Mydriasis in eastern box turtles (Terrapene carolina carolina) following topical administration of proparacaine, 10% phenylephrine, and rocuronium bromide.

OBJECTIVE: To determine the mydriatic effect of topical 10% phenylephrine with 10 mg/mL rocuronium bromide and compare this protocol with and without pretreatment with proparacaine. ANIMALS STUDIED: Ten client-owned pet adult eastern box turtles (Terrapene carolina carolina). PROCEDURES: All turtles were sedated with 8 mg/kg alfaxalone intramuscularly. One group of four turtles received four 20 µL drops of 10% phenylephrine and four 20 µL drops of rocuronium bromide in the right eye. Another group of four turtles received one standard drop of proparacaine followed by four 20 µL drops of 10% phenylephrine and four 20 µL drops of rocuronium bromide in the right eye. Two control group turtles received four 20 µL drops of saline in the right eye. The left eye was untreated in all turtles. Drops of the same type were separated by 2 min while drops of different types were separated by 5 min. Pupil size was recorded at 0, 15, 30, 60, 90, 120, 180, 240, and 360 min after administration of the final drop. RESULTS: Treatment with 10% phenylephrine and rocuronium bromide resulted in pupil diameter changes from baseline that were statistically significant from zero at 60, 90, and 120 min in the non-proparacaine group and 90 min in the proparacaine group. The time to peak effect was 90 min in the proparacaine group and 75 min in the non-proparacaine group. Saline-treated pupils in the control group decreased in diameter over the study period. Overall, the treated eyes of the proparacaine group and non-proparacaine group were not different from each other, but both dilated more than the control group. CONCLUSIONS: Rocuronium bromide and 10% phenylephrine can produce effective and safe mydriasis in eastern box turtles, but there was wide interindividual variation in effectiveness. Proparacaine did not improve the mydriatic effect.

Comparison of a blind and an ultrasound-guided technique for Retrobulbar anesthesia in dogs undergoing unilateral subconjunctival enucleation.

OBJECTIVE: This study compared the quality of retrobulbar anesthesia using a blind inferior-temporal palpebral approach (ITP) with an ultrasound-guided supratemporal (ST) technique in dogs undergoing unilateral enucleation. ANIMAL STUDIED: Twenty-one client-owned dogs were undergoing enucleation. PROCEDURES: Dogs were randomly assigned to receive ITP (n = 10) or ST (n = 11) with 0.5% ropivacaine at 0.1 mL/cm of neurocranial length. The anesthetist was blinded to the technique. Intraoperative data included cardiopulmonary variables, inhalant anesthetics requirement, and requirement for rescue analgesia (intravenous fentanyl 2.5 mcg/kg). Postoperative data included pain scores, sedation scores, and need for intravenous hydromorphone (0.05 mg/kg). Treatments were compared using Wilcoxon's rank sum test or Fisher's exact test as appropriate. Comparison of variables over time were tested using a mixed effect linear model on rank. Significance was set at p = 0.05. RESULTS: Intraoperative cardiopulmonary variables and inhalant requirements were not different between groups. Dogs receiving ITP required median (interquartile range, IQR) 1.25 (0, 2.5) mcg/kg intraoperative fentanyl while those receiving ST required none (p < 0.01). Intraoperative fentanyl was required in 5/10 and 0/11 of dogs in the ITP and ST groups, respectively (p = 0.01). Postoperative analgesia requirements were not significantly different between groups; 2/10 and 1/10 dogs in the ITP and ST groups, respectively. Sedation score negatively affected pain score (p < 0.01). CONCLUSIONS: The ultrasound-guided ST technique was more effective at decreasing intraoperative opioid requirements than the blind ITP approach in dogs undergoing unilateral enucleation.

Age-associated changes in electroretinography measures in companion dogs.

