from nuclear sclerosis to total mature cataract. METHODS: Dogs were treated three times daily with topical 2% N-acetyl carnosine in a buffered vehicle containing the antioxidants glutathione, cysteine ascorbate, L-taurine and riboflavin (Ocluvet, Practivet, Phoenix, AZ, USA). Dogs were examined prior to treatment and at 2, 4 and 8 weeks during treatment, by direct and indirect ophthalmoscopy and slit-lamp biomicroscopy after pharmacologic pupil dilation. Photographic documentation of lens opacity was achieved by retroillumination photography, with three photographs taken at each examination time-point. A lens opacification index (LOI), determined by integration of the grayscale level of each pixel across the image, was evaluated by computerized image analysis of digitized images. Alteration in mean LOI was determined for each animal, having normalized the initial LOI. RESULTS: Fifty-eight eyes of 30 dogs were evaluated, 22 with mature cataract, 13 with immature cataract, 9 with cataract associated with other intraocular disease such as uveitis and 14 with nuclear sclerosis alone. One dog was unilaterally anophthalmic after previous enucleation and one had a phthytic eye after previous uveitis-induced glaucoma. Image analysis showed a reduction in mean LOI in all cataract groups (mean resolution in opacity of 2.3 +/- 0.33% for all cataracts), although this was only statistically significant in those eyes with immature cataract (mean resolution of opacity 4.5 +/- 0.33%) or nuclear sclerosis (mean decrease in opacity 5 +/- 0.37%). Reduction in lens opacity was seen in eyes with mature cataract (0.5 +/- 0.4%) and in miscellaneous cataract associated with intraocular inflammation (1.3 +/- 0.4%), but these changes were not statistically significant. Owner evaluation of visual capability, however, suggested improvement in vision in 80% of cases by the end of the study. CONCLUSIONS: This study demonstrates some marginal reduction in lens opacification in a substantial number of cases of canine cataract with the use of a topical nutritional antioxidant formulation including N-acetyl carnosine. Lens opacification was improved with treatment in eyes with immature cataract or nuclear sclerosis while in eyes with mature cataract or cataract with associated intraocular inflammatory pathology less reduction was seen.     

The effects of cataract stage, lens-induced uveitis and cataract removal on ERG in dogs with cataract

OBJECTIVE: The purpose of this study was to determine the effects of cataract stage, lens-induced uveitis and cataract removal on the electroretinogram (ERG) of dogs with cataract. ANIMALS STUDIED: Fifty-seven dogs diagnosed with unilateral or bilateral cataract whose ERG was recorded at Rakuno Gakuen University Teaching Animal Hospital from 2001 to 2004. PROCEDURES: Four responses were recorded during the ERG: rod ERG, standard combined ERG, single-flash cone ERG and 30-Hz flicker ERG. Cataracts were divided into four stages: incipient, immature, mature and hypermature, and with or without lens induced uveitis (LIU). Noncataractous eyes of dogs with unilateral cataract were used as the control. We compared ERG amplitude, implicit time, and the b- to a-wave amplitude ratio of cataractous vs. noncataractous eyes, preoperative vs. postoperative cataractous eyes, and cataractous eyes with and without LIU. RESULTS: No significant difference was found in ERG amplitude between incipient, immature and hypermature cataractous eyes, while in mature cataractous eyes decreased amplitude was confirmed in all responses compared with control eyes. However, no significant difference in b/a ratio was found at any stage of cataract. In postoperative eyes, increased amplitude was recorded in all responses compared to preoperative values. In eyes with LIU a decreased amplitude in the rod ERG and b-wave of standard combined ERG was recorded and, furthermore, a significant decline was confirmed in b/a ratio. CONCLUSION: ERG values were influenced by cataract stage and LIU. LIU was associated with a reduction in the b/a ratio.     

Ocular findings in two colonies of gray mouse lemurs (Microcebus murinus)

