Polarized light biomicroscopic observations on the pre-corneal tear film. 1. The normal tear film of the dog

Polarized light biomicroscopy was used to examine the normal pre-corneal tear film in 25 dogs. Blink rates were also determined. The normal range of surface morphology of the canine tear film was established. Three categories of surface patterning of the lipid layer of the tear film were identified. These were: (a) a wave-like pattern, (b) a pattern of irregular islets, and (c) a pattern resembling the polished surface of granite. All three patterns may occur in the same eye. The inter-blink thickness of the lipid layer of the pre-corneal tear film varied between 0·013 μm (the minimum thickness discernable by this method) and over 0·581 μm (the maximum thickness at which coloured interference fringes are clearly defined) in localized areas. The mean total blink rate was 14·2/min. Overall, incomplete blinks constituted approximately 66 per cent of the total blink rate, but the ratio of complete to incomplete blinks varied considerably between animals. By dividing the dogs into thick and thin lipid layer groupings, it was possible to demonstrate a statistically greater rate of complete blinks (P < 0·05, Mann-Whitney U test) in animals with a thinner lipid layer. The applicability of polarized light biomicroscopy to veterinary clinical ophthalmology is discussed.     

Polarized light biomicroscopic observations on the pre-corneal tear film. 2. Keratoconjunctivitis sicca in the dog

Polarized light biomicroscopy was used to examine the pre-corneal tear film in 16 dogs which were suspected of, or confirmed to be, suffering from keratoconjunctivitis sicca. One animal displayed a normal tear film, while the other 15 showed variable degrees of abnormality. The abnormal features included: contamination of the ocular surface with particulate debris and plaques of mucus, discontinuity and excessive granularity of the surface lipid film, pronounced thinning of the aqueous phase, and breakup of the tear film. After parotid duct transposition, the tear film of some animals was almost indistinguishable from normal. However, in others the surface lipid layer was thinned, discontinuous, or virtual absent. Discontinuity of surface lipid was most obvious in animals with marked salivary epiphora, and was associated with a variable amount of crystalline concretion over the ocular surface. The clinical usefulness of polarized light biomicroscopy for the diagnosis, and subsequent monitoring, of keratoconjunctivitis sicca is discussed.     

Biomicroscopy of the tear film: aqueous and lipid tear substitutes in the normal and abnormal eye

Polarised light biomicroscopy was used to assess the behaviour and interactions of two polymer-containing preparations of artificial tears, and two lipid-containing ointments, with the normal and abnormal pre-corneal tear film. The preparations were used topically in six normal dogs, and three dogs with keratoconjunctivitis sicca. A transient morphological alteration of the surface lipid layer of the tear film was commonly observed after the use of polymer solutions. The ointments spread as a continuous or semi-continuous layer over the normal, or polymer-supplemented, aqueous tears. Further applications of artificial tears produced only a temporary disruption of this layer. In dogs with keratoconjunctivitis sicca, thickening of the lipid layer of the tear film was observed for over 20 hours after the administration of ointment. These observations are discussed in relation to the prospects for the improved medical treatment of keratoconjunctivitis sicca by the use of polymer-containing solutions and ointments in combination.     

Biomicroscopy of the tear film: the tear film of the pekingese dog

Polarised light biomicroscopy was used to examine the normal pre-corneal tear film in 21 eyes of 12 pekingese dogs. The purpose of the study was to examine the influence of excessive exophthalmos on the pre-corneal tear film in the dog. The majority of the animals were found to have high levels of ocular surface contamination by particulate material and plaques of viscous mucus. Other abnormalities included surface lipid with an abnormal granular (three dogs) or 'curdled' (two dogs) appearance; excessive thinning of the lipid layer of the tear film; and the presence of dark globular structures in two dogs, which were presumed to be abnormal meibomian lipid. Break up of the tear film was observed in one dog. Grossly, a thread of viscous mucus was frequently observed along the margin of the lower eyelid. It is postulated that this thread forms because of the excessively exophthalmic conformation of the breed, which prevents the normal access of effete mucus and entrapped debris to the lower conjunctival fornix. The combination of the above factors in the pekingese is suggested as the mechanism whereby the tear film has a reduced stability, thus enhancing the risk from factors more usually considered to initiate corneal ulceration in the breed. The possible adverse effects of lid splitting for the mass removal of distichiae in exophthalmic dogs is discussed.     

