Bilateral corneal dermoids associated with bilateral choroido-scleral colobomas in a cat: retinographic and optical coherence tomography study with surgical outcome and follow-up.

PURPOSE: To report a case of feline bilateral corneal dermoids, associated with unilateral iris coloboma and bilateral choroido-scleral colobomas in the same dorsolateral position, to describe retinographic and optical coherence tomography (OCT) characteristics, surgical outcome, and follow-up. ANIMAL STUDIED: A 9-month-old domestic shorthaired cat in which a full ophthalmoscopic examination was performed for evaluation of dermoids resulting in a diagnosis of associated iris coloboma in one eye and posterior colobomas in both eyes. PROCEDURES: Retinographies and OCT were performed under anesthesia to characterize the lesions of both fundi and allow surgical excision of the corneal dermoids. RESULTS: Ophthalmoscopy and retinographies revealed oval lesions in the dorsolateral fundi of both eyes. The lesions precisely mirrored their respective dermoids' (10-11 h OD and 1-2 h OS) clock positions, lacked a tapetum lucidum and choroidal vessels, and featured thin retinal vessels plunging to a posterior plane of the fundus. OCT crossline scans demonstrated preservation of retinal thickness and morphological layering in the fundic colobomas leading to the conclusion that the colobomas were purely choroido-scleral. The outcome of the surgical excision of the dermoids was satisfactory without hair recurrence and with acceptable corneal clarity making it possible to visualize the unilateral associated iris coloboma. Follow-ups did not reveal any fundic evolution nor retinal detachment. CONCLUSIONS: Retinographies and OCT made possible the characterization of choroido-scleral colobomas associated with corneal dermoids in this first reported case in a cat. We hypothesize that the recently described superior ocular sulcus might be the embryological link between these anomalies.

Novel insights into chorioretinal and juxtapapillary colobomas by optical coherence tomography.

PURPOSE: The purpose was to describe the in vivo microanatomy of typical and atypical chorioretinal and juxtapapillary colobomas in the dog. METHODS: Three cross-breed dogs were found to be affected with colobomas. Two of the cases were NEHJ1 homozygous and Collie Eye Anomaly (CEA) affected and had the typical optic nerve head colobomas seen with the disease. The third case had an unexpected atypical coloboma. In vivo retinal photography and non-invasive retinal imaging by confocal scanning laser ophthalmoscope (cSLO) and optical coherence tomography (OCT) were done, and the eye affected with the atypical coloboma was collected and processed for histopathological evaluation. RESULTS: The majority of the defining features within the CEA defects were similar, with the extent of change to the choroid being of note. Similar to the first two cases, the atypical coloboma demonstrated absent normal retina, RPE, and choroid within the coloboma. Prominent intercalary membranes and vitreal strands attached to the depth of the coloboma were also apparent in all affected eyes. However, unlike the CEA-associated colobomas, the atypical coloboma possessed normal choroid surrounding the lesion and the depth of the lesion was apparent throughout. CONCLUSIONS: Advanced retinal imaging enables the appreciation of microanatomical changes that occur in the living eye. The ability of OCT to enhance visualization of abnormal retinal structures and detect subtle neurosensory retinal defects has allowed for the in vivo characterization of features observed in typical and atypical colobomas, as well as the appreciation of some of the resulting structural changes not visible by ophthalmoscopy alone.

Use of subdermal hyaluronic acid injections and a free labial mucocutaneous graft for the repair of feline eyelid agenesis.

OBJECTIVE: To describe a technique to repair feline eyelid agenesis using a hyaluronic acid (HA) subdermal filler injection to allow for acute soft tissue expansion, followed by a free labial mucocutaneous graft. MATERIALS AND METHODS: Thirty-nine colobomatous eyelids in 24 feline patients with secondary keratitis were recruited to the study group. RESULTS: Keratitis and trichiasis were markedly resolved in 27/39 (69.2%) eyelids after a single procedure. Post-operative HA subdermal filler injections were required to resolve 5/39 (12.8%) eyelids that had mild post-operative trichiasis, and 1/39 (2.5%) eyelids that had post-operative lateral canthal collapse. Complications occurred in 6/39 (15.4%) cases, consisting of distal graft necrosis (n = 2 eyes), suture rubbing the cornea (n = 2 eyes), moderate trichiasis (n = 1 eye) and graft adherence to the episclera (n = 1 eye). CONCLUSION: The technique was successful in enhancing corneal protection, cosmesis and eyelid function and should be considered as a surgical option for any degree of eyelid agenesis in feline patients.

