Induced corneal ulcers in cats - effects of 2% dorzolamide on epithelization time and on the expression of matrix metalloproteinase-9

Background: Topically administered 2% dorzolamide is among the most commonly used agents to lower IOP. As a complication of glaucoma, blind patients may develop corneal ulcers secondary to trauma. Nonetheless, in patients with a hypertensive or glaucomatous eye, in which the cornea has also been ulcerated, medical hypotensive therapy should not be discontinued. Therefore, the present study aimed to determine whether the instillation of a benzalkonium chloride (BAK)-preserved 2% dorzolamide alters corneal wound healing time and the levels of matrix metalloproteinases (MMP-9) in the tears of cats with experimentally induced corneal ulcers. Materials, Methods & Results: Sixteen cats (8/group) were randomly assigned to receive 40 µL of 2% dorzolamide (TG) or saline (CG) 3 times daily until corneal re-epithelialization. Experimental keratectomies were performed under general and topical anesthesia using an operating microscope. For this purpose, a millimitred trephine was calibrated and used to create a temporal paraxial corneal ulcer with a diameter of 6 mm and a depth of 200 µm. After corneal wounding, the ulcerated area, the healing time, blepharospasm, conjunctival hyperemia, and aqueous flare were compared between groups. Tears were collected at baseline and 24 and 48 h after keratectomy, and the total MMP-9 was quantified by ELISA. Data were assessed statistically using unpaired Student's t test, one-way, and two-way ANOVA followed by a Bonferroni post hoc test. Statistical significance was set at P < 0.05 for all analyses. The average time to achieve corneal wound healing did not differ between groups (P = 0.36) and was 65.50 ± 3.62 h in the CG and 71.00 ± 4.58 h in the TG. Twenty-four h after keratectomy, the ulcerated area in the CG was 3.34 mm2 larger than that observed in the TG (P = 0.04); the rest of the comparisons did not reach statistical significance at any time point between groups (P > 0.05). Higher blepharospasm scores were observed in cats of TG (P = 0.04). When compared with baseline of both groups, the levels of MMP-9 increased significantly at 24 and 48 h post-keratectomy (P < 0.001), but differences between groups were not observed at 24 and 48 h post-keratectomy (P > 0.05). Discussion: In cats, 9 mm axial corneal ulcers created by superficial debridement re-epithelize approximately 48 h postwounding. In the present study, re-epithelialization post keratectomy occurred within an average time of 68.25 h in most cats and in a delayed manner in one cat of the TG after 96 h. In the current study, the lesions in both groups healed without corneal scarring, pigmentation, or vascularization. Although BAC was present in all topical medications used in the present study, the authors attribute the higher scores of blepharospasm in the TG to the rheological characteristics and the pH of the dorzolamide ophthalmic solution. Indeed, the pH value of dorzolamide (5.58) may cause signs of irritation, as the tear film has an approximate pH of 7.6. Previous studies showed that ulcerated corneas presented significantly higher levels of MMP-9 in tears at the early stages (8 to 36 h) post-wounding. In the current study, the levels of this enzyme after wounding did not change significantly in the tears of cats treated with 2% dorzolamide when compared to the eyes in the control group. This study showed that the instillation of a BAC-preserved 2% dorzolamide ophthalmic solution did not impair the corneal wound healing time or the early expression of MMP-9 in the tears of cats with experimentally induced corneal ulcers. However, our results warrant further investigation in patients with ocular hypertension or glaucoma presenting concomitant naturally occurring corneal ulcers to certify our findings.

Distiquíases em gatos / Distichiasis in cats

Background: Distichiasis is a disease that is rare in cats, but very common in dogs. The term distichiasis may be controversial when used in the feline species, given that they do not possess true cilia, but rudimentary hair along the superior palpebra. The patients may be asymptomatic, though some show signs of ocular discomfort and ulcerative keratitis. The diagnosis is reached through an ophthalmological exam, and the treatment consists of the removal of the cilium with or without its hair follicle. With this work, we aim to report a series of cases of distichiasis in cats, as it is an uncommon anomaly, and has the potential to cause ocular discomfort in cats. Cases: Two mobile services of veterinary ophthalmology, one in the federal district of Brasília (DF) and the other in the municipality of Valinhos (SP), attended to 9 cats over a period of 5 years (2018 to 2022). The cats (n = 9) attended are of an undefined breed with ages varying from 10 months to 9 years, with an average of 3.9-year-old. The number of distichiasis presented by the animals was classified according to their quantity, being categorized as a mild grade when there was a single cilium, moderate grade when there were 2 to 4 cilia, and severe grade when there were more than 5 cilia. The highest incidence of distichiasis in this study was in males (78%) while females accounted for (22%) of the cases. The clinical changes reported by the owners consisted of signs of ocular discomfort (photophobia, blepharospasm, and periocular itching), ocular discharge and ocular redness. In the ophthalmological evaluations, blepharospasm (22%), serous to mucosal secretion (56%), chemosis (22%), mild (44%) to moderate (11%) conjunctival hyperemia, and ulcerative keratitis (22%) were observed. Distichiasis was more frequent affecting both eyes (56%), while in only (44%) of cases it affected the left eye only. The highest occurrence of cilia was identified in the upper palpebra (78%). Distichiasis was found more often in the temporal palpebral portion (78%), and in 2 patients the identification was more challenging since these cilia lack pigmentation. Single cilium affected (44%) of patients, while 5 cats had multiple distichiasis (56%). A total of 29% of the cats had a mild grade, whereas 14% had a moderated grade, and 57% had a severe grade. The treatments performed consisted of manual epilation (ME) and electroepilation (EE). ME was carried out in 56% of the cats, with relapses occurring in 80% of the patients, while 44% of the cats submitted to EE had a relapse in 20% of the cases. Discussion: Distichiasis is an inherited disorder very frequent in dogs, but considered uncommon in cats. Its causative factor is still unknown, as is its mode of inheritance. In distichiasis therapy, epilation, electroepilation, electrolysis, diode laser, cryotherapy and surgical palpebral resection techniques are referred to as procedures. Among the treatments used in this study, we observed a lower incidence of relapse with the electroepilation technique, which proved to be a viable and successful therapeutic modality. This series of cases shows that perhaps this disorder is much more frequent than what has been reported in the literature, being sometimes underdiagnosed and consequently underreported. Therefore, distichiasis in cats should be considered as a differential diagnosis in patients with clinical signs of ocular discomfort and ulcerative keratitis.