Topical effect of various agents on gelatinase activity in the tear film of normal dogs

OBJECTIVE: To evaluate the topical effect of various agents, currently used in the treatment of melting ulcers, on gelatinase activity present in the tear film of normal dogs. ANIMAL STUDIED: Eight normal adult beagles. PROCEDURES: Each animal received the following agents: cyclosporine A 1%, N-acetylcysteine 10%, ciprofloxacin 0.3%, ethylenediaminetetraacetic acid (EDTA) 1%, doxycycline 0.001%, polysulfated glycosaminoglycans (PSGAG) 5%, autoserum, and artificial tears during a 48-h period following a Latin square design. Tear samples were collected with micro-capillary pipettes following a corneal surface irrigation of each eye with sterile saline on four different occasions. Basal and total gelatinase activities were evaluated by optical density after processing in a commercial gelatinase activity assay. From the optical density ratio, a semi-quantitative measure of gelatinase activity was obtained. Basal and total activities were measured in all samples. RESULTS: The lowest total gelatinase activity, representing a percent decline in the enzyme activity although not significant, was observed 1 h after the last treatment in seven out of the eight ophthalmic agents; EDTA (68%), ciprofloxacin (76%), cyclosporine A (68%), doxycycline (47%), artificial tears (26%), PSGAG (25%), and N-acetylcysteine (20%). However, only the reduction observed with EDTA 6 h after the last treatment was significantly lower compared to the reduction observed with the artificial tears. CONCLUSION: This study indicated that only EDTA was able to significantly reduce the gelatinase activity in a persistent manner in the tear film of normal canine eyes. Further studies will be required to evaluate the effect of EDTA under ulcerative conditions and to more accurately ascertain the potential in vivo effect of the other agents.     

The precorneal tear film in horses: its importance and disorders.

The precorneal tear film (PTF) is of critical importance in the physiologic and pathologic findings of the cornea. Clinicians should recall that quantitative and qualitative disorders of the PTF can be a cause of corneal diseases as well as a clinical sign of ocular surface diseases. It is also important to consider that some systemic and topical treatments may affect the PTF volume and composition. Not all interactions are known at this time. There is a continued need for basic research into PTF components in healthy and diseased equine eyes, because much remains unknown. Until additional basic information about the biochemical composition and pH of the PTF as well as the interactions between equine corneal pathogens and specific PTF deficits becomes available, it will not be possible to define the cause and effect relations precisely between the various ocular surface diseases and deficiencies,excesses, and imbalances of PTF components. It is quite possible that a number of equine corneal diseases may be manifestations of qualitative PTF disorders.     

Proteinases of the cornea and preocular tear film

Maintenance and repair of corneal stromal extracellular matrix (ECM) requires a tightly coordinated balance of ECM synthesis, degradation and remodeling in which proteolytic enzymes (proteinases) perform important functions. There are natural proteinase inhibitors present in preocular tear film (PTF) and cornea simultaneously with proteinases that prevent excessive degradation of normal healthy tissue. Disorders occur when there is an imbalance between proteinases and proteinase inhibitors in favor of the proteinases, causing pathologic degradation of stromal collagen and proteoglycans in the cornea. Two matrix metalloproteinases (MMPs), MMP-2 and MMP-9, are of major importance in terms of remodeling and degradation of the corneal stromal collagen. Immunohistochemical studies have shown different origins of MMP-2 and -9. MMP-2 is synthesized by corneal keratocytes and performs a surveillance function in the normal cornea, becoming locally activated to degrade collagen molecules that occasionally become damaged. Alternatively, MMP-9 may be produced by epithelial cells and polymorphonuclear neutrophils following corneal wounding. Because the cornea is in close contact with the preocular tear film (PTF), proteinases have been evaluated in the PTF. In damaged corneas, total proteolytic activity in the tear fluid was found to be significantly increased compared to normal eyes and contralateral eyes. Studies analyzing the proteolytic activity in serial PTF samples during corneal healing led to the following conclusions: ulcerative keratitis in animals is associated with initially high levels of tear film proteolytic activity, which decrease as ulcers heal; proteinase levels in melting ulcers remain elevated leading to rapid progression of the ulcers. The success of medical and surgical treatment of the corneal ulcers is reflected by the proteolytic activity in tears. In animals, successful treatment leads to a rapid reduction in tear film proteolytic activity that corresponds with the improvement in the clinical signs of corneal ulceration. The in vitro effects of various compounds on proteolytic activity in the tear fluid of animals with ulcerative keratitis have been evaluated and their important inhibitory effects have been confirmed. Because these various compounds utilize different mechanisms to inhibit various families of proteinases, a combination of these proteinase inhibitors may be beneficial.     

