Clinical description with magnetic resonance appearance of a high-grade undefined optic nerve glioma with intracranial extension.

A 4-year-old mixed-breed dog was presented for hyphema and glaucoma of the right eye. Enucleation of the right globe was carried out, and histopathology examination revealed an optic nerve glioma with incomplete surgical margins. At 8 wk after surgery, the dog had depressed mentation and a diminished pupillary light reflex of the left eye. Magnetic resonance imaging revealed an irregular, heterogeneously T2 hyperintense/T1 isointense mass in the region of the optic chiasm. Compression of the rostral thalamus was present, with effacement of the pituitary gland and involvement of the right orbit. The dog was euthanized 4.5 mo after initial presentation. An undefined glioma of the right optic nerve with extension to the diencephalon was diagnosed on necropsy. Key clinical message: Although rare, intraocular glioma is a differential diagnosis for hyphema, glaucoma, and retinal detachment. Magnetic resonance imaging should be considered in cases of intraocular neoplasia, notably in those with incomplete surgical margins of the optic nerve.

Description clinique avec aspect en résonance magnétique d'un gliome indéfini de haut grade du nerf optique avec extension intracrânienne. Un chien de race croisé âgé de 4 ans a été présenté pour un hyphéma et un glaucome de l'œil droit. Une énucléation du globe droit a été réalisée et l'examen histopathologique a révélé un gliome du nerf optique aux marges chirurgicales incomplètes. Huit semaines après la chirurgie, le chien avait une diminution du processus mental et un réflexe pupillaire à la lumière diminué de l'œil gauche. L'imagerie par résonance magnétique a révélé une masse irrégulière hétérogène hyperintense T2/T1 isointense dans la région du chiasma optique. Une compression du thalamus rostral était présente, avec effacement de l'hypophyse et atteinte de l'orbite droite. Le chien a été euthanasié 4,5 mois après la présentation initiale. Un gliome indéfini du nerf optique droit avec extension au diencéphale a été diagnostiqué à l'autopsie.Message clinique clé:Bien que rare, le gliome intraoculaire est un diagnostic différentiel pour l'hyphéma, le glaucome et le décollement de la rétine. L'imagerie par résonance magnétique doit être envisagée en cas de néoplasie intraoculaire, notamment chez ceux dont les marges chirurgicales du nerf optique sont incomplètes.(Traduit par Dr Serge Messier).

Feline post-sterilization hyphema.

OBJECTIVE: To determine incidence and risk factors of post-sterilization hyphema in shelter cats. ANIMALS STUDIED: Retrospective medical record review of 1204 cats and prospective screening of 195 cats. PROCEDURES: The study consisted of three parts: (a) Survey responses were collected from 20 veterinarians, who perform high-quality high-volume spay-neuter (HQHVSN) in both shelter and public clinic settings; (b) medical records of 1204 cats were analyzed retrospectively over a 14-month time period; and (c) ophthalmic examinations, including tonometry, were performed prospectively on 195 cats before and after sterilization surgery over 8 weeks. RESULTS: Nine of 20 surveyed veterinarians reported having witnessed hyphema in cats following sterilization surgery. Retrospective review of 1204 medical record and prospective screening of 195 cats showed that three juvenile (<1 year of age) male cats (<2 kg) developed hyphema within 1 hour following surgery (0.2% incidence). In all three affected cats, anesthesia was induced with tiletamine/zolazepam (3 of 523 cats induced with this drug combination; 0.6% incidence), and hyphema resolved within 20 hours. Mean intraocular pressures as measured by Icare® TonoVet were (mean ± standard deviation) 11.5 ± 3.8 mm Hg and 21.7 ± 4.6 mm Hg for juvenile (<1 year of age) and adult (>1 year of age) cats, respectively. CONCLUSIONS: Survey responses and three observed cases confirm the existence of feline post-sterilization hyphema with an estimated incidence of 0.2%. The underlying mechanism for this occurrence remains unknown.

Iris aneurysm in feline hypertensive oculopathy.

