Iatrogenic keratoconjunctivitis sicca in a dog

Anormalidades quali-quantitativas em componentes primários da lágrima podem alterar a dinâmica do filme lacrimal, comprometendo sua função. O filme lacrimal é composto por lipídios, uma fração aquosa e por mucoproteínas. A ceratoconjuntivite seca (CCS) é uma enfermidade freqüentemente diagnosticada em cães, caracterizada pela deficiência da fração aquosa do filme lacrimal, resultando em dessecação e inflamação da conjuntiva e córnea, dor, doença corneana progressiva e redução da visão. Devido à contribuição significativa da glândula da terceira pálpebra na produção da porção aquosa do filme lacrimal, a remoção desta glândula, quando prolapsada, constitui-se em importante causa de CCS iatrogênica. Este trabalho relata um caso clínico de ceratoconjuntivite seca iatrogênica, em um cão da raça Boston Terrier de 10 meses de idade, causada pela remoção cirúrgica da glândula lacrimal da terceira pálpebra, quando esta encontrava-se prolapsada.

Conjunctival effects of canine distemper virus-induced keratoconjunctivitis sicca

Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES)

Detection of Mycoplasma conjunctivae in the eyes of healthy, free-ranging Alpine ibex: possible involvement of Alpine ibex as carriers for the main causing agent of infectious keratoconjunctivitis in wild Caprinae

Mycoplasma conjunctivae is considered the major cause of infectious keratoconjunctivitis (IKC) in Alpine ibex (Capra i. ibex) and chamois (Rupicapra r. rupicapra). While it is known that domestic sheep can act as healthy carriers for M. conjunctivae, this question has not been addressed in wild ungulates so far. In this study, bacteriological investigations and field observations were performed to assess whether free-ranging Alpine ibex can be healthy carriers of M. conjunctivae. Among 136 ibex without clinical signs of IKC, M. conjunctivae was identified 26 times (19.1%) by TaqMan PCR. To assess the potential pathogenicity of M. conjunctivae strains isolated from asymptomatic eyes, strains from three healthy ibex and from 15 IKC-ibex and IKC-chamois were analysed genetically by DNA sequence analysis of the variable part of the lppS gene. No significant differences were observed between strains from asymptomatic and clinically affected animals, reflecting the assumption that healthy ibex may act as carriers for M. conjunctivae strains that may be pathogenic for other individuals. Our results further indicate that development of IKC is associated with M. conjunctivae load in the eyes. In addition, a questionnaire survey revealed that IKC is generally less common in ibex than chamois and that infection in wild ungulates is not necessarily linked to the presence of sheep. These data support the hypothesis that apparently healthy ibex may be important in the epizootiology of IKC and indicate that host predilection may play a role in IKC development.

Occurrence, quantification, and genotyping of Mycoplasma conjunctivae in wild Caprinae with and without infectious keratoconjunctivitis

Mycoplasma conjunctivae, the causative agent of infectious keratoconjunctivitis (IKC), was recently detected in asymptomatic Alpine ibex (Capra ibex ibex). This suggested that an external source of infection may not be required for an IKC outbreak in wildlife but might be initiated by healthy carriers, which contradicted previous serologic investigations in chamois. Our aims were to 1) assess the prevalence of M. conjunctivae among asymptomatic ibex and Alpine chamois (Rupicapra rupicapra rupicapra) and its frequency in IKC-affected animals, 2) determine mycoplasma loads in different disease stages, and 3) characterize the M. conjunctivae strains involved. Eye swabs from 654 asymptomatic and 204 symptomatic animals were collected in diverse Swiss regions between 2008 and 2010, and tested by TaqMan real-time PCR. Data analysis was performed considering various patterns of IKC occurrence in the respective sampling regions. Strains from 24 animals were compared by cluster analysis. Prevalence of M. conjunctivae was 5.6% (95% confidence interval [CI]: 3.7-8.1%) in asymptomatic ibex and 5.8% (CI: 3.0-9.9%) in asymptomatic chamois, with significant differences between years and regions in both species. Detection frequency in symptomatic animals was significantly higher during IKC outbreaks than in nonepidemic situations (i.e., regular but low incidence or sporadic occurrence). Mycoplasma load was significantly lower in eyes from healthy carriers and animals with mild signs than from animals with moderate and severe signs. Although some strains were found in both asymptomatic and diseased animals of the same species, others apparently differed in their pathogenic potential depending on the infected species. Overall, we found a widespread occurrence of M. conjunctivae in wild Caprinae with and without IKC signs. Our results confirm the central role of M. conjunctivae in outbreaks but suggest that other infectious agents may be involved in IKC cases in nonepidemic situations. Additionally, presence and severity of signs are related to the quantity of M. conjunctivae in the eyes rather than to the strain. We propose that individual or environmental factors influence the clinical expression of the disease and that persistence of M. conjunctivae in populations of wild Caprinae cannot be excluded.