Optic nerve colobomas associated with unilateral focal serous retinal detachment in a dog - In-vivo imaging and outcome following laser retinopexy.

PURPOSE: To describe the ophthalmoscopic, in-vivo imaging, fluorescein angiography, and therapeutic photocoagulation outcome in a case of bilateral optic nerve colobomas associated with focal unilateral retinal detachment in a dog. METHODS: Pretraining eye examination of a 1.6-year-old female German shepherd service dog showed a focal juxta-papillary bullous retinal separation in the right eye. In vivo imaging and angiography were performed under general anesthesia using optical coherence tomography. Nonoverlapping diode laser burns were applied through an operating microscope adapter to selected areas along the leading margins of the detachment. RESULTS: The funduscopic examination and in-vivo imaging revealed bilateral optic nerve colobomas associated with a focal bullous detachment in the right eye. Fluorescein angiography showed absence of blood vessel leakage and absence of staining inside of the retinal elevation. Photocoagulation induced immediate changes in retinal layer reflectivity. Three months post-photocoagulation, the retinal detachment had improved and scarring of the burns was visible. One and two years post-procedure, the retinal detachment resolved. CONCLUSIONS: Optical coherence tomography (OCT) imaging provides a detailed analysis of the retinal abnormalities associated with the clinical lesion. Laser retinopexy is a valid therapeutic option to limit the extension of the detachment.

Use of free oral mucosal graft for treatment of feline eyelid agenesis in seven patients.

OBJECTIVE: To describe a simple and effective surgery for feline eyelid agenesis. PROCEDURE: Free oral mucosal grafts were harvested from the upper lips of the surgical patients. A recipient bed was created by incising the conjunctiva at the conjunctival-skin border and opening a space in the tissue with blunt dissection without removal of tissue. The free oral mucosal graft was sutured into the space with simple continuous suture pattern of 7-0 Vicryl. RESULTS: Eyelids were cosmetically acceptable at final examination, and areas of coloboma appeared less prominent. Patient comfort was improved in all subjects as subjectively noted by decreased blepharospasm. All grafts were successfully incorporated. All patients developed brown-colored crusting over the grafts within days of the surgery, which gradually resolved over a 4- to 6-week period. Three of seven patients developed few trichiatic hairs at the donor-recipient junction, and two of these patients had follow-up cryoepilation. CONCLUSION: For feline eyelid agenesis, free oral mucosal graft implantation was successful in creating space between fur and cornea with insertion of smooth-surfaced, hairless tissue, alleviating the discomfort of hair contacting the cornea. The extra tissue can also create a small overhang or fold of tissue (pseudo-lid) which may also be protective. For two cases, cryoepilation of few trichiatic hairs at the donor-recipient border was performed at a later date. As illustrated by case 3, use of a long and wide rectangular graft with squared edges is recommended to lessen the chance of trichiasis at lateral or medial edges of recipient-donor junctions.

LIP-TO-LID TRANSPOSITION AND HUSBANDRY MANAGEMENT FOR SEVERE BILATERAL EYELID COLOBOMA IN THREE SNOW LEOPARDS (PANTHERA UNCIA).

Three sibling snow leopard (Panthera uncia) cubs were evaluated shortly after birth and found to have bilateral eyelid colobomas involving >50% of the upper central and lateral lid margins. The cubs also had iris to cornea persistent pupillary membranes and developed varying degrees of keratitis caused by trichiasis and exposure. No fundic abnormalities were noted. Given the severity of the defects an extensive surgical correction was required. Prior to surgical correction, the cubs were separated from the dam daily and a human-animal socialization plan was enacted to prepare the cubs for the intensive postoperative care that would be required. Bilateral lip commissure to eyelid transposition surgeries were performed on one cub at a time at 2 wk intervals starting at 3 mo of age. Postoperative care was labor and time intensive and each cub was maintained at the zoo's veterinary hospital for 11-21 days with daily supervised visits with the cub's siblings. All cubs were successfully reintroduced together and with the dam at the end of each hospitalization. The surgical procedure yielded fully functional eyelids and an excellent cosmetic appearance in all three cubs. The planned consistent human interaction with the cubs before and during the postoperative period made the procedure and its intensive aftercare possible and was crucial to the successful outcome of the surgeries.