OBJECTIVE: To describe and document the prevalence and cause of iris aneurysm in feline hypertensive oculopathy. ANIMALS STUDIED: Privately owned cats with systemic hypertension presented for sudden visual deficits and/or hyphema. PROCEDURES: A retrospective search of medical records of cats with systemic hypertension was performed in a specialized eye practice from October 2001 to August 2016. Inclusion criteria used for further evaluation were (1) systolic blood pressure exceeding 170 mm Hg measured by Doppler ultrasound, (2) typical fundus changes consistent with systemic hypertension (retinal folds, retinal edema, intraretinal bullous fluid accumulation, retinal detachment-partial or total, intra-/preretinal bleeding) in at least one eye, and (3) at least one follow-up visit with documented response to therapy with amlodipine. Cats with bilateral hyphema were excluded. RESULTS: A total of 206 cats fulfilled the inclusion criteria. Twenty-eight cats (14%) showed an aneurysm of the iridal vessels, 21 75% with some amount of hyphema. In total, hyphema was present in 62 cats (30%). Pearson correlation of fundus changes, hyphema, and aneurysm was performed. A high correlation between fundus changes without posterior segment hemorrhage and hyphema was found. The histopathology of one eye showed iridial vascular changes compatible with an aneurysm. In 75 cats, additional blood analysis was performed. Presumed chronic kidney disease (80%) was the most common cause of systemic hypertension with eye disease, followed by hyperthyroidism (20%). CONCLUSION: Vascular changes of the iris compatible with aneurysms were seen in 14% of cats with systemic hypertension and may result in vascular rupture and acute hyphema.

First Report of Acute Bilateral Hyphema in a Theileria equi-Infected Kathiawari Horse.

Theileria equi is a tickborne hemoparasite that can cause severe illness in equids. In this report, we are describing a condition of acute bilateral hyphema in a 4-month-old Kathiawari filly infected with T. equi. The horse showed clinical signs such as fever, lethargy, icterus, tachycardia, tachypnea, and bilateral hyphema. Laboratory diagnosis revealed anemia and thrombocytopenia. Atypical clinical manifestation of bilateral hyphema, to our knowledge, has never been reported so far in equids infected with T. equi. The diagnosis was confirmed by microscopic examination of Geimsa-stained blood smear. Specific and supportive therapy for T. equi allowed remission of clinical signs and laboratory profile abnormalities.

Causes and outcomes of dogs presenting with hyphema to a referral hospital in Colorado: a retrospective analysis of 99 cases.

OBJECTIVE: To investigate the causes of hyphema in dogs and identify factors associated with poor visual outcomes. ANIMALS STUDIED: Ninety-nine dogs (120 eyes) that presented with hyphema. PROCEDURE: Medical records from the Colorado State University Veterinary Teaching Hospital between the years 2004-2015 were reviewed. RESULTS: Overall, 36.4% of dogs were diagnosed with hyphema from systemic causes, 32.9% due to local ocular disease, 26.1% due to trauma, and 4.5% due to idiopathic causes. Regardless of cause, 55.4% of eyes were blind at their last recheck, but the percentage of eyes that lost vision ranged from 11.1 to 100%, depending on the cause. Causes of hyphema with poor outcomes were ocular neoplasia, chronic uveitis, and trauma. Enucleation was performed or recommended in 36 eyes (39.5%), and 27 eyes (31.4%) were diagnosed with glaucoma. Initial exam findings associated with a significantly increased risk of blindness were absent consensual PLR (odds ratio (OR) = 28.6), absent dazzle (OR = 19.4), elevated intraocular pressure (IOP) (OR = 9.1), presence of a retinal detachment (OR = 7.6), unilateral hyphema (OR = 5.8), and complete hyphema (OR = 3.9). Factors associated with a significantly increased risk of glaucoma included hyphema present for 8-30 days (OR > 6), absent consensual PLR (OR = 6.4), absent dazzle (OR = 5.3), and the presence of a retinal detachment at the final evaluation (OR = 5.8). CONCLUSION: Prognosis for vision is highly dependent on the cause of hyphema and initial exam findings. Poor prognostic factors on presentation include absent dazzle, absent consensual PLR, elevated IOP, unilateral hyphema, and complete hyphema.