Effect of lacrimal punctal occlusion on tear production and tear fluorescein dilution in normal dogs

OBJECTIVE: To evaluate effects of lacrimal punctal plugs positioned in either the upper, lower, or combination of upper and lower lacrimal canaliculi on plug retention and tolerance; tear production, as measured by the Schirmer tear test; and the dilution of fluorescein within the tear film in normal dogs. MATERIAL AND METHODS: Lacrimal punctal plugs were positioned in the lower, upper, or combination of lower and upper plugs in six laboratory-quality Beagles under topical anesthesia. Retention of plugs was evaluated daily from 8 to 23 days by visual inspection and slit-lamp biomicroscopy. Schirmer tear tests (STT 1 without topical anesthesia) were performed at 48-h intervals. Dilution of fluorescein was determined at 5- and 45-min post-fluorescein instillations once weekly. RESULTS: Lacrimal punctal plugs of 0.4 and 0.6 mm in diameter were retained for 14 (lower plugs: 100%) and 23 days (75%), and for the upper plugs at 8 days less often (75%), and were infrequently locally nonirritating. Combination of lower and upper plugs seemed to adversely affect retention of either plug. When loss of the plugs occurred, a next larger size plug was necessary suggesting some stretching of the lacrimal canaliculi occurred. Pre- and postplug placement STT results indicated no change with lower and combination lacrimal punctal plugs, but decreased levels following upper lacrimal punctal plugs. Tear fluorescein levels at 5 and 45 min in control eye (no punctum plugs) were 3.39% and 0.14%, respectively. With lower, upper, and the combination of lower and upper lacrimal puncta plugs, tear fluorescein levels at 45 min were higher than the controls (lower: 0.76%; upper: 0.45%, and combination 0.56%). CONCLUSION: Lacrimal punctal silicone plugs are retained for 8-23 days in the lower, upper, and combined lower and upper canaliculi at high rates. Effects on STT levels appear limited. Fluorescein within the tear film persists longer with all different positioned lacrimal punctum plugs than in the control eyes.     

New histochemical and ultrastructural observations on normal bovine tonsils.

Samples of normal bovine palatine tonsils were examined by light and electron microscopy. Like human tonsils, they were composed of crypts, subepithelial areas, follicles, and T-dependent zones, but their well-developed capsule subdivided the lymphoid tissue by connective septa. B cells formed the major lymphoid component. The follicles and T-dependent zones had morphological and histochemical features typical of peripheral lymph organs. Follicular dendritic cells were isolated and shown to be similar to human follicular dendritic cells.     

Ultrasonographic anatomy of abdominal lymph nodes in the normal cat.

Lymph nodes are essential structures to be evaluated in an ultrasonographic examination of the feline abdomen. It was hypothesized that current technical proficiency would allow all feline abdominal lymph nodes to be identified ultrasonographically. Ten clinically normal, adult, domestic shorthair cats were examined using real-time compound ultrasonographic imaging. The medial iliac lymph nodes were visible in 100% of the cats, the jejunal lymph nodes in 90%, the hepatic lymph nodes in 70%, the aortic lumbar, the splenic, and the pancreaticoduodenal lymph nodes in 60% each, the ileocecal and the colic lymph nodes in 50% each, and the renal, the gastric, the sacral and the caudal mesenteric lymph nodes in 40%, 30%, 20%, and 10% of the cats, respectively. The inconsistent presence of lymph nodes, their poor echocontrast and interposed gas of the gastrointestinal tract explain the lower percentages of identification. The ultrasonographic length and diameter of the lymph nodes were determined. The majority of these measurements corresponded to those in the literature. We conclude that ultrasonography is a valuable tool for the identification and evaluation of most abdominal lymph nodes in the normal cat. Average ultrasonographic measurements are presented as a preliminary guideline for normal feline abdominal lymph nodes. ete     

Effect of acepromazine or xylazine on tear production as measured by Schirmer tear test in normal cats

Objective  To evaluate the effect of acepromazine or xylazine on Schirmer tear test 1 results in clinically normal cats.
Animals  Sixteen healthy cross-breed cats.
Procedure  The animals were randomly divided into two groups of eight cats each. The first group was sedated with acepromazine alone (0.2 mg/kg) and the second group received only xylazine (2 mg/kg). All cats had Schirmer tear test (STT) readings taken prior to sedation and at 15 and 25 min postsedation.
Results  Sedation with acepromazine or xylazine in cats with normal pre-sedation STT 1 values caused a statistically significant decrease in mean values of tear production in both groups. In acepromazine group the mean ± SEM STT at T₁₅ and T₂₅ were 4.31 ± 0.98 ( P  < 0.001) and 5.18 ± 1.07 ( P  = 0.002). The post-treatment mean ± SEM values in xylazine group were 2.18 ± 0.97 ( P  < 0.001) and 2.62 ± 1.17 ( P  = 0.001) at 15 and 25 min respectively. Comparison between T₁₅ and T₂₅ in acepromazine group ( P  = 0.49) and xylazine group ( P  = 0.56) revealed no significant differences.
Conclusion  These observations indicate that both acepromazine or xylazine significantly reduced tear production in clinically normal cats. In cats, clinicians should measure STT values prior to utilizing acepromazine or xylazine as sedatives in order to accurately assess the results. Moreover, sterile ocular lubricant or tear replacement should be used as a corneal protectant during sedation with these drugs.     