Genetic analysis of optic nerve head coloboma in the Nova Scotia Duck Tolling Retriever identifies discordance with the NHEJ1 intronic deletion (collie eye anomaly mutation).

Collie eye anomaly (CEA) encompasses a spectrum of different ophthalmic phenotypes from clinically inconsequential choroidal hypoplasia to blindness from coloboma of the optic nerve head (ONH). A previous study found a 7.8-kb deletion in intron 4 of the NHEJ1 gene to be associated with CEA. A genetic test based on this association is recommended for many breeds, including the Nova Scotia Duck Tolling Retriever (NSDTR). Collection of ONH coloboma-affected NSDTR showed lack of concordance of the NHEJ1 intronic deletion with ONH coloboma. Using genomewide single nucleotide polymorphism (SNP) genotyping in 7 ONH coloboma-affected NSDTR cases and 47 unaffected NSDTR controls with no ophthalmic signs, one SNP, located on chromosome 7, demonstrated genomewide significance. However, high genomic inflation may have confounded the results. Therefore, the genomewide association study was repeated using EMMAX to control for population structure in the cohort of 7 cases and 47 controls. However, no regions of the genome were significantly associated with ONH coloboma. These results failed to document significant association with the CEA locus. Due to the complex genetic etiology of ONH coloboma, the NHEJ1 intronic deletion test results should be carefully considered when making breeding decisions. If the goal is to select for visually competent dogs, our data suggest that eye examinations of puppies would be more effective as a guide in selection of breeding pairs than relying solely on currently available genetic tests.

Atypical chorioretinal coloboma in a Golden Retriever: a retinographic, fluoroangiographic, and optical coherence tomography study.

PURPOSE: To report a case of canine atypical chorioretinal coloboma where ophthalmoscopic, fluoroangiographic and optical coherence tomography characteristics are described. ANIMAL STUDIED: A 2-year-old Golden Retriever dog in which routine ophthalmoscopic examination allowed diagnosis of a posterior coloboma on the left eye. PROCEDURES: Retinography, fluorescein angiography, and optical coherence tomography were performed to characterize the lesion of the left fundus. RESULTS: Ophthalmoscopy revealed a pigmented circumscribed lesion dorsal to the optic nerve of the left fundus, surrounded by small areas of hyper-reflectivity and retinal vessels with an abnormal pattern. Fluoroangiography revealed a constant hypofluorescence of the defect and a complete altered vascular pattern associated with the coloboma. Optical coherence study demonstrated an important craterlike depression showing an atrophic neurosensory retina, and a lack of retinal pigment epithelium and choroidal tissue. CONCLUSIONS: Fluoroangiographic and optical coherence tomographic studies of an atypical chorioretinal coloboma in a dog are reported for the first time. Both imaging techniques are of great importance to characterize this type of congenital defects.

Congenital ocular and adnexal disorders in reptiles.

Ocular and adnexal congenital disorders are those that manifest at birth and could involve single or multiple tissues. Several abnormalities have been reported in literature affecting reptilian ocular and/or adnexal tissues. The objectives of this review are: (i) review those disorders previously reported in reptile literature; (ii) present new cases; (iii) provide a basic classification of them according to the moment of occurrence and (iv) indirectly, encourage the clinician dealing with these cases to go further in their diagnosis. The authors consider that categorizing ocular and adnexal congenital disorders could help the clinician to deal with them. The categorization of these disorders required an intense review of cases previously reported in literature and allows the authors suspect that some of them could not have been accurately diagnosed according to the definitions of the anomalies and/or not accurately described. The authors consider that ocular and adnexal congenital disorders could have been underestimated in reptiles and further studies could be helpful to promote the description of new disorders and to expand the knowledge about those previously reported. The review will first describe abnormalities reported during organogenesis (describing possible etiopathogenesis, cases reported, an approach to their diagnosis and recommended therapeutic options).Then a mention of the ocular disorders occurring after organogenesis is made. These disorders are divided when possible in those affecting all or most part of the globe and those affecting only specific tissues (surface ectoderm, neurocrest and mesenchyma and neuroectoderm).