Hydrodissection in the construction of conjunctival flaps in dogs

Background: Hydrodissection is a minimally invasive procedure that consists of injecting fluid into an anatomical space to facilitate dissection during surgery. Although this procedure is employed in several areas of veterinary medicine, including ophthalmology, there are no reports of the use of this maneuver in conjunctival procedures in dogs. The use of this technique can facilitate the construction of conjunctival pedicle flaps, thereby improving the results. The purpose of this work was to evaluate the use of hydrodissection in the construction of conjunctival pedicle flaps in dogs. Materials, Methods & Results: The sample consisted of 20 eyes from 10 healthy dogs that had been subjected to elective surgical procedures of ovariohysterectomy and orchiectomy. The dogs were divided into 2 groups; the 1st group of 10 eyes underwent hydrodissection and the 2nd group of 10 eyes did not. All the patients underwent a complete ophthalmic examination and assessment of their systemic conditions. The patients were then anesthetized and the procedures were performed under a surgical microscope. In the group subjected to hydrodissection, the conjunctival flap was prepared by means of a previous subconjunctival injection of 0.7 mL of 0.9% sodium chloride, followed by preparation of the flap. In the group without hydrodissection, the flap was prepared by means of conventional divulsion using iris scissors. After producing the conjunctival flaps, a conjunctival fragment was collected from both groups for histological analysis and evaluation of the presence of the Tenon capsule. The operating time, degree of hemorrhage and ease of handling the conjunctiva in the intraoperative period were evaluated. Postoperative evaluations were performed at 1, 7 and 14 days after surgery and included: blepharospasm, conjunctival hyperemia and edema, which were classified as absent, mild, moderate or severe; tear production was evaluated using the Schirmer test, and the appearance of the conjunctival scar was assessed based on photographs taken in the postoperative period, and by a visual analogue scale, with healing classified as fair, good or excellent. The 2 groups showed no statistical difference in terms of operating time, bleeding, ease of handling and conjunctival divulsion. A volume of 0.48 ± 0.12 mL of 0.9% sodium chloride was administered to the conjunctiva. Postoperative assessments of hyperemia, blepharospasm, conjunctival edema, and tear production also did not differ statistically. Conjunctival scarring was considered optimal until the 14th postoperative day, with no statistically significant difference between the 2 groups. These results demonstrate that both maneuvers are effective in creating conjunctival flaps. The Tenon capsule could not be identified in histological stains. Discussion: The literature offers numerous descriptions of the use of hydrodissection in surgical procedures in humans in order to facilitate dissection and reduce surgical duration and handling, thereby improving the clinical recovery of patients. Conversely, this technique has not been described frequently in veterinary medicine, notably with respect to conjunctival procedures. In this study, we demonstrated that conjunctival hydrodissection was perfectly feasible, contributing to the divulsion and preparation of conjunctival flaps, thus proving to be a viable option for this type of procedure. The absence of the Tenon capsule in the evaluated samples demonstrates that, in both groups, the techniques were effective in separating them from the conjunctiva. It was therefore concluded that the hydrodissection technique is a feasible maneuver in the construction of conjunctival flaps, providing a new option for surgeons, especially for novice ophthalmologists.

Glaucoma in dogs and cats - management with cyclocryotherapy

Background: The treatment of glaucoma often requires numerous therapeutic modalities to achieve the desired reduction in intraocular pressure (IOP). Cyclodestructive procedures or ciliary body destruction have been performed using techniques with considerable differences in efficacy and complication rates. Among these methods, cyclocryotherapy is non-invasive and simple for the management of uncontrolled glaucoma in dogs and cats. The objective of this case report is to describe the technique of carbon dioxide cyclocryotherapy to reduce intraocular pressure in dogs and cats with glaucoma. Cases: Nine canine patients and one cat with glaucoma were treated with cyclocryotherapy performed under general anaesthesia. Clinical signs patients included blepharospasm, ocular pain, episcleral congestion and ocular hypertension. The patients showed higher levels of IOP, higher than 30 mmHg. Surgical treatment with general anaesthesia was applied. The pre-anaesthesia protocol included acepromazine 0.05 mg/kg with methadone 0.2 mg/kg, followed by intravenous propofol and maintenance with isoflurane and oxygen. An ophthalmological cryocautery unit was used with carbon dioxide as the cryogenic agent and a retinal cryoprobe of 3.2 mm diameter tip for the procedure. The method used was a double cycle of freezing and thawing for 60 s in each site. The cryoprobe was centred approximately 5 mm posterior to the corneoscleral limbus over the ciliary body. The temperature of each cyclocryotherapy spot was between -60°C and -80°C and each site was maintained in place for 60 s; 4 to 6 spots of the double freeze-thaw cycle were made. This technique did not have any serious complications during or after the application of cryotherapy, but chemosis and hyperaemia of the bulbar conjunctiva developed. Subconjunctival anti-inflammatory steroids were injected to minimise swelling and patient discomfort. Satisfactory results were observed; in all cases, the intraocular pressure decreased, with the usual result being a cosmetic and painless eye. Discussion: Even with recent surgical and medical advances, pain and blindness are still common occurrences in glaucoma in human and veterinary practice. The cyclodestructive procedures included cyclodialysis, cyclodiathermy, cyclocryotherapy, and cyclophotocoagulation. The cryosurgery in veterinary ophthalmology has many indications for the treatment of ocular diseases and is effective at decreasing intraocular pressure in patients with persistent uncontrolled glaucoma. Cyclocryotherapy has been shown to reduce intraocular pressure in dogs, cats, rabbits and humans with normotensive and glaucomatous eyes. The application of a cryoprobe over the ciliary processes results in ablating ciliary tissue so that aqueous humour inflow is reduced to acceptable levels. In the clinical cases evaluated, there was a reduction in intraocular pressure reaching acceptable levels, with the usual result being cosmetic and painless eye. Medical therapy remains the predominant method for treating glaucoma in veterinary patients; therefore, cyclocryotherapy is an effective, simple way to lower IOP and is a reasonable treatment option for glaucoma management. Cyclocryotherapy has shown good results, with a low learning curve and it can also be repeated if necessary.