PURPOSE: To determine the association between age and retinal full-field electroretinographic (ERG) measures in companion (pet) dogs, an important translational model species for human neurologic aging. METHODS: Healthy adult dogs with no significant ophthalmic abnormalities were included. Unilateral full-field light- and dark-adapted electroretinography was performed using a handheld device, with mydriasis and topical anaesthesia. Partial least squares effect screening analysis was performed to determine the effect of age, sex, body weight and use of anxiolytic medication on log-transformed ERG peak times and amplitudes; age and anxiolytic usage had significant effects on multiple ERG outcomes. Mixed model analysis was performed on data from dogs not receiving anxiolytic medications. RESULTS: In dogs not receiving anxiolytics, median age was 118 months (interquartile range 72-140 months, n = 77, 44 purebred, 33 mixed breed dogs). Age was significantly associated with prolonged peak times of a-waves (dark-adapted 3 and 10 cds/m2 flash p < 0.0001) and b-waves (cone flicker p = 0.03, dark-adapted 0.01 cds/m2 flash p = 0.001). Age was also significantly associated with reduced amplitudes of a-waves (dark-adapted 3 cds/m2 flash p < 0.0001, 10 cds/m2 flash p = 0.005) and b-waves (light-adapted 3 cds/m2 flash p < 0.0001, dark-adapted 0.01 cds/m2 flash p = 0.0004, 3 cds/m2 flash p < 0.0001, 10 cds/m2 flash p = 0.007) and flicker (light-adapted 30 Hz 3 cds/m2 p = 0.0004). Within the Golden Retriever breed, these trends were matched in a cross-sectional analysis of 6 individuals that received no anxiolytic medication. CONCLUSIONS: Aged companion dogs have slower and reduced amplitude responses in both rod- and cone-mediated ERG. Consideration of anxiolytic medication use should be made when conducting ERG studies in dogs.

Sulcus intraocular lens implantation in 17 dogs using a modified ab externo technique.

OBJECTIVE: To describe a modified ab externo method of sulcus intraocular lens (IOL) fixation and report outcomes of eyes treated with this approach. PROCEDURES: Records of patients with lens instability or luxation that underwent a lensectomy and sulcus IOL implantation from January 2004 to December 2020 were reviewed. RESULTS: Nineteen eyes of 17 dogs had a sulcus IOL placed via a modified ab externo approach. The median follow-up time was 546 days (range 29-3387 days). Eight eyes (42.1%) developed POH. A total of six eyes (31.6%) developed glaucoma and required medical management long term to control IOP. The IOL position was satisfactory in most cases. Nine eyes developed superficial corneal ulcers within 4 weeks following surgery, all of which healed without complication. At the time of the last follow-up, 17 eyes were visual (89.5%). CONCLUSIONS: The technique described represents a potentially less technically challenging option for sulcus IOL implantation. The success rate and complications are similar to previously described approaches.

Equine pectinate ligament descemetization is associated with age.

PURPOSE: To evaluate the correlation between equine pectinate ligament descemetization and ocular disease. METHODS: The pathology database of the North Carolina State University Veterinary Medical Center was searched from 2010-2021 for all equine globes. Disease status was then assigned as affected by glaucoma, uveitis, or "other" based upon clinical records. The iridocorneal angles (ICA) of each globe were evaluated for the presence of pectinate ligament descemetization, the length of descemetization, as well as for the degree of angle collapse and the extent of cellular infiltrate or proteinaceous debris. One slide from each eye was evaluated by two separate, blinded investigators (HW & TS). RESULTS: A total of 66 eyes from 61 horses were identified, with a total of 124 sections of ICA of sufficient quality to review. 16 horses were affected by uveitis, 8 by glaucoma, 7 by both glaucoma and uveitis, and 30 horses by other ocular disease, most commonly ocular surface disease or neoplasia, which served as controls. Pectinate ligament descemetization was most prevalent in the control group compared to the glaucoma and uveitis groups. Pectinate ligament descemetization length was positively correlated with age, with an increase of 13.5 µm per year of age (p = .016). Infiltrate scores and angle closure scores were higher in both the glaucoma and uveitis group compared to the control group (p < .001). CONCLUSIONS: Equine pectinate ligament descemetization appears to be correlated with increased age and should not be used as a histologic marker for the presence of glaucoma.

