CASE REPORT: Iridociliary melanoma with secondary lens luxation: distinctive findings in a long‐horned cowfish (Lactoria cornuta)

This report describes a long‐horned cowfish, which was diagnosed with buphthalmia and lens sub‐luxation in the right eye, conditions that progressed to complete anterior lens luxation and secondary keratoconus. Three months after the initial evaluation, a pigmented mass was observed protruding from the vitreous. An enucleation was performed under general anesthesia. Ocular histopathology revealed an iridociliary melanoma. Reports of intraocular melanomas are extremely rare in fish. To the authors’ knowledge, this is the first report of an iridociliary melanoma that led to buphthalmia, lens luxation, and keratoconus in a fish. Histological findings of lens luxation are also demonstrated. Due to the presence of a complex suspensory apparatus involving the teleost lens, this report speculates that lens luxation is a more devastating disease process in teleosts than in mammals.     

Inheritance of cataracts and primary lens luxation in Jack Russell Terriers

OBJECTIVE: To characterize heritability and mode of inheritance of cataracts and primary lens luxation in Jack Russell Terriers. ANIMALS: 872 Jack Russell Terriers from which buccal epithelial cells were collected and phenotypes for cataracts and lens luxation were determined and an additional 1,898 Jack Russell Terriers without phenotypic information used to complete pedigree relationships and that were included in the analyses. PROCEDURES: Narrow-sense heritabilities and genetic correlation for cataracts and lens luxation were modeled by use of threshold analysis, whereas complex segregation analysis was used to characterize mode of inheritance. For the analyses, dogs < 6 years old, unless confirmed as having cataracts or lens luxation, were classified as an unknown phenotype. The possible involvement of an HSF4 mutation in cataracts was determined by DNA sequencing. RESULTS: Cataracts and primary lens luxation were highly heritable and genetically correlated, and neither was controlled by a single gene. Cataracts were not associated with an HSF4 mutation. CONCLUSIONS AND CLINICAL RELEVANCE: Analysis of the data indicated that concerted selection against both cataracts and primary lens luxation when choosing breeding animals can be used to improve ocular health in Jack Russell Terriers.     

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.     

Lens luxation in the dog and cat

Dislocation, or luxation, of the lens arises as a result of rupture of the zonular fibers, which suspend the lens from the ciliary body. In the dog, lens luxation is most frequently encountered as a primary, heritable condition in which there appears to be an inherent weakness of the zonule. The condition is limited mainly to the Terrier breeds but has also been described in the Tibetan Terrier and Border Collie. The disease is essentially bilateral but seldom becomes apparent clinically before 3 or after 7 years of age. In most primary luxations, the lens passes into the anterior chamber and such cases must be regarded as emergencies on account of the likely development of secondary glaucoma; posterior luxations are usually less troublesome. Other causes of lens luxation include cataract formation, glaucoma, and uveitis. Congenital dislocations and those attributable to trauma alone are rare. In the cat, lens luxations are usually secondary and arise in later life.     

Primary lens instability in ten related cats: clinical and genetic considerations

Objectives : To describe bilateral lens instability in 10 related domestic shorthair cats over three generations. Methods : Complete ophthalmic examinations were performed. Lentectomies were carried out. Sections of affected lenses focused on the equatorial area were examined by transmission electron microscopy. The potential involvement of several candidate genes (ADAMTS17, ADAMTSL4, ADAMTS10 and FBN1) known to be associated with lens luxation in other species was investigated. Results : The group of animals included 10 related cats, nine of them being affected by lens instability over three generations. Transmission electron microscopy showed the presence of zonular material at the lens equator. Signs of lens instability were not associated with other ocular disease. Analysis of the pedigree suggests a dominantly inherited condition. A mutation in ADAMTS17 was excluded, but a possible association between the condition and a microsatellite flanking FBN1 indicates this gene should be considered a strong candidate responsible for primary lens luxation in this pedigree. Clinical Significance : These observations suggest an inherent zonular defect unrelated to extraneous factors. The family relationship is compatible with a possible genetic basis, and the pedigree suggests that the condition could be dominant. Data also suggest the mutation in the FBN1 gene could be responsible for primary lens luxation in this pedigree of cats.     