Úlcera de córnea em bugio-ruivo (Alouatta guariba clamitans) - tratamento com soro heterólogo / Corneal ulcer in a Southern brown howler monkey (Alouatta guariba clamitans) - treatment with heterologous serum

Background: In the routine care of non-human primates, ocular trauma is frequent, however, unlike the small animal clinic, the prevalence of corneal ulcers is not documented. Among the numerous therapeutic options available in dogs, blood serum is being increasingly used as an adjuvant treatment in these conditions, due to its tear-like properties. Based on this, the present study aims to describe a case of corneal ulcer in a southern brown howler monkey (Alouatta guariba clamitans) attacked by a porcupine, and the use of heterologous serum obtained from an equine as an adjuvant treatment. Case: A southern brown howler monkey (Alouatta guariba clamitans), which had been attacked by porcupine quills, was treated at a University Veterinary Hospital. During the clinical examination, the presence of blepharospasm and secretion in the right eye was noticed. The ophthalmological examination, through the fluorescein test, detected the presence of an extensive superficial corneal ulcer in the right eye. After removing the spines, the corneal ulcer was treated with tobramycin-based eye drops, 1% atropine sulfate eye drops, and serum from equine blood in the form of eye drops, as an adjuvant therapy. After 5 days of treatment, the fluorescein test was repeated, which was negative in both eyes due to complete healing of the lesion, and thus the treatment was concluded. Discussion: The scarcity of scientific literature on wild animals is one of the factors responsible for the difficulty in advancing clinical and surgical procedures in non-human primates. Corneal ulcers are characterized by the loss of corneal epithelium with exposure of the stroma. The main clinical treatments adopted include antimicrobial therapy, analgesics, lubricating agents, and antiprotease drugs. Widely used as an adjuvant therapy in corneal ulcers in small animals, blood serum presents some advantages, as it is rich in growth factors, vitamins, immunoglobulins, and anti-collagenolytic substances, in addition to being obtained for a low cost. Considering the aforementioned, in the case reported, it was decided to use blood serum obtained from an equine as an adjuvant treatment of the corneal ulcer in a southern brown howler monkey. Complete healing of the corneal ulcer was confirmed in just five days, contributing to the well-being of this animal and contributing to the evolution of ophthalmology in this species that is still poorly studied.

Abscesso estromal em córnea de cão / Corneal stromal abscess in a dog

Background: The eye is an important sense organ responsible for sight. The cornea is the outermost of many eye layers,being predisposed to several lesions, some of them being frequent in small animal clinics meanwhile others are unusualand seldom reported in specialized literature. The stroma abscess is a common condition in horses, but atypical in dogs,it’s a condition in which a microperforation in the corneal epithelium allows microorganisms or a foreign body to penetratethe corneal stroma, and those become inside the cornea after a re-epithelialization, producing an intense inflammatoryresponse. Therefore, this case reports a case of deep stromal abscess in a Shih Tzu dog.Case: A 4-year-old female Shih Tzu, weighing 4.6 kg, was submitted to ophthalmic examination in which the left eyepresented an opaque yellowish-white protruding structure located on the right side, in the center of the cornea (3 o´clockposition), bulbar and palpebral conjunctival hyperemia and congestion, chemosis, blepharospasm, and a moderate amountof mucous discharge. The clinical diagnosis was stromal abscess with reflex uveitis. A differential diagnosis should includeconditions affecting the anterior part of the cornea, such as an epithelial inclusion cyst and a corneal ulcer. The inclusioncyst, contrarily to the corneal abscess, doesn’t cause pain, meanwhile, the corneal ulcer was ruled out by the FluoresceinStaining Test. The recommended treatment was surgical, through lamellar keratectomy, followed by overlapping pedicledconjunctival graft and third eyelid flap. In association with the surgical treatment, oral antibiotics, anti-inflammatory,and opioids, plus topical antibiotics and autologous serum eye drop. Seventy days post-surgery, the previously observedinflammatory signs were no longer present. In the conjunctival graft insertion site perpetuated a scar leucoma with few...

Abscesso estromal em córnea de cão / Corneal stromal abscess in a dog

Background: The eye is an important sense organ responsible for sight. The cornea is the outermost of many eye layers,being predisposed to several lesions, some of them being frequent in small animal clinics meanwhile others are unusualand seldom reported in specialized literature. The stroma abscess is a common condition in horses, but atypical in dogs,its a condition in which a microperforation in the corneal epithelium allows microorganisms or a foreign body to penetratethe corneal stroma, and those become inside the cornea after a re-epithelialization, producing an intense inflammatoryresponse. Therefore, this case reports a case of deep stromal abscess in a Shih Tzu dog.Case: A 4-year-old female Shih Tzu, weighing 4.6 kg, was submitted to ophthalmic examination in which the left eyepresented an opaque yellowish-white protruding structure located on the right side, in the center of the cornea (3 o´clockposition), bulbar and palpebral conjunctival hyperemia and congestion, chemosis, blepharospasm, and a moderate amountof mucous discharge. The clinical diagnosis was stromal abscess with reflex uveitis. A differential diagnosis should includeconditions affecting the anterior part of the cornea, such as an epithelial inclusion cyst and a corneal ulcer. The inclusioncyst, contrarily to the corneal abscess, doesnt cause pain, meanwhile, the corneal ulcer was ruled out by the FluoresceinStaining Test. The recommended treatment was surgical, through lamellar keratectomy, followed by overlapping pedicledconjunctival graft and third eyelid flap. In association with the surgical treatment, oral antibiotics, anti-inflammatory,and opioids, plus topical antibiotics and autologous serum eye drop. Seventy days post-surgery, the previously observedinflammatory signs were no longer present. In the conjunctival graft insertion site perpetuated a scar leucoma with few...(AU)

Rare primary choroidal melanoma in a dog, with optic nerve infiltration / Raro melanoma primário de coroide em cão, com infiltração no nervo óptico

Intraocular melanocytic neoplasms are common in dogs. However, the choroidal location of these neoplasms and their infiltration into the optic nerve are unusual. This paper reports a case of primary choroidal melanoma in a 12-year-old male Dachshund. On the first examination, the animal presented left eye blepharospasm, protrusion of the nictitating membrane, conjunctival hyperemia, moderate congestion, hyphema, and intraocular hypertension. Opacity hindered the performance of fundoscopy in the affected eye. The ocular ultrasound examination revealed a cupuliform mass in the choroid. Due to suspected intraocular neoplasia, an exenteration was performed. Histopathological examination revealed primary choroidal melanoma with scleral and optic nerve invasion.(AU)