Use of Cognitive Testing, Questionnaires, and Plasma Biomarkers to Quantify Cognitive Impairment in an Aging Pet Dog Population.

BACKGROUND: Aging dogs may suffer from canine cognitive dysfunction syndrome (CCDS), a condition in which cognitive decline is associated with amyloid pathology and cortical atrophy. Presumptive diagnosis is made through physical examination, exclusion of systemic/metabolic conditions, and completion of screening questionnaires by owners. OBJECTIVE: This study aimed to determine whether cognitive function could be quantified in aging pet dogs, and to correlate cognitive testing with validated questionnaires and plasma neurofilament light chain (pNfL) concentration. METHODS: Thirty-nine dogs from fifteen breeds were recruited (9.3 to 15.3 years). Owners completed the Canine Dementia Scale (CADES) and Canine Cognitive Dysfunction Rating scale (CCDR). Executive control and social cues were tested, and pNfL was measured with single molecule array assay. Comparisons were made between cognitive testing scores, CADES, CCDR scores, and pNfL. RESULTS: CADES scoring classified five dogs as severe CCDS, six as moderate, ten as mild, and eighteen as normal. CCDR identified seven dogs at risk of CCDS and thirty-two as normal. Cognitive testing was possible in the majority of dogs, although severely affected dogs were unable to learn tasks. CADES score correlated with sustained attention duration (r = -0.47, p = 0.002), inhibitory control (r = -0.51, p = 0.002), detour (r = -0.43, p = 0.001), and pNfL (r = 0.41, p = 0.025). Concentration of pNfL correlated with inhibitory control (r = -0.7, p≤0.001). The CCDR scale correlated with performance on inhibitory control (r = -0.46, p = 0.005). CONCLUSION: Our findings suggest that a multi-dimensional approach using a combination of questionnaires, specific cognitive tests, and pNfL concentration can be used to quantify cognitive decline in aging pet dogs.

Conservation of a flagship species: Health assessment of the pink land iguana, Conolophus marthae.

The pink land iguana, Conolophus marthae, is one of four species of iguanas (three terrestrial and one marine) in the Galápagos Islands, and the only one listed as critically endangered by the IUCN. The species can only be found on the north-west slopes of the highest volcano on Isabela Island and was first described to science in 2009. As part of a population telemetry study, a health assessment was authorized by the Galápagos National Park. Wild adult iguanas were captured on Wolf Volcano in September 2019 and April 2021 to record morphological and physiological parameters including body temperature, heart rate, intraocular pressures, tear formation, and infrared iris images. Blood samples were also collected and analyzed. An i-STAT portable blood analyzer was used to obtain values for base excess in the extracellular fluid compartment (BEecf), glucose (Glu), hematocrit (HctPCV), hemoglobin (Hb), ionized calcium (iCa), partial pressure of carbon dioxide (pCO2), partial pressure of oxygen (pO2), percent oxygen saturation (sO2%), pH, potassium (K), and sodium (Na). When possible, data were compared to previously published and available data for the other Galápagos iguanas. The results reported here provide baseline values that will be useful in detecting changes in health status among pink land iguanas affected by climate change, invasive species, anthropogenic threats, or natural disturbances. The collected data also provide an invaluable resource for conservation scientists planning to implement conservation strategies, like translocations, that may temporarily alter these baseline values.

Gonioscopic iridocorneal angle morphology and incidence of postoperative ocular hypertension and glaucoma in dogs following cataract surgery.