A novel rapid genotyping technique for Collie eye anomaly: SYBR Green-based real-time polymerase chain reaction method applicable to blood and saliva specimens on Flinders Technology Associates filter paper.

Collie eye anomaly (CEA) is a canine inherited ocular disease that shows a wide variety of manifestations and severity of clinical lesions. Recently, a CEA-associated mutation was reported, and a DNA test that uses conventional polymerase chain reaction (PCR) has now become available. The objective of the current study was to develop a novel rapid genotyping technique by using SYBR Green-based real-time PCR for future large-scale surveys as a key part in the strategy to eradicate CEA by selective breeding. First, a SYBR Green-based real-time PCR assay for genotyping of CEA was developed and evaluated by using purified DNA samples from normal, carrier, and affected Border Collies in which genotypes had previously been determined by conventional PCR. This real-time PCR assay demonstrated appropriate amplifications in all genotypes, and the results were consistent with those of conventional PCR. Second, the availability of Flinders Technology Associates filter paper (FTA card) as DNA templates for the real-time PCR assay was evaluated by using blood and saliva specimens to determine suitability for CEA screening. DNA-containing solution prepared from a disc of blood- or saliva-spotted FTA cards was available directly as templates for the real-time PCR assay when the volume of solution was 2.5% of the PCR mixture. In conclusion, SYBR Green-based real-time PCR combined with FTA cards is a rapid genotyping technique for CEA that can markedly shorten the overall time required for genotyping as well as simplify the sample preparation. Therefore, this newly developed technique suits large-scale screening in breeding populations of Collie-related breeds.

Lip commissure to eyelid transposition for repair of feline eyelid agenesis.

Repair of eyelid agenesis in nine eyes of five cats using a lip commissure to eyelid transposition is described. The procedure is a modification of the technique described by Pavletic for reconstruction of the canine inferior eyelid and provides skin, mucosa, a mucocutaneous junction, and muscle to reconstruct the superior and inferior eyelid and lateral canthus. The technique was successful in all eyes and resulted in improvement in corneal protection, cosmesis and in several cats a return of the palpebral reflex.

Collie Eye Anomaly in Switzerland.

In this retrospective study, the results of 3'527 eye examinations in 6 different breeds affected with Collie Eye Anomaly (CEA) over a period of 8 years (1999 - 2007) are described. CEA was divided into three main ophthalmoscopic features, a) choroidal hypoplasia (CRH), b) CRH and coloboma and c) coloboma alone. Of the 101 Smooth Collies 8.9 % showed signs of CRH, whereas 36.9 % of Rough Collies were affected with CRH, 2.8 % with CRH and coloboma and 0.38 % with coloboma alone. Choroidal hypoplasia was present in 13.1 %, CRH and coloboma in 1.8 % and coloboma alone in 0.2 % of the Shetland Sheepdogs. Only one Australian Shepherd dog had CRH, while 0.7 % of the Border Collies were affected with CRH. None of the Nova Scotia Duck Tolling Retrievers were affected with CEA. There were no statistically significant differences in the occurrence of CEA between males and females, nor was there any relation between coat colors. Significant differences could be shown between dogs younger or older than 8 weeks at first examination. CEA was more often diagnosed in dogs younger than 8 weeks within the Rough Collie and Shetland Sheepdog.

Bilateral typical complete colobomas in a donkey: retinographic and fluorangiographic description.

An 18-year-old male donkey was referred with a history of blindness. On ocular examination a complete bilateral typical colobomatous defect involving iris, ciliary body, lens, choroid, retina and optic nerve was observed. An optic pit was presented at the temporal side of the right optic head. Ophthalmoscopic and fluorangiographic characteristics are described.

Collie eye anomaly in a mixed-breed dog.

