Ocular
Manifestations
of Systemic
Diseases in
Small Animals
Dennis E. Brooks DVM, PhD
University of Florida
Ocular
Manifestations
of Systemic
Diseases in
Small Animals
Dennis E. Brooks DVM, PhD
University of Florida
The eye has limited ways to react to injury.
Red
Loses transparency
Vascularizes
Pigments or depigments
Septicemia (bacterial)
ï®
anterior uveitis to
endophthalmitis
ï®
embolization of
bacteria
ï®
circulating Ag-Ab
complexes
Blepharitis
SLE
Zn
KCS and Hypothyroidism
Immune mediated
Infectious
Hormonal
Canine distemper virus
ï®
ocular signs:
– ocular discharge, KCS
– ± corneal ulcers
– optic neuritis (blindness)
– Chorioretinitis- “gold-medallionâ€
Distemper
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conjunctival epithelial scrapings
– ± intracellular inclusion bodies
Infectious canine hepatitis
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canine adenovirus I (CAV-I), “blue eyeâ€
ï®
ocular signs: 7 days PI or post vaccination
– uveitis and corneal edema
– edema is due to an Arthus reaction to viral replication in the endothelium
– ocular signs often unilateral and temporary (1-2 weeks)
ï®
severe cases: Afghans!
– bullous keratopathy
– secondary glaucoma
Feline Ocular
Bartonellosis
ï®
Bartonella hensela:
gram
negative rods
•Iritis
•KPs
•White vitreous exudate causing
lack of tapetal reflex
5 year old Persian
Feline Ocular
Bartonellosis
ï®
Large white
fibrinous exudate in
anterior chamber
15 year old DSH
Cryptococcus neoformans
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ocular signs
– cats more often affected than dogs
– optic neuritis, dilated pupils,
exudative granulomatous chorioretinitis
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systemic signs
– CNS, skin and respiratory lesions
Cryptococcosis-diagnosis
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ocular extension from vascular*, respiratory, or CNS systems
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may identify organism in vitreal or CSF aspirates
*most common
Histoplasma capsulatum
ï®
Uncommon; affects cats
>
dogs
ï®
usually ocular extension from a respiratory infection
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granulomatous choroiditis with retinal detachment
Active
Inactive
Blastomyces dermatitidis
ï®
affects dogs
>
cats
ï®
respiratory, skin, bone, testicles, CNS lesions
ï®
~ 43% develop ocular signs
– unilateral or bilateral
Blastomycosis
ï®
ocular signs
– corneal edema/vascularization
– granulomatous chorioretinitis
– retinal detachment
– secondary glaucoma
– optic neuritis
Ehrlichia canis
ï®
acute, subclinical, and
chronic phases
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replicates in mononuclears
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incites a vasculitis in target
tissues
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tortuous vessels & grey
perivascular foci
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chorioretinitis & retinal vasculitis,
optic neuritis, retinal
detachment/hemorrhages
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uveitis, hyphema
Rocky mountain spotted fever
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Rickettsia rickettsii
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multifocal vasculitis
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uveitis, conjunctivitis, retinal
vasculitis/perivasculitis
Hyperlipidemia
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primary
– hyperlipoproteinemia in Miniature
Schnauzers
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secondary: diabetes, hypothyroidism,
pancreatitis, Cushing’s, liver disease
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increased triglycerides
– lipid-laden aqueous humor
– lipemia retinalis
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increased cholesterol
– lipid keratopathy
– atherosclerosis
Hyphema and lipid in AC
Uveodermatological syndrome
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spontaneous autoimmune disease
against melanin containing tissues
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Akitas, OESD, Golden Retrievers,
Samoyeds, Irish Setters
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panuveitis, retinal detachments
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poliosis/vitiligo- nose, muzzle
Retinitis
Healed
GME and Reticulosis
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usually presents with CNS signs
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acute blindness with fixed dilated pupils
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optic neuritis (absent if retrobulbar)
leading to optic nerve atrophy
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peripapillary retinitis with RD
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Etiology: inflammation/neoplasia
Lymphosarcoma
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ocular metastasis is common
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uveitis, hyphema, pseudohypopyon
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tortuous retinal vessels, perivascular cuffing,
retinal detachment or neoplastic infiltration
Orbital lymphoma
Diabetes mellitus
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cataracts develop in dogs
>>
cats
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sorbitol draws water into the lens
causing lens fiber swelling & rupture
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early cataractous changes appear
as vacuoles in the equatorial lens cortex
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cataracts rapidly progress to maturity
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28% lower STT; 37% lower corneal
sensation; 58% lower TFBUT
Toxoplasmosis
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Retinochoroiditis
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Cats with retinitis and iritis
have systemic signs more
often than cats with iritis
alone.
Herpes
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Conjunctivitis, uveitis,
keratitis
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Chronic cases should be
tested for FIV
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Viroptic, acyclovir,
idoxuridine
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Oral lysine
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Oral interferon
FIP
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Perivascular cuffing
FIP
KP
Post TPA
FIP
FIV
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uveitis
FeLV
Uveitis and retinitis
Nutritional Retinopathy
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Taurine deficiency
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Vit E deficiency
Vascular Hypertension
Poor Prognosis for vision
Vascular Hypertension
Retina
Hyphema
Cornea
Hyperviscosity Syndromes
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Plasma cell tumors
Ophthalmomyiasis
Intraocular Tumors
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Melanomas
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Adenomas
Melanomas
The angle
Iris melanoma
Intraocular Cysts or Tumors??
Dirofilaria
Brucella canis
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ocular
– corneal edema, anterior
uveitis, chorioretinitis,
glaucoma
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systemic
– reproductive problems,
discospondylitis,
lymphadenopathy
Coccidioides immitis
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cats rarely affected
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ocular signs-
– granulomatous uveitis and retinitis, retinal detachments,
keratitis
– posterior segment lesions predominate
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vitreal sample-may see endospores
Bartonellosis Therapy
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Azithromycin 5mg/kg QOD PO for 10-21 days
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Rifampin
10mg/kg SID PO for 1 week
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Doxycycline 5 mg/kg BID PO for 6 weeks
– Combinations of first two with doxycycline