PURPOSE: To investigate the relationship between gonioscopic iridocorneal angle (ICA) morphology and the incidence of postoperative ocular hypertension (POH) and postoperative glaucoma in dogs undergoing cataract surgery. ANIMALS STUDIED: Retrospective analysis of 138 eyes of 78 canine patients who underwent phacoemulsification at North Carolina State University from December 1, 2015 through April 30, 2017. METHODS: Medical records of all phacoemulsification patients with preoperative RetCam gonioscopic images were reviewed for preoperative, intraoperative, and postoperative variables. Gonioscopic angle indices were calculated using a novel (ZibWest) angle grading system, and these indices were analyzed for outcome-related significance. RESULTS: Increased surgeon experience was associated with increased probability of POH and vision loss. Higher average ZibWest Angle indices (ie, more open angles with less pectinate ligament dysplasia/ abnormality) were associated with a significantly decreased probability of medically unresponsive glaucoma. Increased patient age was significantly associated with an increased probability of both postoperative glaucoma and vision loss. Female dogs were significantly more likely to experience postoperative glaucoma compared to male dogs. Increased surgery time was significantly associated with increased probability of vision loss. CONCLUSIONS: The ZibWest angle index may predict increased risk for developing medically unresponsive glaucoma with cataract surgery. Female sex, and increased patient age, surgical time, and surgeon experience were associated with increased postoperative morbidity.

Glaucoma-associated pain results in mechanical sensitivity changes in dogs: A pilot study.

PURPOSE: To explore the effects of chronic, uncontrolled glaucoma on pressure sensitivity in dogs before and after enucleation of the painful globe. METHODS: Client-owned dogs undergoing enucleation for chronic glaucoma with no other sources of pain were enrolled. Normal dogs of similar breeds and skull morphology were enrolled as controls. Craniofacial ratio (CFR) and relative palpebral fissure width (RPFW) were assessed in all patients. Serial mechanical quantitative sensory testing (QST) was performed the day before surgery, and 14, 30, 60, and 120 days after surgery. QST consisted of electronic Von Frey (eVF), and blunt algometry (BA) performed above and below the nonglaucomatous eye, the metacarpus, and metatarsus. Cochet-Bonnet esthesiometry (CB) was also performed on the remaining eye. RESULTS: Twelve dogs (6 per group) were included. Compared to baseline values, sensitivity tended to decrease over time (increased thresholds) in treatment dogs while it stayed constant or increased slightly in control dogs. The difference in change from baseline sensitivity between control and treatment groups was significant at day 120 using BA at supraorbital (P = .0153), infraorbital (P = .0209), and metacarpal sites (P = .007) and overall (P = .0470). This divergence was also significant using CB (P = .0470) on the opposite cornea. As patient CFR and RPFWV increased, both eVF (P = .005-.023) and BA (P = .004-.041) increased. CONCLUSIONS: Sensitivity to mechanical stimuli decreased both locally and at remote sites in dogs following enucleation for painful chronic glaucoma. Cranial conformation is associated with differences in sensitivity.

Optimizing corneal riboflavin administration in ex vivo horse, dog, rabbit, and pig samples for use in corneal collagen cross-linking.