A 5-year-old, mixed-breed dog was presented for tetraparesis. Neurologic alterations included a decreased menace response in both eyes. Therefore, an ophthalmic examination was requested. The dog was visual, but menace response, dazzle and pupillary light reflexes were reduced bilaterally. Indirect ophthalmoscopy revealed bilateral optic nerve coloboma and severe choroidal hypoplasia. These lesions closely resembled the ophthalmoscopic features of Collie eye anomaly (CEA). In spite of treatment, the dog's condition worsened and the animal was therefore euthanized. Histology of the globes confirmed severe choroidal hypoplasia and optic disc coloboma in both eyes. The dog was diagnosed to have a lymphoma involving the spinal cord. The two entities were considered not related. As only moderate sight impairment was caused by the posterior segment anomalies, it is by chance that these lesions resembling CEA were found in this mixed-breed dog.

Vascular changes associated with chorioretinal and optic nerve colobomas in rats (Crj: CD(SD), IGS).

OBJECTIVE: Three female adult rats (Crj: CD(SD) IGS) with colobomatous anomalies were investigated. MATERIALS AND METHODS: The microvascular changes of the coloboma were studied using the techniques of fluorescein angiography, histology and scanning electron microscopy (SEM) of vascular corrosion casts. RESULTS: Fluorescein angiography revealed the pits of the optic disk as a dark hole with some abnormalities in vessel arrangement. Light microscopy confirmed the presence of attenuated lamina cribrosa, retinal dysplasia and marked dilation of the retinal veins. SEM revealed that the optic disk coloboma formed a crater-like pit and that central retinal vessels ran a tortuous course along the bottom and side of the crater. Capillaries in the optic nerve head were missing in the affected area. The central retinal veins were thick and had various changes such as strangulation, rough surface structures, mural voids and evaginations, which represent loss of integrity of the vascular wall. CONCLUSIONS: These vascular changes that are associated with colobomatous anomalies may impede the retinal circulation and be responsible for the fluctuating fluorescein pattern during fluorangiogram of affected animals. The lesions of the vascular wall may increase the subretinal fluid due to the leakage of fluid, thus causing the maculopathy or serous retinopathy, which is frequently associated with posterior pole coloboma.

Colobomas of the iris in a flock of rosecomb bantam chickens.

A defect in the pupil shape ofrosecomb bantam chickens was noticed by a breeder. The pupil in affected birds appeared to be elongated at the lower margin and consistent with a coloboma of the iris. Upon examination of all birds in the flock, the defect was found in 26% of females and 9% of males. Examination of breeders older than 1 yr led to the discovery ofcolobomas, although there were not enough birds to accurately determine the prevalence of the problem for previous generations. Affected birds were examined for other lesions, and none were found. Specific-pathogen-free (SPF) eggs were incubated and hatched with eggs from the affected flock as sentinels. No SPF chicks developed colobomas of the iris, while 37% of the bantams in the same hatch were affected. This experiment eliminated many possible infectious agents and incubator or brooder malfunction as causes of this eye lesion. An analysis of the flock pedigree suggested that the defect might be inherited and might be related either to feather color or to gender. No statistically significant correlation could be made between feather color and the iris colobomas. However, the trait was twice as likely to occur in females as in males, which suggests that it is a sex-influenced trait. Based on the determination that this was an inherited trait, a breeding strategy to reduce the prevalence of the lesion in which affected birds were removed from the breeding flock was developed and followed for 2 yr. The prevalence of colobomas was 22% in females and 2.9% in males after the first year and 7.8% and 0.8% in females and males, respectively, after the second year.

Staphyloma in a cat.

A unilateral scleral staphyloma in an 18-month-old, female spayed Domestic Short-haired cat was treated with excision, primary closure and fascial graft. Other ocular abnormalities noted on examination included iris coloboma, anterior cortical cataract, focal lens equator flattening and retinal dysplasia. The staphyloma was presumed to be congenital in origin.

Correction of eyelid coloboma in four cats using subdermal collagen and a modified Stades technique.

Four feline cases of bilateral eyelid coloboma were treated with injectable subdermal collagen and a modified Stades technique. This new technique was found to be easy to perform and the long-term results appear to be similar to other published reports.