A modified ab externo approach for suture fixation of an intraocular lens implant in the dog

The goals of canine cataract and lens instability surgery should be to ensure a small incision, minimal tissue trauma, shortened surgical time, maintenance of the anterior chamber, and restoration of emmetropia through the use of a stable intraocular lens specifically designed for the canine eye. While this is usually the case with routine phacoemulsification and in-the-bag intraocular lens implantation, it is often not the case with lens instability, lens luxation or large posterior capsular ruptures. In such cases the incisions are often larger, surgical time and tissue trauma are excessive, and the patient is often left aphakic. The goal of this paper is to present a modified ab externo technique designed to allow removal of the lens and placement of a ciliary sulcus sutured IOL through a small incision, with minimal trauma and shortened surgical time. Use of this technique may allow more canine patients to be emmetropic postoperatively. In addition, the ease of this procedure may encourage earlier removal of an unstable lens and decrease the risk of secondary glaucoma and retinal detachment that occur in association with lens luxation.     

Genetic aspects of lens luxation in the Tibetan terrier.

Analyses were undertaken of 20 cases of lens luxation in British-bred Tibetan terriers, together with a further seven from Sweden. General proband segregation tests showed that the data were consistent with a simple autosomal recessive hypothesis (P = 0.152 +/- 0.0563). This was supported by high levels of inbreeding ranging from 0 to 24.3 per cent, with a mean of 14.3 per cent (SD 5.32 per cent). All affected cases traced back to one or more of three animals (born mid 1950s) on both sides of their pedigrees, all three being breed champions. Inclusion of data from repeat litters between presumed heterozygous animals gave a ratio of 25 lens luxation cases in 121 progeny, which again supported the same genetic theory. The age at onset (three to five years) mitigates against test mating of animals within the breed.     

Primary lens luxation in the Chinese Shar Pei: clinical and hereditary characteristics

A pedigree analysis of a family of 15 related Chinese Shar Peis was conducted. This pedigree analysis, including affected and nonaffected dams, sires and offspring, was compiled to document and characterize the occurrence, common clinical signs, and age of onset of primary lens luxation while suggesting a possible mode of inheritance in this breed. Of the five offspring from the mating of an affected dam to two unrelated affected males, 100% of offspring were affected with bilateral primary lens luxations. Of the four viable offspring from the mating of the same affected dam to an unrelated, unaffected male, two dogs (50%) were affected. The average age of onset of affected animals (seven) in this first generation was 4.9 years (range 3–6 years). The six dogs in the second generation of the same pedigree line were 2-years-old at examination with none of these animals affected at the time of this study. The most common presenting complaints were a unilateral change in ocular appearance (5 of 7 dogs) and subjective vision impairment (4 of 7 dogs). The most common clinical sign upon ophthalmic examination was iridodonesis (unilateral 4 of 7 dogs; bilateral 3 of 7 dogs) and the presence of an aphakic crescent (3 of 7 dogs). Gonioscopy and tonometry of severely affected eyes revealed a narrow or closed iridocorneal angle and ocular hypertension. This study suggests that primary lens luxation does occur in the Chinese Shar Pei, resembling the clinical condition (age of onset, clinical signs) previously described in the terrier breeds, the Border Collie, and the Tibetan Terrier. Application of the phenotypic findings in this study to a Mendelian genetic model of inheritance suggests that primary lens luxation in the Chinese Shar Pei is inherited as a simple autosomal recessive trait.     

Secondary glaucomas in the dog in North America

OBJECTIVE: To determine the prevalence of secondary glaucomas in dogs associated with cataract formation, lens luxation or displacement, cataract surgery, uveitis, hyphema and intraocular neoplasia. METHODS: Information was obtained from the Veterinary Medical Data Base (VMDB) from all veterinary medical teaching hospitals in North America from March 1964 to March 2003. Secondary glaucomas were diagnosed at the same examination or after the primary diagnosis was made, and included those associated with cataract formation, lens luxation, cataract surgery, uveitis of unknown cause, hyphema of unknown cause, and intraocular neoplasia. The data were evaluated by decade, breed, gender and age of presentation. RESULTS: A total of 1 592 831 dogs were presented, and 9695 canine secondary glaucomas. Secondary glaucoma associated with cataract formation represented 81% of all the canine secondary glaucomas. Breeds (n = 7890 dogs) predisposed to secondary glaucoma and cataracts had an overall prevalence of 0.5%, but nearly 20% of all the cataractous dogs developed secondary glaucoma in at least one eye. For the years 1994-2003, these breeds included the American Cocker Spaniel; Boston Terrier; Toy, Miniature and Standard Poodle; English Springer Spaniel; Bichon Frise; and Labrador Retriever. The other forms of secondary glaucoma occurred less frequently, and included those glaucomas with lens luxation or displacement (779 dogs; 12.0%), postcataract surgery (528 dogs; 5.1%), with uveitis from unknown cause (399 dogs; 7.1%), with hyphema from unknown cause (117 dogs; 7.3%), and with intraocular neoplasia (19 dogs; 3.5%). The risk of the secondary glaucomas from 1984 to 2002 was highest after the intracapsular lens extraction (ICLE), less in the extracapsular technique (ECLE), and lowest for the phacoemulsification/phacofragmentation method. CONCLUSION: Prevalence of the canine secondary glaucomas ranges from 0.25% (1964-1973), 0.46% (1974-1983), 0.79% (1984-1993), to 0.80% (1994-2003) and are as frequent as the primary or breed-related glaucomas during these same time periods.     