Is the development of infectious keratoconjunctivitis in Alpine ibex and Alpine chamois influenced by topographic features?

Infectious keratoconjunctivitis (IKC) caused by Mycoplasma conjunctivae is a widespread ocular affection of free-ranging Caprinae in the Alpine arc. Along with host and pathogen characteristics, it has been hypothesized that environmental factors such as UV light are involved in the onset and course of the disease. This study aimed at evaluating the role of topographic features as predisposing or aggravating factors for IKC in Alpine chamois (Rupicapra rupicapra rupicapra) and Alpine ibex (Capra ibex ibex). Geospatial analysis was performed to assess the effect of aspect (northness) and elevation on the severity of the disease as well as on the mycoplasmal load in the eyes of affected animals, using data from 723 ibex and chamois (583 healthy animals, 105 IKC-affected animals, and 35 asymptomatic carriers of M. conjunctivae), all sampled in the Swiss Alps between 2008 and 2010. An influence of northness was not found, except that ibex with moderate and severe signs of IKC seem to prefer more north-oriented slopes than individuals without corneal lesions, possibly hinting at a sunlight sensitivity consequent to the disease. In contrast, results suggest that elevation influences the disease course in both ibex and chamois, which could be due to altitude-associated environmental conditions such as UV radiation, cold, and dryness. The results of this study support the hypothesis that environmental factors may play a role in the pathogenesis of IKC.

Unilateral pseudogerontoxon

Peripheral corneal opacities are a common clinical finding. In this case report we describe the routine presentation of a young adult male patient with unilateral opacities in the peripheral cornea resembling a corneal arcus. These opacities were confined to the level of the anterior corneal stroma. The patient also exhibited bilateral signs of mild keratoconus and reported a history of vernal keratoconjunctivitis as a child. A diagnosis of unilateral pseudogerontoxon was made. Pseudogerontoxon is an opacity of the peripheral cornea resembling corneal arcus that typically occurs in patients with a history of allergic eye disease. The clinical features and differential diagnoses of this relatively uncommon cause of peripheral corneal opacity are discussed.

Chlamydia

Chlamydial infections of humans can cause blindness and infertility as a result of diseases such as keratoconjunctivitis (trachoma), urethritis and cervicitis. However, in greater than half of all chlamydial diseases in males and females there are no signs or symptoms of infection. Chlamydia trachomatis is the causative bacterial organism responsible for the global estimate of 40.6 million people currently suffering with active trachoma and for the five million new cases of sexually transmitted infections each year in the United States of America. Even though antibiotics are available to treat Chlamydia, the incidence of each of these primarily asymptomatic infections continues to increase. In this Chapter we review the current knowledge of C.trachomatis including clinicial diseases and sequelae, the chlamydial developmental cycle in vivo, immunobiology and immune responses to infections, chlamydial genomics and vaccine development.