OBJECTIVE: To determine the incidence and describe the characteristics of cataracts and other ocular lesions found in two colonies of gray mouse lemurs (Microcebus murinus). ANIMALS STUDIED: A total number of 218 mouse lemurs (age range: 4 months-11 years) were included in this study. All individuals were property of the Muséum National d'Histoire Naturelle (France), and were housed either in Paris (colony #1: 75 animals examined), or in Brunoy (colony #2: 143 animals). METHODS: Ocular examinations were performed on all animals before and after pupil dilation, and included slit-lamp biomicroscopy and indirect ophthalmoscopy. In both colonies, a limited number of individuals were re-examined between several months and 2 years following the initial eye examinations. The eyes of five mouse lemurs with incipient or immature cataracts that died during this period were collected, and processed for routine histopathologic examination. RESULTS: A high incidence of cataracts was observed in both colonies (48% in colony #1; 21% in colony #2). Cataracts were predominantly bilateral, started in the anterior and/or posterior subcapsular area, and appeared to be slowly progressive. The earliest age at which lens opacities were observed was 3.5 years, and more than 50% of mouse lemurs over 7 years of age were diagnosed with cataracts. Complete cataracts led to blindness and were occasionally associated with other ocular lesions. CONCLUSION: We report a high incidence of acquired, slowly progressive, bilateral cataracts in two colonies of mouse lemurs (Microcebus murinus). Further studies need to be conducted to determine the cause of this disease in this species.     

Effect of oral antioxidants on the progression of canine senile cataracts: a retrospective study

BackgroundCataracts are the leading cause of impaired vision or blindness in dogs. There are many antioxidants that can prevent cataract progression, but whether they are clinically effective in dogs has not been established.ObjectivesTo analyze the delaying or preventing effect of oral antioxidants on canine senile cataracts through retrospective analysis.MethodsMedical records of dogs from January 1, 2015 to July 10, 2020 were reviewed. Dogs that were 8 yr of age or older with senile cataracts were included in this study. The dogs were divided into two treatment groups (dogs administered with Ocu-GLO supplement and dogs administered with Meni-One Eye R/C supplement) and a control group (dogs that were not administered any supplement). Dogs with incipient and immature cataracts were included in this study. Altogether, 112 dogs (156 eyes) with incipient cataracts and 60 dogs (77 eyes) with immature cataracts were included. The period of time that cataracts progressed from incipient to immature, and from immature to mature was recorded for each dog.ResultsThere was no significant delaying effect on the progression of incipient cataracts. However, both Ocu-GLO (hazard ratio = 0.265, p = 0.026) and Meni-One (hazard ratio = 0.246, p = 0.005) significantly delayed the progression of immature cataracts compared to the control group.ConclusionsAlthough there was no significant delaying effect of oral antioxidants on incipient cataract progression, antioxidants could be used to delay the progression of senile immature cataract.     

Prevalence of canine cataract: preliminary results of a cross-sectional study

Objective In this study 2000 dogs were examined ophthalmoscopically to determine presence of cataract. Materials and methods The dogs examined were predominantly from veterinary hospital populations but also from the Waltham Center For Pet Nutrition, rehoming charities and breeding kennels. Prevalence of cataract was thus determined for different age groups (year cohorts). The age at which prevalence of cataract was 50% (C₅₀) was determined indirectly from a fitted prevalence curve. Results The mean ± standard deviation of C₅₀ for all dogs in the study was 9.4 ± 3.3 years. All dogs over 13.5 years were affected by some degree of lens opacity. C₅₀ was determined for animals of different genders and different breeds. For dogs of six breeds sufficient data were available for calculation of breed‐specific C₅₀. In these dogs C₅₀ was positively correlated with longevity with a least squares correlation coefficient of 0.74. Conclusion The study yields novel findings regarding the prevalence and incidence of cataract in the dog and forms the basis for considerable further work on the epidemiology and pathophysiology of age‐related cataract in the dog.     

Vascular endothelial growth factor in diabetic and nondiabetic canine cataract patients

Objective To measure vascular endothelial growth factor (VEGF) levels in aqueous humor, serum, and plasma in diabetic and nondiabetic cataractous dogs. Methods Canine VEGF was assayed in the plasma and serum of 32 dogs (20 diabetics; 12 nondiabetics) and aqueous humor in 57 eyes of those dogs (39 diabetic; 18 nondiabetic) undergoing phacoemulsification, using a commercial canine VEGF assay. Statistical analysis was performed using Fisher’s PLSD, t‐test, and regression analysis to compare values by diabetic status, duration of diabetes, age, weight, gender, left vs. right eye, and blood clarity. Results Plasma, but not serum or aqueous humor VEGF values of diabetics were significantly greater than nondiabetics (P = 0.019). Older nondiabetics (10–15 years) had higher plasma VEGF values than younger (0–5 and 5–10 years) dogs (P = 0.0002 and 0.0001, respectively). There was no significant difference in aqueous humor VEGF between left and right eyes in all patients. Serum and plasma, but not aqueous humor, VEGF values in females were significantly higher than males in both groups. Conclusion Similar to human diabetic patients, VEGF aqueous humor values in all dogs are significantly higher than blood values. Aqueous humor VEGF values in human diabetics are elevated and correlate with the severity of diabetic retinopathy. However, aqueous humor values of VEGF in diabetic dogs are not greater than nondiabetics and may serve to protect the dog against development of diabetic retinopathy.     