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.     

Primary lens luxation in the dog

Primary lens luxation in the dog is encountered only in the terrier breeds and is typically a bilateral condition of both sexes arising in early to late middle age. The condition has recently appeared in the Tibetan Terrier and there is evidence to suggest an autosomal recessive mode of inheritance in this breed. In the majority of cases the dislocated lens passes forwards into the anterior chamber where its presence is likely to cause the development of acute glaucoma through obstruction of the pupil or filtration angle; for this reason lendectomy is the treatment of choice in such cases. Posterior luxations are less problematic but the approach to the treatment of subluxated lenses is controversial.     

Ehlers-Danlos syndrome in a dog: ocular, cutaneous and articular abnormalities

Ehlers-Danlos syndrome (EDS) is an hereditary connective tissue disease in man in which the skin is easily torn. A similar condition has been described in dogs and other animals. This case report records a case in the United Kingdom in which the whole syndrome was exhibited: skin fragility, joint laxity and ocular signs of bilateral lens luxation, cataract and corneal oedema. It is the first report of ocular signs in EDS in the dog and joint laxity has been reported only rarely.     

Diagnostic ultrasonography of equine lens and posterior segment abnormalities

Purpose To define the indications for equine ocular ultrasonography and to provide representative ultrasonographic images of lens and posterior segment diseases. Methods Retrospective study. Equine medical records dating from January 1983 to March 2001 were reviewed. All cases that: (1) had a lens and/or posterior segment abnormality; and (2) received a complete ophthalmic examination and ocular ultrasonography were included. Results Forty‐three cases (n = 64 eyes) out of 112 total cases of equine lens and/or posterior segment abnormalities qualified. The following conditions were identified ultrasonographically in order of decreasing frequency: cataracts, vitreal opacities, retinal detachment, lens luxation, endophthalmitis, microphthalmos, choroiditis, lens rupture, lenticonus, buphthalmos and phthisis bulbi. Ultrasonography often enabled diagnoses to be made in the presence of anterior opacities in both surgical (pre and/or postoperatively) and nonsurgical cases. Additional ocular conditions were identified in adults with cataracts more frequently than in foals with cataracts. Conclusions Cataracts were the most common lens abnormality identified in horses that received ocular ultrasound examination. Cataracts were commonly found in association with other ocular abnormalities. Ultrasonography was a practical and effective method of evaluating the lens and posterior segment, particularly in cases with anterior opacities. Ultrasonography also provided critical information with regard to the potential for surgical removal of cataracts and was a valuable component of postsurgical follow‐up.     

Geriatric ophthalmology

The threat of vision loss increases with age owing to a combination of the accumulation of untreated or partially managed eye disease (for example, immune-mediated keratoconjunctivitis) as well as the late-in-life onset of certain ocular disorders such as lens subluxation/luxation syndrome and senile/age-related cataracts. In addition, the ophthalmic effects of age-related systemic diseases such as systemic hypertension can be vision threatening as well. The veterinarian must always weigh the potential ophthalmic benefits of contemporary therapy against the potential patient risk, not only when ophthalmic surgery is considered but also with the use of various drugs.     

Glaucoma in the dog and cat

Conjunctivitis, mydriasis, corneal edema, lens luxation, buphthalmos, and blindness are caused by elevated IOP in the glaucomas. Primary glaucomas with a bilateral potential for development are noted in two cats and several dog breeds, with secondary glaucomas caused by uveitis and neoplasia common in the cat and dog. Tonometric evaluation is essential for the early diagnosis and management of glaucoma. Medical therapy of topical demecarium bromide and timolol maleate, with systemic dichlorphenamide, are recommended for general glaucoma maintenance therapy in dogs and cats. Transcleral cyclophotocoagulation will surgically reduce IOP in cases in which maximum medication has been reached.     