PURPOSE: Determine optimal iontophoresis times for riboflavin delivery to the corneal stroma across different species and compare these to corneal injection. METHODS: Ex vivo horse, dog, rabbit, and pig globes were treated with riboflavin administered with either iontophoresis for 2.5-20 minutes with or without corneal epithelium; or with purpose-designed precise corneal injection (PCI) application with intact epithelium. Immediately following riboflavin administration, samples were harvested, frozen, and sectioned. Riboflavin penetration was imaged using fluorescence microscopy. RESULTS: Horse samples processed with iontophoresis without epithelium for 2.5, 5, and 7.5 minutes, and processed with intact epithelium for 20 minutes, had mean percent stromal penetration (%SPmean ) of 63.4%, 93.8%, 100.0%, and 0.0% (respectively). Dog samples processed with iontophoresis without epithelium for 2.5 and 5 minutes, had %SPmean of 60.7% and 82.1% (respectively). Pig samples processed with iontophoresis for 5 minutes without and with epithelium had %SPmean of 63.3% and 35.1% (respectively). Rabbit samples processed with iontophoresis without epithelium for 2.5 and 5 minutes, had %SPmean of 81.8% and 100.0% (respectively). For all injected volumes, riboflavin was observed spanning throughout the corneal stroma, and lamellar separation was noted surrounding all sites of injection. CONCLUSIONS: Both iontophoresis and injection via PCI needles provide efficient and effective means of riboflavin administration in ex vivo horse, dog, rabbit, and pig corneas. Epithelial debridement is required for stromal delivery of riboflavin using iontophoresis in horses. Following epithelial removal, riboflavin penetrated through the horse corneal stroma faster than all other species tested.

Suspected Spontaneous Aqueous Humor Misdirection Syndrome in a Boston Terrier.

An eight-year-old female spayed Boston Terrier presented to the North Carolina Veterinary Hospital with glaucoma in the left eye (OS). Initial ophthalmic examination revealed moderate ocular hypertension, a diffusely and markedly shallow anterior chamber with anteriorly displaced iris and lens, vitreal prolapse, and a normal iridocorneal angle (ICA) morphology. The patient displayed a paradoxical response to topical latanoprost with an increase in intraocular pressure. These examination findings led to a putative diagnosis of spontaneous aqueous humor misdirection syndrome (AHMS). The patient was successfully managed with topical carbonic anhydrase inhibitors (CAIs) and apraclonidine for eight months until progressive ulcerative keratitis necessitated enucleation of the affected globe. Histopathology and high-field magnetic resonance imaging (MRI) of the enucleated globe did not identify an underlying cause for the glaucoma. This case suggests that AHMS should be considered in dogs presenting with a shallow anterior chamber, vitreal prolapse, increased intraocular pressure, and no other causes of glaucoma.

Detection of circulating anti-retinal antibodies in dogs with sudden acquired retinal degeneration syndrome using indirect immunofluorescence: A case-control study.

Sudden acquired retinal degeneration syndrome (SARDS) in dogs is proposed to have an immune-mediated etiology. However, there is conflicting evidence regarding the presence of antiretinal antibodies, as assessed by western blotting, in the serum of SARDS patients. Because of the possibility that antibodies recognize only conformational epitopes, we hypothesized that a more sensitive method to investigate circulating retinal autoantibodies in SARDS is immunofluorescence. Sera from 14 dogs with early SARDS, and 14 age- and breed-matched healthy control dogs were screened for circulating antiretinal IgG, IgM, IgE and IgA using indirect immunofluorescence on lightly fixed frozen sections of normal canine retina. Controls without canine serum were also performed. A nuclear counterstain was used to identify cellular retinal layers. Images were obtained using a fluorescence microscope, and 2-3 separate masked observers graded retinal layers for fluorescence staining intensity using a 0-3 scale. Total circulating IgG and IgM was assessed by radial immunodiffusion. Statistical analysis was performed using 2-way ANOVA, paired 2-tailed student's t-test and correlation analysis. Intensity of IgG staining of photoreceptor outer segments was significantly higher using serum from dogs with SARDS compared with healthy controls in 2/3 observers (P < 0.05). Intensity of IgM staining throughout the retina was higher in SARDS dogs compared to matched healthy controls (P < 0.0001), although no specific retinal layer was statistically significant. There were no differences in staining intensity for IgE or IgA. Dogs with SARDS had a comparably lower circulating IgG and higher IgM than healthy controls (P = 0.01 and 0.001 respectively) and IgG and IgM were negatively correlated (r = -0.69, P = 0.007). Despite having decreased serum IgG compared with healthy controls, circulating IgG in dogs with SARDS binds photoreceptor outer segments to a greater extent. Dogs with SARDS have a relatively higher circulating IgM than matched healthy controls. The pathogenic nature of these antibodies is unknown.