Neoplasias melanocíticas intraoculares são comuns em cães, contudo, a localização destas neoplasias na coroide e a infiltração delas no nervo óptico são pouco frequentes. O presente trabalho relata um caso de melanoma de coroide primário em um cão da raça Dachshund, com 12 anos de idade. O animal ao primeiro exame apresentou blefaropasmo no olho esquerdo, protrusão da terceira pálpebra, hiperemia conjuntival, congestão moderada, hifema e pressão intraocular elevada. Opacidade de meios transparentes impediu a realização de fundoscopia no olho acometido. O exame ultrassonográfico ocular revelou massa cupuliforme na coroide. Em razão da suspeita de neoplasia intraocular foi realizada exenteração. No exame histopatológico foi diagnosticado melanoma primário em coroide com invasão escleral e do nervo óptico.(AU)

Coloboma eyelid in cats - treatment with carbon dioxide cryosurgery

Background: Eyelid colobomas are congenital and developmental disorders. Generally, they affect the temporal portion of the upper eyelids of cats, bilaterally. This ocular defect is accompanied by trichiasis associated with pain and ulcerative keratitis. Any breed can be affected and it has been reported in Domestic Shorthair, Persian, Burmese, Mongrel cats and captive felids. The objective of this case report is to describe the technique of dioxide carbon cryosurgery for the treatment of eyelid coloboma in felines. Cases: Seven mongrel cats (14 eyes) with bilateral eyelid coloboma were included in this study, 5 females and 2 males, with a median age of 5 months (range 6-8 months). The patients presented with blepharospasm, bilateral mucopurulent ocular discharge and eyelid coloboma extension of 30-50% in the upper eyelid, resulting in severe trichiasis of both eyes. In 5 cats, 1 or both eyes were diagnosed with keratitis and superficial corneal ulcers. Surgical treatment with general anaesthesia was applied. The pre anaesthesia protocol included acepromazine 0.05 mg/kg with methadone 0.2 mg/kg, followed by intravenous propofol and maintenance with isoflurane and oxygen. An ophthalmological cryocautery unit was utilised with carbon dioxide as the cryogenic agent and a retinal cryoprobe of 3.2 mm diameter tip, reaching -50ºC for the procedure. The method used was a double cycle of freezing and thawing for 60 s in the margins of eyelid agenesis. Epilation of hairs was made after freezing with eyelash tweezers. Immediately after the surgical procedure, an Elizabethan collar was placed to safeguard the area and anti-inflammatory therapy with meloxicam 0.1 mg/kg once daily for 3 days was prescribed. Antibiotic ointment every 6 h (chloramphenicol and associations) was also prescribed for topical application. Two weeks post-operatively, hyperaemia, oedema and skin wounds at the margins were observed. After 30 days these clinical signs were minimal. No signs of pain were observed post-operatively. The follow-up was 90 days and the trichiasis was resolved in all cats. Discussion: Usually, young cats are affected with eyelid colobomas. The age of the patients in this study was between 6-8 months. Eyelid colobomas are repaired with a variety of blepharoplastic procedures and the choice depends on the size and position of the defect. Generally, larger defects require more extensive reconstructive procedures. All techniques can have post-operative complications. Suture dehiscence, skin flap necrosis and facial deformation can occur with traditional surgical techniques. Furthermore, posterior hair growth in the margins can lead to new trichiasis. Cryosurgery was chosen and performed as the temperature of -20°C is sufficient to destroy hair follicles, without surgical incisions, avoiding scar formation. Hence, sutures are not necessary in cryosurgery procedures. Carbon dioxide is a good cryogenic agent for the purpose of this procedure. In the cases described, no recurrence of hair growth was observed in the follow-up period of 90 days. Nevertheless, a good aesthetic appearance was maintained. Therefore, the use of carbon dioxide cryosurgery is an effective and safe alternative for treatment of eyelid coloboma in cats. To our knowledge, no paper has described the use of carbon dioxide cryosurgery for the correction of palpebral agenesis in felines and other species as a single treatment. This technique is easy to perform, has good aesthetic and functional results and can be considered a treatment option for this congenital condition.

Cisto de inclusão epitelial corneal em canino / Corneal epithelial inclusion cyst in canine

Este estudo descreve-se o caso de um canino com cisto de inclusão epitelial corneal. Um cão, sem raça definida, macho de 12 anos, foi atendido apresentando uma massa em seu olho esquerdo, a qual apresentava uma evolução de 5 meses sem resposta positiva a diferentes protocolos terapêuticos. O tutor relatou não haver lesão prévia ou trauma, assim como nenhum sinal de desconforto apresentado pelo animal, como epífora ou blefaroespasmo. O exame oftalmológico revelou uma deformação na estrutura corneana, sem sinais de dor. Alterações em outras estruturas oculares não foram observadas. Associado ao exame oftalmológico e ao resultado da citologia, chegou-se ao diagnóstico de cisto corneal e foi feita a excisão completa por meio de uma ceratectomia lamelar. Devido ao fato da massa não ultrapassar a porção média do estroma, o recobrimento da superfície não foi realizado. Dois meses após a cirurgia, o paciente não apresentou qualquer tipo de secreção ocular ou sinais de dor. Além disso, a córnea não continha neovascularização nem sequelas do processo cicatricial, recuperando sua transparência.

This study described the case of a canine with a corneal epithelial inclusion cyst. A twelve-year-old male dog of undefined race was attended presenting a mass on his left eye, which did not respond to any therapeutic protocols for the last five months. The tutor reported that there was no previous injury or trauma, as well as no signs of discomfort presented by the animal, such as epiphora or blepharospasm. The ophthalmological examination revealed a deformity in the corneal structure, without signs of pain. Alterations in other ocular structures were not observed. Regarding the ophthalmological exam and cytology result, a diagnosis of corneal cyst was obtained and the complete excision by a lamellar keratectomy was done. Since the mass did not exceed the middle portion of the stroma, the surface covering was not performed. Two months after surgery, the patient did not present any type of ocular secretion or signs of pain. Moreover, the cornea did not contain neovascularization or sequelae of the healing process, recovering its transparency.