Clinical signs and results of treatment in cats with patellar luxation: 42 cases (1992-2002)

OBJECTIVE: To describe clinical signs and results of treatment in cats with patellar luxation. DESIGN: Retrospective case series. ANIMALS: 42 cats in which patellar luxation had been diagnosed on the basis of results of palpation of the stifle joints. PROCEDURES: Degree of luxation was graded on a scale from 1 to 4, and severity of lameness was graded on a scale from 0 to 5. Radiographs of stifle joints were evaluated for signs of osteoarthritis. Long-term function was classified as poor, fair, good, or excellent. RESULTS: 34 cats had bilateral luxation and 8 had unilateral luxation. Only 7 (17%) cats had a history of trauma. Mean age of the cats was 3.3 years, and mean weight was 4.26 kg (9.4 lb); 26 (62%) were domestic shorthairs. Seventy-three of the 76 (95%) affected joints had medial patellar luxation. Luxation grades could be assigned to 65 joints, with grade 2 (30 joints) and 3 (22 joints) luxation being most common. Lameness grades could be assigned to 73 joints, with grade 1 lameness (27 joints) most common. Outcome was excellent for 8 of 17 joints treated without surgery and for 23 of 35 joints treated surgically. Complications attributable to surgery were reported in 8 cats. CONCLUSIONS AND CLINICAL RELEVANCE: Patellar luxation should be considered as a cause of hind limb lameness in cats. Low-grade luxation can be associated with lameness of the same severity as high-grade luxation. Surgical correction of patellar luxation in cats with grade 2 or 3 lameness can result in a favorable outcome.     

Genetic analysis of presumed inherited eye diseases in Tibetan Terriers

We analysed the systematic environmental influences and the additive genetic variation for the presumed inherited eye diseases (PIED), membrana pupillaris persistens, distichiasis, primary lens luxation, non-congenital cataract, and progressive retinal atrophy, in Tibetan Terriers. Data were obtained from the International Kennel Club for Tibetan dog breeds in Germany. PIED were recorded in the years 1987 to 2001 by standardised protocols of the Dortmunder Kreis, the association for diagnosis of inherited eye diseases in animals (DOK). The material included 849 Tibetan Terriers from 596 litters in 203 different kennels. The multivariate linear animal model using residual maximum likelihood methods regarded the fixed effects of sex, birth year, experience of the veterinary ophthalmologist, litter size, percentage of examined dogs per litter, inbreeding coefficient, and age at examination. The common environment of the litter and the additive genetic effect of the animal were taken into account as randomly distributed effects. The heritability estimates for PIED in Tibetan Terriers were h2=0.17+/-0.04 (membrana pupillaris persistens), h2=0.04+/-0.03 (distichiasis), h2=0.13+/-0.04 (primary lens luxation), h2=0.13+/-0.04 (non-congenital cataract), and h2=0.49+/-0.08 (progressive retinal atrophy). The additive genetic correlation between non-congenital cataract and progressive retinal atrophy was highly positive rg=0.76+/-0.11, while that between membrana pupillaris persistens and progressive retinal atrophy rg=-0.43+/-0.14 was highly negative. The number of examinations performed by the veterinary ophthalmologists was associated with higher heritabilities for non-congenital cataract and progressive retinal atrophy. We concluded from our analysis that all investigated PIED in Tibetan Terriers are genetically influenced.     

Dorso-medial ante-brachiocarpal luxation with radio-ulna luxation in a domestic shorthair

An 8-year-old domestic shorthair was admitted with non-weight bearing left forelimb lameness. Examination and radiographs revealed dorso-medial ante-brachiocarpal luxation with palmar luxation of the distal radio-ulnar joint. Primary repair was performed and stabilised using an arthrodesis wire and type Ia Kirschner-Ehmer (K-E) external skeletal fixator (ESF). The cat regained excellent pain-free limb function by 14 weeks with only minor reduction in range of movement. This is the first case report of a cat with distal radio-ulnar joint luxation associated with ante-brachiocarpal luxation. Primary repair of carpal luxation in the cat should be considered before arthrodesis.     

A case of dorso-medial luxation of the radial carpal bone in a dog

Luxation of the radial carpal bone is an uncommon injury in the dog and cat. Previous clinical cases have reported palmaro-medial luxation with injury to the short radial collateral ligament. In this study a case of dorsomedial luxation of the radial carpal bone in a 10-year-old female Gordon Setter is described. A closed reduction of the luxation was performed and a conservative treatment was carried out. Thirteen months after the reduction, the dog had a satisfactory limb function, despite the presence of degenerative joint disease of the carpus. A pathogenic hypothesis for this dorso-medial luxation of the radial carpal bone is proposed reproducing the luxation on canine cadavers.     

Treatment of recurrent coxofemoral luxation in a calf by use of open reduction and translocation of the greater trochanter.

A 4-day-old bull calf was admitted for treatment of a coxofemoral luxation. Closed reduction of the luxation was successfully performed on 2 occasions, and the limb was placed in an Ehmer sling. On both occasions, however, the luxation recurred. The luxation was reduced a third time with open reduction and caudal and distal relocation of the greater trochanter. Luxation did not recur after this treatment, and the calf grew and developed normally.