Evaluation of the relationship between Chlamydia pecorum sequence types and disease using a species-specific multi-locus sequence typing scheme (MLST)

Chlamydia pecorum is globally associated with several ovine diseases including keratoconjunctivitis and polyarthritis. The exact relationship between the variety of C. pecorum strains reported and the diseases described in sheep remains unclear, challenging efforts to accurately diagnose and manage infected flocks. In the present study, we applied C. pecorum multi-locus sequence typing (MLST) to C. pecorum positive samples collected from sympatric flocks of Australian sheep presenting with conjunctivitis, conjunctivitis with polyarthritis, or polyarthritis only and with no clinical disease (NCD) in order to elucidate the exact relationships between the infecting strains and the range of diseases. Using Bayesian phylogenetic and cluster analyses on 62 C. pecorum positive ocular, vaginal and rectal swab samples from sheep presenting with a range of diseases and in a comparison to C. pecorum sequence types (STs) from other hosts, one ST (ST 23) was recognised as a globally distributed strain associated with ovine and bovine diseases such as polyarthritis and encephalomyelitis. A second ST (ST 69) presently only described in Australian animals, was detected in association with ovine as well as koala chlamydial infections. The majority of vaginal and rectal C. pecorum STs from animals with NCD and/or anatomical sites with no clinical signs of disease in diseased animals, clustered together in a separate group, by both analyses. Furthermore, 8/13 detected STs were novel. This study provides a platform for strain selection for further research into the pathogenic potential of C. pecorum in animals and highlights targets for potential strain-specific diagnostic test development.

Allo-limbal transplantation in patients with limbal stem cell deficiency

Aim - To report the outcome of a series of patients with stem cell deficiency who underwent allo-limbal transplantation and to describe a technique for this procedure. Methods - Six consecutive patients underwent allo-limbal stem cell transplantation. The primary diagnosis included alkali burn (n = 2), trachoma (n = 1), chronic rosacea blepharitis and keratoconjunctivitis (n = 1), aniridia (n = 1), and Stevens-Johnson syndrome (n = 1). The limbal rim consisted of peripheral cornea and perilimbal sclera, FK-506 was used postoperatively for immunosuppression. Results - The length of follow up ranged from 3 to 24 months (mean follow up 11.8 (SD 9.3) months). The outcome was considered satisfactory in five of six cases. The corneal surface was completely epithelialised within 2 weeks, and there was a substantial improvement in vision and symptoms. One patient had recurrent epithelial defects related to eyelid abnormalities. No side effects associated with systemic immunosuppression were noted. Conclusion - Allo-limbal transplantation, with systemic immunosuppression with FK-506 is useful in reconstruction of the ocular surface with improvement in vision in patients with severe stem cell deficiency.

Frecuencia de neoplasia escamosa de la superficie ocular coexistente con pterigio

Introducción: En la literatura, han aparecido reportes de neoplasia escamosa de superficie ocular (NESO) asociado con pterigio en un mismo paciente. Sin embargo, Colombia no cuenta con una estadística para ninguna de estas patologías. Objetivos: Determinar la frecuencia de NESO en pterigios resecados, en la Fundación Oftalmológica Nacional. Identificar factores de riesgo y características clínicas que predispongan a su aparición. Metodología: Estudio descriptivo de corte transversal. Se realizó una clasificación prequirúrgica y estudio histopatológico de los pterigios resecados en 93 pacientes, para confirmar su coexistencia con NESO. Se efectuó un análisis de frecuencias para datos demográficos y factores de riesgo asociados su aparición. Resultados: La frecuencia de NESO asociado a pterigio fue 7,07%. De estos, 28,5% identificados como sospechosos en la evaluación preoperatoria. La mayoría se presentaron en mujeres (71,4%), las ocupaciones con mayor frecuencia: labores domésticas (42,8%) y el comercio (28.5%). La exposición a derivados del petróleo y tabaquismo fue del 14,28%. No se presentaron casos asociados a infección por VIH. No hubo diferencias estadísticamente significativas sobre la presencia de NESO al comparar los casos en edad (p=0,8), procedencia (p=0,6) tabaquismo (p=0,4), leucoplaquia (p=1,0), queratinización (p=0,137), o vasos amputados (p=0,137). Conclusiones: De los pacientes con diagnóstico histopatológico de NESO, un porcentaje mínimo es sospechado clínicamente. Además se encontró este diagnóstico en pacientes más jóvenes que lo reportado en la literatura. Se recomienda realizar estudios con mayor número de pacientes para una mejor identificación de factores de riesgo. Palabras clave:

Transplante de glândulas salivares menores no tratamento da ceratoconjuntivite seca em cães

Relatou-se o efeito do transplante de glândulas salivares menores (TGSM) em cães portadores de ceratoconjuntivite seca (CCS) e estudaram-se os efeitos da secreção dessas glândulas usadas como alternativa de lubrificação ocular. A aplicação da técnica foi satisfatória, uma vez que resultou em melhora no quadro clínico oftalmológico sem que houvesse mínimas intercorrências pós-operatórias.

