Evaluation of conjunctival graft procedures and factors that lead to graft complications in canine cases.

PURPOSE: To describe the complications of conjunctival graft surgery occurring in cases at a referral ophthalmic service and evaluate factors that lead to occurrence of complications in canine cases. METHODS: A retrospective case-control study was completed using data from the Veterinary Medical Center at the Western College of Veterinary Medicine, Saskatoon, Canada, between May 2015 and March 2020. Case records from dogs that underwent conjunctival pedicle graft surgery and subsequently either did or did not develop a conjunctival graft complication were reviewed. RESULTS: One hundred and six dogs undergoing conjunctival graft surgeries were identified. Sixteen conjunctival graft complications occurred, of which, eight led to negative outcomes. Univariable analysis comparing canine eyes that developed complications to control eyes revealed potential (p ≤ .05) differences between the groups in post-operative fluoroquinolone use, Streptococcus canis isolation, intraoperative intravenous cefazolin use, corneal stromal white cell infiltrate, and mean ulcer diameter. The use of intraoperative cefazolin could not be effectively evaluated with available data; however, no dogs (n = 22) receiving intraoperative cefazolin developed complications. Multivariable analysis revealed that dogs that were treated with a second-generation fluoroquinolone and that had S. canis isolated had higher odds of experiencing complications than dogs that were not treated with a second-generation fluoroquinolone and that were S. canis negative (Odds ratio = 64.7 [95% CI 6.3-669], p < .0001). CONCLUSIONS: Streptococcus species played a role in conjunctival graft complications in our study. Empiric selection of second-generation fluoroquinolone monotherapy may need reconsideration given the frequent isolation of Streptococcus spp. from canine ulcers. The use of intraoperative cefazolin may be associated with a lower complication rate.

Phacoemulsification and intraocular lens implantation in a Canada lynx with phacoclastic uveitis.

A 4-year-old male Canada lynx (Lynx canadensis) was referred to the ophthalmology service at the University of Saskatchewan with a 7-month history of cataract and chronic phacoclastic uveitis secondary to penetrating trauma from a lynx claw. Ophthalmic examination of the right eye revealed a corneal scar, marked aqueous flare, extensive fibrovascular membranes extending from the iris to the lens, anterior and posterior synechiae, immature cataract, and anterior vitritis; the fundus was not visible. Phacoemulsification surgery and intraocular lens implantation using a custom lens of D+46 and 14 mm (An-vision, West Jordan, Utah, USA) was performed. Post-operative medications included sub-conjunctival injections of atropine, cefazolin, and triamcinolone, and oral doxycycline and prednisolone. At the 5-month follow-up, the uveitis was controlled, and a normal fundus was visualized; at 21 mo, the eye remained comfortable and visual. This is the first case report to describe phacoemulsification in a wild felid as a treatment for a traumatic cataract and severe phacoclastic uveitis. Key clinical message: Despite chronic phacoclastic uveitis, phacoemulsification surgery can provide a positive outcome for mature wild felids with traumatic lens rupture, even when topical treatment cannot be administered.

Phacoémulsification et implantation de lentilles intraoculaires chez un lynx du Canada atteint d'uvéite phacoclastique. Un lynx du Canada mâle de 4 ans (Lynx canadensis) a été référé au service d'ophtalmologie de l'University of Saskatchewan avec une histoire de 7 mois de cataracte et d'uvéite phacoclastique chronique secondaire à un traumatisme pénétrant d'une griffe de lynx. L'examen ophtalmique de l'oeil droit a révélé une cicatrice cornéenne, un phénomène de Tyndall marqué, des membranes fibrovasculaires étendues s'étendant de l'iris au cristallin, des synéchies antérieure et postérieure, une cataracte immature et une vitreite antérieure; le fond d'oeil n'était pas visible. Une chirurgie de phacoémulsification et une implantation de lentille intraoculaire à l'aide d'une lentille personnalisée de D+46 et 14 mm (An-vision, West Jordan, Utah, USA) ont été réalisées. Les médicaments postopératoires comprenaient des injections sous-conjonctivales d'atropine, de céfazoline et de triamcinolone, ainsi que de la doxycycline et de la prednisolone par voie orale. Au suivi à 5 mois, l'uvéite était contrôlée et un fond d'oeil normal était visualisé; à 21 mois, l'oeil restait confortable et visuel. Il s'agit du premier rapport de cas décrivant la phacoémulsification chez un félin sauvage comme traitement d'une cataracte traumatique et d'une uvéite phacoclastique sévère.Message clinique clé:Malgré l'uvéite phacoclastique chronique, la chirurgie de phacoémulsification peut donner un résultat positif pour les félins sauvages matures présentant une rupture traumatique du cristallin, même lorsqu'un traitement topique ne peut pas être administré.(Traduit par Dr Serge Messier).