A preoperative bupivacaine retrobulbar block offers superior antinociception compared with an intraoperative splash block in dogs undergoing enucleation.

PURPOSE: Investigate nociception differences in dogs undergoing enucleation administered bupivacaine either via preoperative retrobulbar block (pRB) or intraoperative splash block (iSB). METHODS: Prospective, randomized, double-masked, clinical comparison study. Dogs undergoing unilateral enucleation were randomized to two groups: one received bupivacaine pRB and saline iSB of the same volume, and the other received saline pRB and bupivacaine iSB. The following intraoperative parameters were recorded: heart rate (HR), respiratory rate (RR), end-tidal CO2 (EtCO2 ); systolic, mean, and diastolic arterial blood pressure (SAP, MAP, and DAP respectively); inspired end-tidal isoflurane concentration (EtISOIns), and expired end-tidal isoflurane concentration (EtISOExp). Pain scores were recorded pre- and postoperatively. Analgesic rescue was documented. Surgical hemorrhage and postoperative bruising and swelling were graded subjectively by the surgeon (HDW) and study coordinator (AEZ). RESULTS: A significant (P = .0399) increase from baseline in overall mean heart rate was recorded in iSB bupivacaine patients (n = 11) compared with pRB bupivacaine patients (n = 11), with no significant differences in other intraoperative physiologic parameters, or pain scores. More analgesic rescue events occurred in iSB bupivacaine patients compared to pRB bupivacaine patients. A near-significant increase in intraoperative bleeding (P = .0519), and a significant increase in bruising (P = .0382) and swelling (P = .0223) was noted in the iSB bupivacaine group. CONCLUSIONS: Preoperative retrobulbar block bupivacaine is more effective than an iSB bupivacaine at controlling both intraoperative and postoperative nociception in dogs undergoing enucleation. Additionally, iSB causes more postoperative bruising and swelling and may be associated with increased intraoperative hemorrhage.

Effective mydriasis in juvenile loggerhead turtles (Caretta caretta) following topical administration of rocuronium bromide and 10% phenylephrine.

OBJECTIVE: To determine the combined mydriatic effects of topical rocuronium bromide and phenylephrine in juvenile loggerhead turtles and identify any adverse effects associated with treatment. ANIMALS STUDIED: Eleven juvenile loggerhead turtles (Caretta caretta). PROCEDURES: Four 20 µL drops of rocuronium bromide and four 20 µL drops of 10% phenylephrine were placed into the right eye at 2-minute intervals of 5 turtles, while the same volume of saline was administered to six control turtles. A pupilometer recorded pupil measurements at rest and following a light stimulus at 2, 15, 30, 60, 120, 150, 180, 210, 240, 300, and 360 minutes following delivery of the final drop to the ocular surface. Intraocular pressure (IOP) was also measured at similar time points. RESULTS: The nonilluminated and light-stimulated pupillary diameter of the right eye of treated turtles was significantly greater than baseline starting at 120 and 15 minutes, respectively. Light-stimulated pupillary diameter of treated eyes was greater than that of control eyes from time 15 minutes until the end of the treatment period. No systemic side effects were noted over a 24 hours period following treatment and all turtles showed normal behavior and appetite. No mydriasis was noted in either eye at 24 hours and the anterior segment was normal. CONCLUSIONS: A combination of topical ophthalmic rocuronium bromide and 10% phenylephrine is safe and effective for mydriasis in juvenile loggerhead turtles.

In vitro assessment of the long-term stability of the inhibitory effects of canine and feline plasma on MMP 2 and 9.