Ocular anomalies in a herd of Exmoor ponies in Canada

Objective To characterize the ocular anomalies, determine their recurrence in families and assess the mode of inheritance of the most prevalent anomalies through pedigree analysis in a herd of Exmoor ponies. Animals studied Thirty Exmoor ponies residing in south‐western Ontario, Canada. Procedures Ophthalmic examination was performed using direct ophthalmoscopy, slit‐lamp biomicroscopy and indirect ophthalmoscopy, pre‐ and post‐pupillary dilation. Following compilation of ocular findings, pedigree analysis was conducted to assess the recurrence pattern of specific anomalies in families and the data were tested for significance for breed prevalence and gender dependence, using Fisher’s exact test. Results Twenty‐eight purebred ponies and two cross‐breds, ranging from 14 days to 31 years were examined. A prominent brow above the eyes characteristic of this breed was a consistent periocular feature of adult ponies. In nine ponies, eyelid sarcoid, iris nevus, Mittendorf’s dot, hyaloid artery remnant, and hyper‐reflective vitreal strands were detected while the lesions recorded in the remaining 21 included macroblepharon, persistent pupillary membranes, iris hypoplasia, cataracts, focal choroidal or retinal pigment epithelium hypoplasia and optic nerve head coloboma. The most common ocular finding was cataracts seen mainly in females. Statistical tests on prevalence data confirmed a significant breed and sex association. Pedigree analysis favored a sex‐linked mode of inheritance for cataracts in this line of Exmoor ponies. Conclusions Although the ocular anomalies detected in this group have been previously reported in other breeds of horses, this is the first report of equine cataracts showing a familial trend suggestive of a sex‐linked genetic defect.     

Lens morphometry determined by B-mode ultrasonography of the normal and cataractous canine lens

Purpose To determine axial lens thickness, anterior chamber depth and axial globe length in canine eyes with normal lenses and in eyes with immature, mature, congenital, posterior polar and diabetic cataract. Methods B‐mode ultrasonography was performed in 50 normal dogs and, as a prephacoemulsification screening procedure, in 100 dogs with cataract. Axial B‐mode ultrasonograms were used to determine lens thickness, anterior chamber depth and globe diameter. Statistical comparisons between groups were made by analysis of variance and multivariate analysis, with a significance level of P < 0.05. Results Axial globe lengths were not statistically significantly different between groups apart from the smaller globes in younger dogs with congenital cataract. Axial lens thickness in diabetics (8.4 ± 0.9 mm) was statistically significantly different from the lens thickness in normal eyes (6.7 ± 1.0 mm), eyes with immature cataract (6.4 ± 0.8 mm) and eyes with mature cataract (7.4 ± 0.9 mm) although these groups, while varying in thickness, were not statistically significantly different from each other. Anterior chamber depth was statistically significantly reduced in eyes with diabetic cataract (2.9 ± 0.1 mm) from that in normal eyes (3.8 ± 0.1 mm), eyes with immature cataract (3.5 ± 0.1 mm) and eyes with mature cataract (3.2 ± 0.6 mm) although these groups, while varying in chamber depth, were not statistically significantly different from each other. Conclusions Lenses with diabetic cataracts were significantly increased in axial thickness compared to lenses in other eyes, although lenses with mature cataracts showed a trend towards increased axial thickness and immature cataracts demonstrated a trend towards reduced thickness. While previous studies on cataract pathobiology have suggested a reduction in lens thickness in immature cataract through lens protein loss and an increase in thickness in mature cataracts through intumescence, this study is the first to document these changes in the canine lens.     