Corneal ulcer in a sheep - treatment with third eyelid flap

Background: Corneal ulcers are frequently reported in the literature in several species, however, the treatment of traumaticlesions on the corneal surface of ruminants is still poorly described. The use of the third eyelid flap is questioned whenapplied to deep ulcers, since the technique prevents the evolutionary follow-up of corneal healing and compromises care.However, several authors report its successful use for the treatment of superficial and deep corneal ulcers. This techniqueprotects the ocular surface and prevents the occurrence of new lesions or their aggravation. The aim of this study was toreport the treatment of corneal ulcers in sheep through the third eyelid flap associated with the use of topical antibiotics.Case: A 2-year-old male Dorper sheep, with ocular discomfort, conjunctival hyperemia and mucopurulent secretion in theleft eye, was assisted in a private rural property in the West region of Bahia, Brazil. The owner reported that before seeking veterinary help he used a spray based on oxytetracycline and hydrocortisone, which worsened the animal’s condition.Upon inspection, it was observed eyelid asymmetry, slight lateralization of the head to the left, periorbital alopecia onthe left face, intense blepharospasm in the left eye, with projection of the third eyelid occurring at times. The ophthalmicexamination was performed after application of anesthetic eye drops based on proxymetacaine to reduce eye discomfort.A corneal stromal lesion, edema and fibrovascular tissue in the left eye were identified, but the cause of the lesion was notdefined, with lagophthalmia, entropion, dystychiasis or ectopic cilia being ruled out. So, it was suggested that the lesionhad occurred by a foreign body, such as dust...

Corneal ulcer in a sheep - treatment with third eyelid flap

Background: Corneal ulcers are frequently reported in the literature in several species, however, the treatment of traumaticlesions on the corneal surface of ruminants is still poorly described. The use of the third eyelid flap is questioned whenapplied to deep ulcers, since the technique prevents the evolutionary follow-up of corneal healing and compromises care.However, several authors report its successful use for the treatment of superficial and deep corneal ulcers. This techniqueprotects the ocular surface and prevents the occurrence of new lesions or their aggravation. The aim of this study was toreport the treatment of corneal ulcers in sheep through the third eyelid flap associated with the use of topical antibiotics.Case: A 2-year-old male Dorper sheep, with ocular discomfort, conjunctival hyperemia and mucopurulent secretion in theleft eye, was assisted in a private rural property in the West region of Bahia, Brazil. The owner reported that before seeking veterinary help he used a spray based on oxytetracycline and hydrocortisone, which worsened the animals condition.Upon inspection, it was observed eyelid asymmetry, slight lateralization of the head to the left, periorbital alopecia onthe left face, intense blepharospasm in the left eye, with projection of the third eyelid occurring at times. The ophthalmicexamination was performed after application of anesthetic eye drops based on proxymetacaine to reduce eye discomfort.A corneal stromal lesion, edema and fibrovascular tissue in the left eye were identified, but the cause of the lesion was notdefined, with lagophthalmia, entropion, dystychiasis or ectopic cilia being ruled out. So, it was suggested that the lesionhad occurred by a foreign body, such as dust...(AU)

Ophthalmological and neurological manifestations of a dog with intracranial anaplastic ependymoma. Case report / Manifestações oftalmológicas e neurológicas em um cão com ependimoma anaplásico intracranial: relato de caso

The objective is to report ependymoma associated with uveitis in a four-month-old male boxer crossbreed. The dog initially presented in both eyes conjunctival hyperemia, blepharospasm, projection of the nictitating membrane, and photophobia, characteristic of uveitis.Traumatic uveitis was rejected. Six days after onset of ophthalmic symptoms, vomiting, incoordination, and behavior changes occurred. Neurological symptoms and eyebrow contraction suggesting head pain and brain injury were investigated by computed tomography (CT) nine days after, when the dog showed spasms of the limbs and neck followed by respiratory arrest with reversal and stabilization. The scans revealed extensive amorphic neoformation in the diencephalon, midbrain, and within the right lateral ventricle, along with sinistral displacement of the cerebral sickle. The animal was euthanized, and necropsy of the head revealed hydrocephalus and an intracerebral tumor mass consistent with the CT imaging. Histopathological evaluation by hematoxylin and eosin staining revealed tissue alterations in several CNS segments, showing several pseudorosettes in the neuropil, mitosis, and a high degree of cell atypia, indicating ependymoma. Inflammatory, hemorrhagic, and necrotic tissue lesions were observed in the brainstem and cerebellum due to compression by tumor tissue and hydrocephalus. The neoplasia was phenotyped by Immunohistochemistry (IHC), and tested positive for the tumoral markers vimentin and glial fibrillary acid protein, confirming intracranial anaplastic ependymoma. Behavior changes and neurological signs resulted from vascular, inflammatory, and degenerative processes in the neuropil caused by neoplasm compression and invasion of brain tissue. Although dogs with ependymoma often present with neurological disease, in the present case, blepharospasm was the first symptom noticed by the owner, and it persisted until euthanasia. According to the literature, and confirmed in the evolution of the current case, the symptoms are related to tumor location and extent and to secondary lesions due to tumor expansion. Clinical symptomatology and complementary laboratory testing, CT, necropsy, histology, and IHC characterized ependymoma, a rare condition in young dogs.