PURPOSE: To evaluate the effect of increasing storage time on the inhibitory effects of canine and feline plasma on matrix metalloproteinases (MMP) 2 and 9 in vitro. METHODS: Matrix metalloproteinases 2 and 9 activity in the presence of canine plasma stored for 57, 155, 222, 316, 367, and 438 days, and feline plasma stored for 17, 198, 565, and 954 days was assayed using a commercially available colorimetric assay kit. RESULTS: For canine plasma, the MMP 2 activity for older samples was not significantly different than the 57-day sample (P = 0.2025-0.9033). Two canine samples had significantly lower MMP 9 activity than the 57-day sample (367 days: P = 0.0099, 438 days: P = 0.0348, others P = 0.0778-0.9928). For feline plasma, storage time did not significantly affect inhibition of MMP 2 and MMP 9 activity (ANOVA, P = 0.2688 and P = 0.2404, respectively). CONCLUSIONS: Increasing storage time does not significantly decrease the inhibiting activity of plasma on MMP 2 and 9 for up to 14 months in dogs and 31 months in cats.

Ophthalmic lesions in a population of cold-stunned sea turtles (Chelonia mydas, Lepidochelys kempii, Caretta caretta).

OBJECTIVE: To document ocular lesions present in cold-stunned sea turtles and determine the impact of these lesions on their release. ANIMALS: All sea turtles (Caretta caretta, Chelonia mydas, and Lepidochelys kempii) presenting to rehabilitation centers in North Carolina over two cold stun seasons. PROCEDURES: Complete ophthalmic examination using slit-lamp biomicroscopy, fluorescein stain, rebound tonometry, and occasionally binocular indirect funduscopy was performed within 1 week of presenting to the rehabilitation centers. A second examination was performed 2 weeks after the first examination in animals with ocular lesions and still present at the center. RESULTS: One hundred and sixty-four turtles (121 Chelonia mydas, 26 Lepidochelys kempii, 17 Caretta caretta) were evaluated over two cold stun seasons (2016-2017 and 2017-2018). Ocular or periocular lesions were identified in 78 of 164 (47.5%) turtles examined with 37 of 164 (22.5%) having bilateral disease. The most common ocular lesion was superficial corneal ulceration, accounting for 21.3% of all lesions. Adnexal lesions were also common, while intraocular abnormalities were overall rare. Most resolved uneventfully. Though some blinding lesions were noted, these were not present bilaterally in any one turtle, and thus, ocular findings did not affect release. CONCLUSION: Ocular lesions in cold-stunned sea turtles are common. Some of these lesions are potentially blinding or require appropriate care, so evaluation of cold-stunned turtles should include a complete ophthalmic examination.

Use of a Versatile, Inexpensive Ophthalmoscopy Teaching Model in Veterinary Medical Student Education Increases Ophthalmoscopy Proficiency.

Ophthalmoscopy is an important examination technique in the diagnosis of disease. Although it is difficult to learn, practice increases confidence and proficiency. Practicing ophthalmoscopy on live animals presents an additional level of complexity, so we sought to evaluate how students would respond to practicing ophthalmoscopy on an ocular fundus model. We constructed a simple and inexpensive model and allowed half of the students (49/100) in a first-year veterinary medicine class to practice ophthalmoscopy (direct, PanOptic, and indirect) for 20 minutes using the model. Students completed a questionnaire regarding ease of use, enjoyment, and recommendations for future use of the model immediately after the practice session. Six weeks later, we tested students' ability to correctly match a fundus to a photograph using indirect ophthalmoscopy. All students who used the model rated it as 'easy' or 'somewhat easy' to use. All students reported that they 'enjoyed' (93.9%) or 'somewhat enjoyed' (6.1%) using the model. Also, all students who used the model stated the models should continue to be used to aid student learning. Students who used the model were significantly more likely (p = .013) to correctly match a fundus photograph to the fundus being observed than students who had not used the model. These findings demonstrate that the model used in this study is well received by students and results in discernible gains in proficiency.

Phacoemulsification cataract surgery in the loggerhead turtle (Caretta caretta): surgical technique and outcomes in 10 cases.