Results of ophthalmologic screening examinations of German Pinschers in Finland – a retrospective study

Objective To retrospectively review ophthalmologic findings in German Pinschers in Finland. Animals studied One hundred and twenty‐two German Pinschers that had ophthalmologic examination performed according to the Finnish Kennel Club’s Eye Scheme before June 15, 1999. Procedures A total of 154 eye examination reports of 122 dogs were analysed and all described findings were reported. Results Persistent hyperplastic tunica vasculosa lentis (PHTVL) was diagnosed in 8.4% of all cases, and hereditary cataract (HC) in 6.5%. Even higher numbers of similar changes were reported by ophthalmologists; some of the dogs, however, were officially diagnosed as ‘free of symptoms’ of inherited ocular diseases. A relatively high number (4.5%) of dogs had reported changes in Y sutures. A pedigree analysis suggests recessive inheritance for both diseases. Because of missing information about many dogs in the pedigree, an autosomal incomplete inheritance pattern cannot be ruled out in either case. Conclusions Both HC and PHTVL are inherited diseases in German Pinschers. Further studies are needed to determine the importance of the changes found in Y sutures. Discrepancies between the official diagnosis and described changes are probably partially due to the lack of familiarity with the published literature concerning this breed. Further studies are needed to ascertain the inheritance pattern for both diseases. So far breeding with affected animals should be avoided.     

Phaco chop technique for cataract surgery in the dog

Phaco chop is a bimanual phacoemulsification technique to remove cataracts. The technique was first presented at the 1993 3rd American-International Congress on Cataract, IOL, and Refractive Surgery in Seattle by Dr Kunihiro Nagahara. He compared the lens with a block of wood and by applying chopping forces parallel to the natural planes of the lens lamellae, as one does in splitting wood, a nucleus can be cleaved with surprisingly little force and time. Dr Nagahara used the phaco tip to impale and high vacuum to hold the nucleus while a second instrument, or chopper, hooked the equator and was pulled centrally, splitting the nucleus along its natural cleavage planes. This was a breakthrough for surgeons who had been utilizing several minutes of phaco energy sculpting grooves and bowls in a lens. Studies have shown that compared with four-quadrant 'divide and conquer', the phaco chop technique uses less phaco time and energy, significantly reducing endothelial cell damage. Other advantages of phaco chop include reduction of zonular and capsular stress because forces are directed toward an opposing instrument and the phaco tip is kept in a central 'safe zone' in the middle of the pupil. This technique has also been successfully adapted to the canine phacoemulsification procedure. The larger canine lens requires some modifications, and lenses with hard nuclear and cortical material may not be amenable to this procedure.     

Identification of mutations in HSF4 in dogs of three different breeds with hereditary cataracts

Cataracts are a leading cause of blindness in both dogs and humans. Mutations in several genes have been associated with inherited forms of human cataract, but no mutations have been identified as the cause of any form of canine inherited cataract. We have used a candidate gene approach to investigate 20 genes, known to be associated with cataract in humans, for their potential association with the development of hereditary cataract (HC) in dogs. We have identified mutations in the HSF4 gene in Staffordshire Bull Terriers, Boston Terriers and Australian Shepherds affected by HC. Interestingly, different mutations in this single gene may be causing a recessive form of cataract in Staffordshire Bull Terriers and Boston Terriers and a dominant cataract in Australian Shepherds. Identification of the mutations that cause HC in these three breeds provides a method of controlling the disease within populations at risk using a simple diagnostic test, and also establishes cataract in these breeds as models for their human counterparts.     

Retrospective study of prophylactic random transscleral retinopexy in the Bichon Frise with cataract

The objective of this study was to determine the efficacy of prophylactic random transscleral retinopexy (PRTR) in preventing rhegmatogenous retinal detachment (RRD) in the Bichon Frise with juvenile cataract. The medical records were reviewed from a private veterinary ophthalmology practice of nondiabetic Bichon Frise dogs younger than 11 years that had inherited cortical cataracts in one or both eyes and that had a follow-up examination after at least 9 months. Eyes were included in the study if the fundus could be visualized by indirect ophthalmoscopy at the last examination either because of phacoemulsification or resorption of the cataract. Four groups of eyes were identified. In group 1, no PRTR was performed and there was resorption of the cataract; in group 2, eyes had no PRTR performed and phacoemulsification of the cataract. Group 3 had PRTR performed and resorption of the cataract. In group 4, PRTR was performed as was phacoemulsification of the cataract. In group 1, 20 eyes had resorbed cataracts, and 12 (60%) of these had RRD. In group 2, 18 eyes had phacoemusification of the cataract, and 10 (55%) of these had RRD. In group 3, 19 eyes had PRTR and resorbed cataracts, and 2 (10%) of them had RRD. In group 4, 39 eyes had PRTR and phacoemulsification of the cataract; of these 5 (12%) had RRD. The Bichon Frise dog with inherited cataract is at high risk of RRD. PRTR reduces this risk.