Objetiva-se relatar um caso de ependimoma anaplásico associado a uveíte em cão macho de quatro meses de idade, mestiço Boxer. O cão apresentou, inicialmente, hiperemia conjuntival, blefaroespasmo, projeção da membrana nictitante e fotofobia bilaterais, sinais característicos de uveíte. Uveíte por causa traumática foi descartada. Seis dias após o início dos sintomas oftálmicos ocorreram vômito, incoordenação motora e alterações de comportamento. Sinais neurológicos e contração das sobrancelhas sugeriram algia na região cefálica. Injúria cerebral foi investigada por tomografia computadorizada (TC) nove dias após o início dos sintomas, quando o cão demonstrou espasmos dos membros e pescoço, seguido por parada respiratória com reversão e estabilização. A TC revelou extensa e amórfica neoformação no diencéfalo, mesencéfalo, e dentro do ventrículo lateral direito, com deslocamento à esquerda da foice cerebral. O animal foi eutanasiado e a necropsia revelou hidrocefalia e uma massa tumoral intracerebral condizente com a imagem da TC. A avaliação histopatológica por coloração hematoxilina e eosina, revelou alterações teciduais em várias áreas do Sistema Nervoso Central (SNC), mostrando várias pseudorosetas no neurópilo, mitose, e um elevado grau de atipia celular, indicando ependimoma.Lesões teciduais inflamatórias, hemorrágicas e necróticas foram observadas no tronco encefálico e cerebelo, devido à compressão do tumor e à hidrocefalia. Amostras da neoplasia foram submetidas à análise imuno-histoquímica (IHQ), sendo positiva a expressão dos marcadores tumorais vimentina e proteína glial fibrilar ácida, confirmando ependimoma anaplásico intracranial. As mudanças comportamentais e sinais neurológicos resultaram do processo vascular, inflamatório e degenerativo no neurópilo, causados pela compressão e invasão do tecido cerebral pela neoplasia. Embora cães com ependimoma frequentemente apresentem manifestações neurológicas, no presente caso, blefaroespasmo foi o primeiro sinal clínico observado pelo proprietário, e persistiu até a eutanásia do paciente. Os sinais neurológicos estão relacionados à localização do tumor e extensão das lesões secundárias devidas à sua expansão. Sintomatologia clínica e testes laboratoriais complementares, TC, necropsia, histologia e IHQ caracterizaram ependimoma, que é raro em animais jovens.

Ophthalmological and neurological manifestations of a dog with intracranial anaplastic ependymoma. Case report / Manifestações oftalmológicas e neurológicas em um cão com ependimoma anaplásico intracranial: relato de caso

The objective is to report ependymoma associated with uveitis in a four-month-old male boxer crossbreed. The dog initially presented in both eyes conjunctival hyperemia, blepharospasm, projection of the nictitating membrane, and photophobia, characteristic of uveitis.Traumatic uveitis was rejected. Six days after onset of ophthalmic symptoms, vomiting, incoordination, and behavior changes occurred. Neurological symptoms and eyebrow contraction suggesting head pain and brain injury were investigated by computed tomography (CT) nine days after, when the dog showed spasms of the limbs and neck followed by respiratory arrest with reversal and stabilization. The scans revealed extensive amorphic neoformation in the diencephalon, midbrain, and within the right lateral ventricle, along with sinistral displacement of the cerebral sickle. The animal was euthanized, and necropsy of the head revealed hydrocephalus and an intracerebral tumor mass consistent with the CT imaging. Histopathological evaluation by hematoxylin and eosin staining revealed tissue alterations in several CNS segments, showing several pseudorosettes in the neuropil, mitosis, and a high degree of cell atypia, indicating ependymoma. Inflammatory, hemorrhagic, and necrotic tissue lesions were observed in the brainstem and cerebellum due to compression by tumor tissue and hydrocephalus. The neoplasia was phenotyped by Immunohistochemistry (IHC), and tested positive for the tumoral markers vimentin and glial fibrillary acid protein, confirming intracranial anaplastic ependymoma. Behavior changes and neurological signs resulted from vascular, inflammatory, and degenerative processes in the neuropil caused by neoplasm compression and invasion of brain tissue. Although dogs with ependymoma often present with neurological disease, in the present case, blepharospasm was the first symptom noticed by the owner, and it persisted until euthanasia. According to the literature, and confirmed in the evolution of the current case, the symptoms are related to tumor location and extent and to secondary lesions due to tumor expansion. Clinical symptomatology and complementary laboratory testing, CT, necropsy, histology, and IHC characterized ependymoma, a rare condition in young dogs.(AU)

Objetiva-se relatar um caso de ependimoma anaplásico associado a uveíte em cão macho de quatro meses de idade, mestiço Boxer. O cão apresentou, inicialmente, hiperemia conjuntival, blefaroespasmo, projeção da membrana nictitante e fotofobia bilaterais, sinais característicos de uveíte. Uveíte por causa traumática foi descartada. Seis dias após o início dos sintomas oftálmicos ocorreram vômito, incoordenação motora e alterações de comportamento. Sinais neurológicos e contração das sobrancelhas sugeriram algia na região cefálica. Injúria cerebral foi investigada por tomografia computadorizada (TC) nove dias após o início dos sintomas, quando o cão demonstrou espasmos dos membros e pescoço, seguido por parada respiratória com reversão e estabilização. A TC revelou extensa e amórfica neoformação no diencéfalo, mesencéfalo, e dentro do ventrículo lateral direito, com deslocamento à esquerda da foice cerebral. O animal foi eutanasiado e a necropsia revelou hidrocefalia e uma massa tumoral intracerebral condizente com a imagem da TC. A avaliação histopatológica por coloração hematoxilina e eosina, revelou alterações teciduais em várias áreas do Sistema Nervoso Central (SNC), mostrando várias pseudorosetas no neurópilo, mitose, e um elevado grau de atipia celular, indicando ependimoma.Lesões teciduais inflamatórias, hemorrágicas e necróticas foram observadas no tronco encefálico e cerebelo, devido à compressão do tumor e à hidrocefalia. Amostras da neoplasia foram submetidas à análise imuno-histoquímica (IHQ), sendo positiva a expressão dos marcadores tumorais vimentina e proteína glial fibrilar ácida, confirmando ependimoma anaplásico intracranial. As mudanças comportamentais e sinais neurológicos resultaram do processo vascular, inflamatório e degenerativo no neurópilo, causados pela compressão e invasão do tecido cerebral pela neoplasia. Embora cães com ependimoma frequentemente apresentem manifestações neurológicas, no presente caso, blefaroespasmo foi o primeiro sinal clínico observado pelo proprietário, e persistiu até a eutanásia do paciente. Os sinais neurológicos estão relacionados à localização do tumor e extensão das lesões secundárias devidas à sua expansão. Sintomatologia clínica e testes laboratoriais complementares, TC, necropsia, histologia e IHQ caracterizaram ependimoma, que é raro em animais jovens.(AU)

Modified eye evisceration in a tropical screech owl (Megascops choliba)