Evaluation of the Schirmer tear test in clinically normal rabbits

Mean (+/- SD) value for results of the Schirmer tear test without use of topical anesthesia on 142 rabbit eyes was 5.30 (+/- 2.96) mm/min; range was 15 mm/min, with low value of 0 and high value of 15 mm/min. Two SD from the mean provided a normal clinical range of 0 to 11.2 mm/min for inclusion of 95% of the population. Significant differences were not evident between eye (right vs left) or gender or among breeds; interaction among eye, gender, and breed also was not observed. Although mean values for 2 breeds were significantly different from values in the other 10 breeds and from each other, they were still within the proposed normal range of 2 SD. The Schirmer tear test without topical anesthesia may be useful in rabbits for evaluation of increased values correlated with ocular irritation, rather than for determination of decreased values associated with keratoconjunctivitis sicca.     

Effect of topical tropicamide on tear production as measured by Schirmer's tear test in normal dogs and cats

Objective To evaluate the effect of a single dose of topical 1% tropicamide on tear production as measured by the Schirmer tear test (STT) in the normal dog and cat. Material and methods Twenty‐eight dogs and 32 cats received 50 µl : l of 1% tropicamide in one eye and the opposite eye served as the control. STTs were performed immediately before instillation of tropicamide and then at 1, 4, 8 and 24 h post drug instillation. STT results were compared between the control and treated eyes at the different times. Results Aqueous tear production in dogs, measured by STT, was not significantly reduced. The mean ± SEM STTs for the baseline time for control and tropicamide‐treated eyes were 19.9 ± 0.8 and 20.3 ± 0.8 mm wetting/min, respectively. For the control eyes, the subsequent mean ± SEM STT levels were 20.3 ± 0.9 (1 h), 21.1 ± 0.8 (4 h), 20.1 ± 0.9 (8 h), and 18.7 ± 0.7 (24 h). For the tropicamide‐treated eyes, the subsequent mean ± SEM STT levels were 19.4 ± 0.9 (1 h), 19.3 ± 0.9 (4 h), 20.0 ± 0.9 (8 h), and 18.4 ± 0.8 (24 h). Aqueous tear production of both eyes was significantly reduced in cats at 1 h but returned to baseline by 4 h post tropicamide instillation. The mean ± SEM STT levels for the baseline time in cats for control and tropicamide‐treated eyes were 14.9 ± 0.8 and 14.7 ± 0.8 mm wetting/min, respectively. Subsequent mean ± SEM STT levels for the control eyes were 6.4 ± 1.1 (1 h), 11.9 ± 1.0 (4 h), 13.9 ± 0.8 (8 h), and 16.4 ± 1.0 (24 h). For the tropicamide‐treated eyes, the subsequent mean ± SEM STT levels were 5.3 ± 0.8 (1 h), 10.2 ± 0.8 (4 h), 14.7 ± 1.0 (8 h), and 16.6 ± 1.0 (24 h). Conclusion Single dose 1% tropicamide does not significantly lower tear production rates, as measured by the STT, in normal dogs. However, in normal cats single doses of 1% tropicamide in one eye cause significant reductions in tear production of both eyes at 1 h that recovered to baseline levels by 4 h.     

The cytology of the external ear canal in the normal dog and cat

This study was conducted on 50 normal dogs and 52 normal cats in order to characterize the normal cytological findings in specimens taken from the vertical ear canal by swabbing. Yeast were detected in 96% of the dogs and 83% of the cats. Gram-positive cocci were found in 42% of the dogs and 71% of the cats. Rods were not seen. In dogs, the median numbers per high-power microscopic field (400x magnification) for yeast, cocci and keratinocytes were 0.2, 0 and 3.9, respectively. In cats, the median numbers were 0.2, 0.3 and 8, respectively. Nucleated keratinocytes were occasionally observed in both species, and should not be mistaken for a pathological process (parakeratotic hyperkeratosis).