Ocular localization of mycobacterial lesions in tank-reared juvenile cobia, Rachycentron canadum.

Severe clinical mycobacteriosis with consistent ocular lesion localization was diagnosed in a population of 800 juvenile tank-reared Cobia (Rachycentron canadum) which experienced a sudden increase in mortality approximately 5 months after arriving into Trinidad and Tobago from Florida, USA. Moderate daily mortality (15-20 animals per day) persisted for just over 1 month. Moribund fish displayed circling behaviour and had an open-mouth gape upon death. Fish consistently presented with bilateral exophthalmia, corneal cloudiness and hyphema. Non-branching acid-fast rods were detected in aqueous humour touch preparations. Histological analysis revealed severe bilateral intra-ocular granulomatous responses in all specimens. Mycobacterium sp. was identified using a real-time PCR assay detecting the RNA polymerase ß-subunit (rpoB) gene in different tissue samples. Specimens did not present with characteristic granulomatous responses usually seen in viscera. To the best of our knowledge, this represents only the third documentation of piscine mycobacterial infection presenting with only localized ocular lesions, and the second documented case of mycobacteriosis in cobia. It is, however, the first documentation of an ocular presentation of mycobacteriosis in a marine species and is the first documentation of such a presentation in cobia.

Bilateral Uveitis and Hyphema in a Catalina Macaw (Ara ararauna × Ara macao ) With Multicentric Lymphoma.

A 20-year-old, female Catalina macaw (Ara ararauna × Ara macao ) was presented with bilateral uveitis and hyphema. The hyphema initially improved with 0.12% prednisolone acetate ophthalmic drops (1 drop OU q4h for 7 days), but the hyphema recurred after the drops were tapered. The bird subsequently developed inappetance, weight loss, regurgitation, and lethargy and was euthanatized 24 days after initial presentation. Necropsy revealed marked splenomegaly and hepatomegaly, with significant mucosal ulcerations of the proventriculus and petechiation associated with both kidneys. Histopathologic examination revealed multicentric lymphoma, with neoplastic cells observed in ocular, splenic, hepatic, renal, proventricular, intestinal, pancreatic, and choanal tissue. Neoplastic lymphocytes effaced the iris, ciliary body, and the choroid of the eyes, and neoplastic lymphocytes were attached to the corneal endothelium and infiltrated the sclera, episclera, and conjunctivae. Immunohistochemical results indicated that the neoplastic lymphocytes were CD3(+) and CD79a(-), which is consistent with T-cell lymphoma.

Hyphema: Considerations in the Small Animal Patient.

Classification, diagnosis, and treatment of hemorrhage into the anterior chamber of the eye, or hyphema, can be a challenging and frustrating process for many practitioners, especially in emergency situations. This review outlines an inclusive list of causes, diagnostics, and treatments for traumatic and nontraumatic hyphema in both canine and feline patients. The review is tailored to small animal practitioners, especially in emergency practice, and is designed to provide concise but thorough descriptions on investigating underlying causes of hyphema and treating accordingly.

Canine Secondary Glaucomas.

Secondary glaucomas are common in dogs, and occur due to obstruction of aqueous humor flow at the pupil, iridocorneal angle, or trabecular meshwork by numerous mechanisms. Secondary glaucoma is suspected based on examination findings, or presence of elevated IOP in an animal with a signalment inconsistent with primary glaucoma. Animals with secondary glaucoma require more diagnostic testing than animals with primary glaucoma. Management is challenging, and treatments used for primary glaucoma may be ineffective or even detrimental. Prognosis for vision and/or globe retention may be better than for primary glaucoma, particularly if underlying causes can be found and addressed promptly.