Background: An adult owl was presented with an injury to the right eye that rendered it blind in that eye. The left eye was normal. Removal of the right eye was recommended and a modified eye evisceration was performed. No complications were observed during or after surgery. The objective of this paper is to describe the modified eye evisceration technique that was successfully used in a tropical screech owl (Megascops choliba). Case: An adult owl was presented with an injury to the right eye that rendered it blind in that eye. Two previous surgical treatments have been carried out but have not been successful. Using a portable slit-lamp (Kowa SL-15®), both eyes were examined. The left eye was normal. Upon ophthalmic examination of the right eye, the owl demonstrated blepharospasm and large central corneal ulcer. Removal of the right eye was recommended. The bird received midazolam hydrochloride [Dormire® - 1 mg/kg, IM] and ketamine hydrochloride [Ketamina® - 5 mg/kg IM] as pre-anesthetic medications. Subsequently, the bird was anesthetized with isoflurane (Isoforine®) by facemask for induction, and then maintained with isoflurane vaporized in 100% oxygen through an endotracheal tube. With the aid of a surgical microscope and microsurgery materials, a modified eye evisceration was performed. Post-operatively, the owl received meloxicam [Maxicam® - 0.5 mg/kg, IM] and tramadol hydrochloride [Cronidor® - 15 mg/kg, orally for 4 days]. The day after surgery, the owl was comfortable and its usual appetite was regained. The patient remained hospitalized for 3 weeks and was evaluated daily. The skin sutures were removed 10 days after the surgical procedure and the surgical wound had healed normally. The patient was reintroduced into the wild after 2 months. During the 6 months post-release, the bird was evaluated once a month, and no complications were observed. Discussion: Severe eye trauma and complicated corneal ulcers are common causes of eyeball removal in birds. In birds, there is a high risk of complications during enucleation. The fragility of the orbital bones makes them susceptible to trauma during the surgery. Evisceration involves the removal of the inner contents of the eye while leaving the cornea and the sclera intact. In the current case, evisceration was chosen because the eye was blind, and maintaining a blind eye would be a source of pain and infection. In the modified evisceration technique, the risk of complications is minimal compared to enucleation, mainly because surgical manipulation is minimal. In our case, the total surgery time was 20 min. Another complication reported after enucleation in birds is the possibility of disfiguring the bird because the removal of the globe disturbs the natural head balance. To avoid these complications, the use of an intraocular prosthesis after evisceration in birds has been performed. However, owls have a tubular-shaped globe with scleral ossicles. These factors could hinder or even prevent the accommodation of a cylindrical silicone prosthesis. In the present case, an intraocular prosthesis implant was never considered due to the unavailability of the prosthesis and to avoid the risk of postoperative complications that have been reported from the literature in dogs. In this case, the owl recovered well from anesthesia without complications, and no postoperative hemorrhage was observed. No signs of pain were observed during the postoperative period and the owl had already shown an appetite and fed on the first postoperative day. The previously published reports using the modified evisceration technique also demonstrated an absence of pain signs during the postoperative period.(AU)

Cirurgia corretiva para coloboma palpebral em um felino através da técnica de transposição da comissura labial / Corrective surgery for palpebral coloboma in a feline using the technique of transposition of the lip commissure

Background: Eyelid coloboma is considered a disease caused by failure in eye development during the first semester of pregnancy. In felines, its prevalence occurs in the upper eyelids, temporal region, and bilaterally. Coloboma, whether to a large or small extent, can lead to keratoconjunctivitis sicca and trichiasis, situations that can give rise to secondary ulcerative keratitis. The only corrective method is blepharoplasty. The current work aims to report the case of corrective surgery for eyelid coloboma in a feline with a successful postoperative period, in order to corroborate the effectiveness of the technique. We also report a finding of persistent pupillary membrane. Case: A 7-month-old male feline, no defined breed, was analyzed with a purulent mucus secretion and signs of discomfort in the right eye. After the ophthalmic screening, the presence of a coloboma was identified, which occupied approximately 50% of the size of the upper eyelid, in the temporal-dorsal region of the right eye. The cat had already undergone an enucleation of the left eye due to a perforation arising from ulcerative keratitis. Together with coloboma, the presence of blepharospasm, trichiasis, keratoconjunctivitis sicca, and secondary ulcerative keratitis were diagnosed. The presence of persistent pupillary membrane was also observed, a rare condition in the feline species. To confirm the ulcer, the fluorescein test was applied and treatment with antibiotic eye drops and lacrimomimetics (tear film replacements) drops was administered until the day of surgery, one week later. Concomitant with the institution of treatment prior to surgery, blood was collected for complementary pre-surgical tests such as blood count and biochemistry, which demonstrated satisfactory results. Corrective surgery was then instituted by the technique of transposing the labial commissure...

Bullous keratopathy in a dog treated with third eyelid flap and autologous serum eye drops

Background: Bullous Keratopathy (BK) is characterized by decompensation of the corneal stroma resulting in visual impairment by corneal opacity, discomfort, excessive tearing, blepharospasm and pain. The aim of this study was to report a case of BK in a dog and the complete recovery of the ocular structure and visual function, with a third eyelid flap associated with the use of autologous blood serum topically. Case: A 2-year-old Shih Tzu male dog, weighing 4.3 kg, with recurrent bilateral eye discomfort was brought to Ophthalmologist Veterinarian Assistance. The patient had already been seen by other veterinarians, but the signs returned in a short period of time after the prescription was suspended. During physical examination it was observed moderate blepharospasm in the right eye, epiphora in the left eye, and in both eyes was noted exophthalmos, medial corneal entropion, caruncle trichiasis and ectopic cilia in the upper and lower eyelids. Fluorescein test was positive in both eyes, and a large bullous, opaque and gelatinous lesion with irregular appearance was observed occupying a large part of the cornea of the right eye. Superficial corneal ulcer was diagnosed in left eye and BK in right eye, both probably in consequence of ectopic cilia presence. Surgical intervention was made, with the cauterization and excision of the ectopic cilia and third eyelid flap in the right eye. The cauterization of caruncle trichiasis was not authorized by the owner. Moxifloxacin eye drops in the dose of one drop four times a day in both eyes, lubricant based on hyaluronic acid in the dose of one drop four times a day in both eyes, and autogenous blood serum, obtained from the centrifugation of a blood sample of the dog itself, in the dose of one drop every hour in the right eye for 24 h, and meloxicam in the dose of...