Cataract removal using phacoemulsification was performed in 10 loggerhead turtles being rehabilitated after stranding. All turtles had significant systemic abnormalities and had cataracts either at the time of rescue or developed them during rehabilitation. Surgical difficulties encountered included an extremely soft globe that did not allow for a partial thickness corneal incision, incomplete topical anesthesia of the ocular surface with proparacaine, inability to dilate the pupil pharmacologically, a markedly shallow anterior chamber, a thick posterior capsular plaque in most cases, and difficulty creating a watertight closure with sutures. Minimal to no intraocular inflammation was seen in all cases following surgery, but all cases in which corneal sutures were used developed a marked inflammatory reaction surrounding the sutures and appeared uncomfortable until sutures were removed or sloughed. All turtles appeared to have improved vision following surgery and were eventually released. Two turtles were re-encountered a year or more after release. Both showed signs of normal growth and the ability to capture prey in the wild. This report documents successful outcomes associated with cataract surgery in loggerhead turtles, but also presents significant surgical challenges that should be taken into account before attempting this procedure in this species.

Safety and efficacy of topically applied 0.5% and 1% pirfenidone in a canine model of subconjunctival fibrosis.

OBJECTIVE: To evaluate tissue levels, safety, and efficacy of topical ophthalmic 0.5% and 1% pirfenidone in decreasing subconjunctival fibrosis. ANIMAL STUDIED: Twelve normal beagle dogs PROCEDURES: A 5 × 1 mm diameter silicone disk was implanted subconjunctivally in one eye, and then dogs were treated with topical 0.5% pirfenidone (n = 9) in artificial tears or artificial tears alone (n = 3) for 28 days. To evaluate tissue drug levels, a single sample of tears, conjunctiva, and aqueous humor was collected 30 (n = 3), 90 (n = 3), and 180 min (n = 3) following administration of the last drop of pirfenidone, respectively. Fibrous capsule thickness and staining for Ki67 and fibroblast activation protein alpha (FAPα) were evaluated histologically. After a 2-week washout, the experiment was repeated in the opposite eye and using 1% pirfenidone. RESULTS: Treatment with pirfenidone resulted in thinner fibrous capsules and decreased staining for FAPα with no adverse effects. The implant in one dog treated with pirfenidone extruded. There was no difference in tissue levels, capsular thickness, or staining for Ki67 or FAPα between dogs treated with 0.5% or 1% pirfenidone. CONCLUSIONS: Pirfenidone may decrease fibrosis following glaucoma shunt surgery and can potentially be used indefinitely due to minimal side effects.

Visual outcome in cats with hypertensive chorioretinopathy.

PURPOSE: To investigate factors associated with long-term visual outcome in cats with hypertensive chorioretinopathy. ANIMALS STUDIED: Eighty-eight client-owned cats diagnosed with hypertensive chorioretinopathy. PROCEDURE: Medical records from cats with systemic hypertension and associated retinal lesions were reviewed. RESULTS: Most cats (61%) were blind in both eyes at presentation. Presence of menace response at last follow-up evaluation was positively correlated with presence of menace response at presentation (P = .0025), time to complete retinal reattachment (P < .0001), and gender (P = .0137). Seventy-six of 132 eyes (57.6%) that were blind at presentation regained some vision following treatment. At the time of last evaluation, 101/176 eyes (60%) had a positive menace response, while 34/46 (74%) eyes with a follow-up of >6 months had a positive menace response. Eyes that had a menace response at presentation were 17 and 37 times more likely to have a menace response at last examination compared to eyes blind for less than 2 weeks and eyes blind greater than 2 weeks, respectively. Female cats were overrepresented (62.5% of cases), and male cats were 4.2 times more likely to be visual at time of last examination compared to female cats. CONCLUSIONS: With treatment, the prognosis for long-term vision in cats with hypertensive chorioretinopathy, even following complete retinal detachment, is good.