Red eyes in the necropsy floor: twenty cases of hyphema in dogs and cats / Olhos vermelhos na sala de necropsia: vinte casos de hifema em cães e gatos

Hyphema (hemorrhage within the anterior chamber of the eye) can be caused by several mechanisms and can easily be detected in routine ophthalmic or necroscopic examination as discolored red eye(s). The purpose of this study is to report the cause of hyphema diagnosed as a postmortem finding in dogs and cats. Twenty cases, 14 dogs and six cats of several ages and breeds and of both sexes were included in the study. Hyphema presented as a unilateral (14 cases out of 20) or bilateral (6/20) disorder in dogs and cats and extension of hemorrhage varied from minimal to diffuse. Hyphema was secondary to systemic disease (15/20) or occurred as a primary ocular lesion (5/20) in four dogs and one cat. Primary hyphema was always unilateral. In four of these cases, the cause of hyphema was trauma and remaining case was caused by phacoclastic uveitis in a dog with bilateral hypermature cataract. Various causes of bleeding disorders were found related to secondary hyphema: in decreasing order of frequency, they included vasculitis (8/15), systemic hypertension (5/15), and acquired coagulopathies (2/15). Vasculitis due to feline infectious peritonitis accounted for half of the cases (n=3) of systemic hyphema in cats. The various pathological aspects and pathogenesis of hyphema in dogs and cats are described and discussed...

Hifema, hemorragia na câmara anterior do olho, pode ser causada por vários mecanismos e pode facilmente ser detectada no exame oftálmico de rotina ou na necropsia como olho(s) vermelhos(s). O objetivo deste trabalho é relatar as causas de hifema diagnosticado como um achado postmortem em cães e gatos. Vinte casos, 14 cães e seis gatos de várias idades e raças, e de ambos os sexos foram incluídos no estudo. O hifema em cães e gatos teve uma apresentação unilateral (14 casos dos 20) ou bilateral (6/20), e a extensão da hemorragia variou de mínima a difusa. O hifema era secundário à doença sistêmica (15/20) ou ocorreu como lesão ocular primária em cinco dos 20 casos (quatro cães e um gato). O hifema primário foi sempre unilateral; em quatro desses casos, a causa foi traumatismo e o caso restante foi causado por uveíte facoclástica em um cão com catarata hipermadura bilateral. Várias causas de distúrbios hemorrágicos foram encontradas em relação ao hifema secundário: em ordem decrescente de frequência foram: vasculite (8/15), hipertensão sistêmica (5/15) e coagulopatias adquiridas (2/15). Os vários aspectos patológicos e a patogênese do hifema são descritos e discutidos...

Resolution of hyphaema following intracameral injection of tenecteplase in a Stock Horse.

Intracameral injection of tissue plasminogen activator has been suggested as a means of hastening the clearance of blood from the anterior chamber and reducing the risk of synechia and fibrotic membrane formation in horses with hyphaema. The following report describes a case of ocular trauma in which intracameral injection of tenecteplase (TNK), a new-generation plasminogen activator, resulted in rapid resolution of hyphaema and successful outcome. However, a large dose (1 mg) was administered and may have been associated with retinopathy and keratopathy. TNK may be an effective treatment for equine hyphaema and further controlled clinical or experimental studies are required to determine its efficacy and safety profiles.

Effects of intracameral administration of α-chymotrypsin on intracapsular lens extraction and postoperative outcome in clinically normal dogs.

OBJECTIVE: To assess the intraoperative and postoperative clinical effects and histologic effects of intracameral administration of α-chymotrypsin in clinically normal dogs undergoing standard intracapsular lens extraction (ICLE). ANIMALS: 6 young adult male dogs without evidence of systemic or ocular disease. PROCEDURES: All dogs underwent bilateral ICLE 7 minutes following injection of 75 U of α-chymotrypsin or an identical volume (0.5 mL) of a commercially available balanced saline solution (BSS) into the posterior chamber of the eye. Ease of lens extraction was subjectively assessed and intraoperative intraocular hemorrhage and fibrin accumulation scored. For 27 days after surgery, ocular hyperemia and discharge, chemosis, corneal edema, hyphema, and aqueous flare were scored, and intraocular pressure (IOP) was measured. Thirty days after surgery, histologic evidence of anterior synechia, collapse of and inflammation within the iridocorneal angle, and iritis were scored. RESULTS: In 5 of 6 dogs, the surgeon was able to correctly identify the eye treated with α-chymotrypsin on the basis of ease of lens extraction. Mean intraoperative intraocular hemorrhage and fibrin scores for BSS-treated eyes were significantly higher than for α-chymotrypsin-treated eyes. Postoperatively, there were no significant differences between treatments for any clinical variables, including IOP Histologic scores were not significantly different between treatments for any variable. Vision was lost as a result of glaucoma in 1 α-chymotrypsin-treated eye and 1 BSS-treated eye. CONCLUSIONS AND CLINICAL RELEVANCE: Intracameral administration of 75 U of α-chymotrypsin 7 minutes before ICLE facilitated lensectomy without apparent adverse effects in clinically normal dogs.