Bullous keratopathy in a dog treated with third eyelid flap and autologous serum eye drops

Background: Bullous Keratopathy (BK) is characterized by decompensation of the corneal stroma resulting in visual impairment by corneal opacity, discomfort, excessive tearing, blepharospasm and pain. The aim of this study was to report a case of BK in a dog and the complete recovery of the ocular structure and visual function, with a third eyelid flap associated with the use of autologous blood serum topically. Case: A 2-year-old Shih Tzu male dog, weighing 4.3 kg, with recurrent bilateral eye discomfort was brought to Ophthalmologist Veterinarian Assistance. The patient had already been seen by other veterinarians, but the signs returned in a short period of time after the prescription was suspended. During physical examination it was observed moderate blepharospasm in the right eye, epiphora in the left eye, and in both eyes was noted exophthalmos, medial corneal entropion, caruncle trichiasis and ectopic cilia in the upper and lower eyelids. Fluorescein test was positive in both eyes, and a large bullous, opaque and gelatinous lesion with irregular appearance was observed occupying a large part of the cornea of the right eye. Superficial corneal ulcer was diagnosed in left eye and BK in right eye, both probably in consequence of ectopic cilia presence. Surgical intervention was made, with the cauterization and excision of the ectopic cilia and third eyelid flap in the right eye. The cauterization of caruncle trichiasis was not authorized by the owner. Moxifloxacin eye drops in the dose of one drop four times a day in both eyes, lubricant based on hyaluronic acid in the dose of one drop four times a day in both eyes, and autogenous blood serum, obtained from the centrifugation of a blood sample of the dog itself, in the dose of one drop every hour in the right eye for 24 h, and meloxicam in the dose of...(AU)

Uso do plasma rico em plaquetas associado a colírios no tratamento de ceratite ulcerativa em equino / Use of rich plasma on platters associated with collieries in the treatment of ulcerative caeratitis in equine

A córnea é a primeira estrutura do olho a receber luz, sendo localizada na parte mais externado bulbo ocular. Devido a sua localização está sujeita, com maior frequência, a processos lesivos, como a úlcera de córnea, também chamada de ceratite ulcerativa. É a patologia com maior ocorrência dentre as afecções oftalmológicas em equinos, e caso não tenha o tratamento adequado, pode levar a perda da visão do animal. Diante desse contexto, objetivo do estudo foi relatar um caso clínico de ceratite ulcerativa em equino tratado com plasma rico em plaquetas (PRP) associado a colírios. Um equino, macho, de 3 anos de idade, raça Quarto de Milha, pelagem alazã foi encaminhado para atendimento veterinário por ter sofrido uma pancada em um caibro. Durante o exame clínico foi constatado que o cavalo apresentava quemose, epífora, blefaroespasmo e perda temporária da capacidade visual. Baseado nos sinais clínicos e histórico a suspeita clínica foi de ceratite ulcerativa. O tratamento indicado foi instilação de Ocucan® colírio, Ciprovet® e PRP, duas gotas de cada, duas vezes ao dia, além de lavagem com solução fisiológica. O animal apresentou evolução significativa ao tratamento e com 30 dias foi liberado para retornar a propriedade e as atividades físicas gradativamente. Dessa forma, podemos concluir que o uso de plasma rico em plaquetas constitui uma ferramenta importante e acessível no tratamento de ceratite ulcerativa em equinos, inclusive demonstrando bons resultados na caraterística da cicatrização e no tempo da mesma.

The cornea is the first structure of the eye receiving light, being located at the outermost part of the ocular bulb. Due to its location is subject, more often, the harmful processes such as corneal ulcer, also called keratitis Ulcerative. It is the disease with higher incidence among ophthalmologic diseases in horses, and if no proper treatment, can lead to the animal vision loss. In this context, objective of the study was to report a case of keratitis Ulcerative equinus treated with platelet-rich plasma (PRP) associated with eye drops. A horse, male, 3 years old, Quarter Horses, sorrel coat was referred to veterinary care after suffering a stroke on a rafter. During the clinical examination revealed that the horse had chemosis, epiphora blepharospasm and temporary loss of vision. Based on clinical signs and history clinical suspicion was keratitis Ulcerative. The treatment was Ocucan® instillation of eye drops, Ciprovet® PRP and two drops each, twice a day, and washing with saline solution. The animal showed evolution significant treatment and was released 30 days to return the property and physical activity gradually. Thus, we conclude that the use of platelet rich plasma is an important tool and accessible in the treatment of ulcerative keratitis in horses, including demonstrating good results in healing characteristic and time thereof.

Primary ocular transmissible venereal tumor in a prepubescent female dog

Background: Canine transmissible venereal tumor (CTVT) is a peculiar neoplasm resulting from the transmission of hostcancerous cells to another canid by implantation. Transmission occurs among reproductive age dogs, especially thosewith unrestricted sexual activity. It usually occurs on the external genitalia of dogs and other areas are unusual. However,implants have been described in injured mucosa, as well as metastases in lymph nodes, spleen, skin, anus and perianalspace, oral mucosa, nasal mucosa, eyeball and brain. The purpose of this report is to describe the first case of exclusivelyextragenital ocular CTVT in a prepubescent female dog.Case: A 6-month-old mixed-breed, non-spayed and prepubescent female dog, showing a fast-growing reddish-coloredmass in the right eye (RE), was examined. Blepharospasm, mild serosanguineous secretion, chemosis and a smooth surfacereddish mass with 2.5 cm in length occupying the orbital area were observed during physical examination, impairing thevisualization of the right eyeball. For ocular ultrasonography examination of the affected eye, acepromazine was used (0.03mg/kg) associated with methadone (0.3 mg/kg) intramuscularly, and propofol (4 mg/kg) for induction and 0.2 mg/kg formaintenance, intravenously. Ultrasonography examination evidenced an amorphous hyperechogenic structure, medial tothe RE, with homogeneous echotexture, punctiform vascularization to amplitude Doppler (Power Doppler), measuring 2.8cm in length and 1.4 cm in diameter, causing eyeball distortion and rejection. Based on ultrasonography results and withthe patient still anesthetized, an incisional biopsy of the peribulbar mass was performed with a 5 mm disposable punch.The final CTVT diagnosis was possible after histopathological analysis. No more CTVT nodules were found, especiallyin the vulva, which had a prepubescent appearance, consistent with age. Treatment...