Ceratoconjuntivite por Encephalitozoon hellem em periquitos agapornis (Agapornis spp.) no Brasil: relato de caso

Relata-se um caso de ceratoconjuntivite causada por Encephalitozoon hellem em agapornis (Agapornis spp.) adultos, provenientes de um criatório comercial. Cinco animais apresentaram sinais clínicos de ceratoconjuntivite, blefaroespasmo e blefaroedema bilateral, com presença de secreção seropurulenta. Amostras fecais foram colhidas e foi realizado exame coproparasitológico, com resultado negativo. Dois animais foram necropsiados, sendo detectados, em impressões de raspado de conjuntiva ocular, esporos e outros estádios evolutivos de Microsporidium. A confirmação do diagnóstico foi feita pela reação em cadeia de polimerase e sequenciamento de fragmentos amplificados, com utilização de primers específicos para o gene da subunidade 18S do rRNA de E. hellem. A análise dos fragmentos amplificados demonstrou 100% de similaridade com outras sequências de E. hellem publicadas no GenBank. Este é primeiro relato de infecção por E. hellem em aves no Brasil.

Microalterations in the third eyelid gland of dogs with keratoconjunctivits sicca secondary to distemper

Analisaram-se, à microscopia óptica, 28 glândulas da terceira pálpebra de cães, que morreram com cinomose. O diagnóstico de ceratoconjuntivite seca baseou-se nas alterações da superfície ocular e no teste da lágrima de Schirmer. À histologia, visibilizaram-se atrofia tubuloacina, espessamento do tecido conjuntivo e exudação inflamatória de leve a intensa com presença de plasmócitos, de histiócitos e por hipertrofia compensatória de algumas glândulas. O lume das glândulas encontrava-se hipertrofiado contendo células epiteliais descamadas, polimorfonucleares e hemácias, além de muco.

Qualitative and quantitative tear film abnormalities in dogs

Anormalidades do filme lacrimal de cães podem ser classificadas quanto ao seu aspecto quantitativo, qualitativo ou ambos, sendo comumente observada na prática cotidiana. Intercorrências na produção de um ou mais componentes do filme lacrimal ensejam distúrbios oculares em graus variados, denominados ceratoconjuntivite seca. Diversas são as causas da ceratoconjuntivite seca em cães, mas a maioria dos casos é de caráter idiopático, estando associada à participação de linfócitos T. O diagnóstico em medicina veterinária é firmado com base nos valores obtidos pelo teste da lacrimal de Schirmer. O presente artigo objetiva revisar os aspectos relacionados à etiopatogenia e ao diagnóstico da ceratoconjuntivite seca em cães, assim como discutir novas modalidades terapêuticas para a doença.

Síndromes oculares secundárias a infecção pelo Herpesvirus felino-1-Revisão

The feline infectious respiratory disease is the most common diagnosed infection in the veterinary clinic routine, being the Feline Herpesvirus1 the most important causal agent. Once infected, the cat will become a lifetime latent carrier, experiencing episodes of viral reactivation and spontaneous spread especially when there is a stress factor involved. This virus acts in the upper respiratory system and is also associated with eye diseases. The diagnosis is made by viral isolation and treatment protocol is based on a topic antiviral therapy, even though many of them are epiteliotoxic and may progress with intense discomfort in felines.The purpose of this paper is to describe the main ocular manifestations and syndromes seen in cats suffering from feline herpesvirus. Conjunctivitis, epithelial and stromal keratitis, corneal ulceration and indolent ulcers are the main ocular manifestations associated with viral infection, whereas symblepharon, keratoconjunctivitis sicca, proliferative keratitis and corneal sequestration are the main eye syndromes that can be observed in infected animals.