In vivo imaging comparison of unilateral circular retinal plaques in retriever dogs to dysplasia and detachment in the English Springer Spaniel.

PURPOSE: To compare the scanning laser ophthalmoscopy (SLO), optical coherence tomography (OCT), and fluorescein angiography (FA) findings in retrievers with a single unilateral circular retinal plaque to those of an English springer spaniel with bilateral retinal dysplasia. PROCEDURES: A retrospective record review identified three dogs with circular retinal plaques that underwent SLO and OCT; in two of the three dogs, FA was also completed. Morphologic changes, lesion measurements, and angiogram characteristics were documented. An English springer spaniel with bilateral retinal dysplasia that had undergone SLO, OCT, and FA was used for comparison. RESULTS: Scanning laser ophthalmoscopy of the retriever dogs revealed circular retinal plaques with a dark periphery located in the tapetal retina. OCT revealed a thickening of the nerve fiber layer corresponding to the circular pattern observed on SLO. Within the circular plaque, the retina was predominantly of normal architecture. FA revealed variable hypofluorescence of both the rim and the center of the circular lesion throughout the early angiogram phases. In the late recirculation phase, small multifocal areas of hyperfluorescence were observed. OCT of geographic retinal dysplasia in the English springer spaniel revealed disorganization of both inner and outer retinal layers, and retinal detachment. CONCLUSIONS: Circular plaques observed in the tapetal retina are predominantly formed by a thickening of inner retina, while retinal dysplasia has disorganization of both inner and outer retinal layers. Further etiologic research is needed, including pedigree mapping to determine whether retinal plaques are an acquired or inherited condition.

Effect of intracameral epinephrine on heart rate, post-operative ocular hypertension, and long-term outcome following canine phacoemulsification.

PURPOSE: To determine the effect of intrsacameral epinephrine on heart rate, blood pressure, post-operative ocular hypertension, and complications following canine phacoemulsification. PROCEDURES: A prospective, double-blinded, controlled trial was carried out using 30 client-owned dogs undergoing phacoemulsification. Eyes were randomly assigned to a treatment group receiving intracameral (IC) epinephrine (n = 31) or balanced salt solution (n = 25) at the beginning of surgery. Heart rate, post-operative intraocular pressures, and outcomes were compared between treatment groups. RESULTS: No adverse reactions to IC epinephrine or saline were observed. Post-operative ocular hypertension developed at the 2 and/or 4 hours pressure reading in 35% and 46% in the epinephrine and saline groups, respectively (P = .5072). There were 9.7% and 23.1% eyes that developed complications in the IC epinephrine and saline groups, respectively (P = .2373). CONCLUSIONS: Intracameral epinephrine is safe to use, and non-significant decreases in post-operative ocular hypertension and long-term complications were observed.

Peripheral cranial neuropathies consistent with cavernous sinus syndrome caused by extracranial nasopharyngeal lymphoma in a cat.

Cavernous sinus syndrome is a unique constellation of cranial nerve deficits occurring typically as a result of pathologic infiltration of the cavernous sinus, which is located in the lateral sellar compartment of the calvarium. This case report describes a polyneuropathy consistent with cavernous sinus syndrome as a result of a lesion outside of the cavernous sinus. The cat was presented with right internal and external ophthalmoplegia, loss of right corneal sensation, inspiratory stridor, dysphagia, dysphonia, tongue weakness, and weight loss. Magnetic resonance imaging identified a large nasopharyngeal mass along the base of, but without extension into, the calvarium. The histologic diagnosis was nasopharyngeal lymphoma. Focal extracranial masses should be considered as differential diagnoses for multiple cranial nerve deficits, including the constellation of clinical signs recognized as cavernous sinus syndrome.

Neuropathies crâniales périphériques compatibles avec un syndrome du sinus caverneux causé par un lymphome nasopharyngé extra-crânial chez un chat. Le syndrome du sinus caverneux est une constellation unique de déficits des nerfs crâniens se produisant typiquement comme le résultat d'une infiltration pathologique du sinus caverneux, qui est situé dans le compartiment sellaire latéral du calvarium. Le présent rapport de cas décrit une polyneuropathie compatible avec un syndrome du sinus caverneux résultant d'une lésion à l'extérieur du sinus caverneux. Le chat fut présenté avec une ophtalmoplégie interne et externe droit, perte de sensation au niveau de la cornée droite, stridor inspiratoire, dysphagie, dysphonie, faiblesse de la langue, et perte de poids. Un examen d'imagerie par résonnance magnétique permis d'identifier une large masse nasopharyngée suivant la base du calvarium, mais sans extension à l'intérieur. Le diagnostic histologique en fut un de lymphome nasopharyngé. Les masses focales extra-crâniales devraient être considérées dans le diagnostic différentiel lors de déficits de plusieurs nerfs crâniens, incluant la multitude de signes cliniques reconnus comme le syndrome du sinus caverneux.(Traduit par Dr Serge Messier).