Secondary acute anterior uveitis with hyphema in a purpose-bred kitten.

The sudden onset of unilateral blepharospasm and hyphema, without evidence of corneal damage, initiated a thorough diagnostic work-up of an 11-wk-old purpose-bred intact male domestic shorthair kitten. Secondary acute anterior uveitis and hyphema were most likely due to trauma within the primary enclosure.

Intraocular osteosarcoma in a dog.

A 10-year-old German shepherd dog was presented with unilateral uveitis and hyphaema. Treatment was unsuccessful and the eye was enucleated. Intraocular osteosarcoma was diagnosed by histological examination.

Clinical resolution of Brucella canis-induced ocular inflammation in a dog.

A 2-year-old spayed female mixed-breed dog was referred with an 8-month history of recurrent bilateral anterior uveitis and hyphema secondary to infection with Brucella canis. Treatment with doxycycline PO and atropine and prednisone acetate topically prior to referral had failed to resolve the ocular inflammation. Successful control of ocular inflammation was achieved after initiation of treatment with gentamicin SC and ciprofloxacin and doxycycline PO. The finite indirect fluorescent antibody (IFA) titer was reduced by half, and results of an agar gel immunodiffusion (AGID) test became negative after rifampin was added to the treatment protocol. Treatment with gentamicin was eventually discontinued because of evidence of renal toxicosis and cutaneous reactions to repeated injections. Thirty-five months after initial examination of the dog, results of the AGID test were still negative, the finite IFA titer was stable, and ocular inflammation had resolved, suggesting that the ocular infection may have been eliminated. To our knowledge, this represents the first report of the successful treatment of ocular inflammation caused by B canis infection in a dog.

Primary ocular osteosarcoma in a dog.

An adult male Rottweiler presented to the veterinary medical teaching hospital at Purdue University with a 1-month history of hyphema. On physical examination conjunctivitis, episcleral hyperemia, corneal edema, hyphema, mild glaucoma and loss of vision were observed in the left eye. No other abnormalities were found. The left globe was surgically removed because of the high likelihood of neoplasia and it was fixed in 10% buffered formalin and submitted for pathology. A histologic diagnosis of primary osteosarcoma of the eye was made. Radiographic evaluation did not reveal any evidence of other tumors or pulmonary metastasis. This is the fourth canine case of primary intraocular osteosarcoma to be documented.

Acute blindness associated with monoclonal gammopathy induced by Ehrlichia canis infection.

Ehrlichia canis infection was diagnosed in a Labrador retriever presented with a primary complaint of acute blindness. Ocular signs on admission included bilateral hyphema, retinal haemorrhage and retinal detachment. Serum protein electrophoresis results revealed monoclonal gammopathy. This report discusses and suggests the pathogenesis of ocular bleeding in canine monocytic ehrlichiosis. Blood hyperviscosity, elevation in oncotic pressure, vasculitis, thrombocytopenia and platelet dysfunction are all proposed to be important factors in the pathogenesis of acute blindness in canine monocytic ehrlichiosis.

Parotid salivary gland adenocarcinoma with bilateral ocular and osseous metastases in a dog.

A case of primary parotid salivary gland adenocarcinoma is described in a three-year-old entire female great dane. The presenting complaint was sudden onset blindness concomitant with the development of bilateral hyphaema and anterior uveitis. A soft-tissue swelling of the left subaural region and right forelimb lameness were also present. A definitive diagnosis of primary parotid salivary gland adenocarcinoma with bilateral ocular metastases was made on post mortem examination. Metastases were also present in the right proximal humerus, left and right prescapular lymph nodes, left axillary lymph node, left retropharyngeal lymph node, bronchial lymph nodes and all lung lobes.