Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases...
Transcript of Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases...
![Page 1: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/1.jpg)
Selected Diseases of the CorneaDick DubielzigJuly 20th, 2009
![Page 2: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/2.jpg)
Canine Collagenolytic Keratitis
![Page 3: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/3.jpg)
Canine Collagenolytic Keratitis270 cases (1.5%)
• Usually associated with suppurative keratitis• Collagenolytic enzymes from neutrophils, bacteria
or native cells• Rapid lysis of the entire stroma• Breeds
– Shih-tzu: 63 cases– Boston Terrier: 29 cases– Pug: 18 cases– Lab & Golden Combined: 14 cases
![Page 4: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/4.jpg)
![Page 5: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/5.jpg)
CanineCollagenolytic
Keratitis
![Page 6: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/6.jpg)
Canine Collagenolytic KeratitisPeracute Lesion
Gram negative bacteria
![Page 7: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/7.jpg)
Corneal Hydrops (Feline)
Associated with a break in Descemet’s membrane and
extreme but transient edema
![Page 8: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/8.jpg)
Equine Mycotic Keratitis82 cases (10% of Equine Cases)
• Superficial vs. Deep presentation• Suppurative inflammation• Lesions poorly vascularized• In deep keratitis, look first in Descemet’s
membrane for fungi
![Page 9: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/9.jpg)
EquineMycoticKeratitis
![Page 10: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/10.jpg)
EquineMycoticKeratitis
![Page 11: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/11.jpg)
Equine Mycotic Keratitis
![Page 12: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/12.jpg)
Superficial Stromal Mycotic Keratitis
![Page 13: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/13.jpg)
Mycotic Keratitis other than Equine
Canine Mycotic Keratitis
![Page 14: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/14.jpg)
Feline Corneal Sequestrum119 Cases = 1.9% of Feline Cases
• Associated with superficial ulcer• The superficial stroma becomes acellular• Desiccation might play a role in sequestrum
formation• Absorbs pigment of unknown chemical
make-up• 25% of cases are in Persian cats
![Page 15: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/15.jpg)
Feline Corneal Sequestrum
![Page 16: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/16.jpg)
Feline Corneal Sequestrum
![Page 17: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/17.jpg)
Feline Corneal Sequestrum
![Page 18: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/18.jpg)
Feline Corneal Sequestrum
![Page 19: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/19.jpg)
Feline Corneal Sequestrum
![Page 20: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/20.jpg)
Feline Corneal Sequestrum
![Page 21: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/21.jpg)
Feline Corneal SequestrumConjunctival
Opportunistic Bacteria
![Page 22: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/22.jpg)
Canine Indolent Ulcer or Recurrent Erosion Syndrome (72 cases)
• 19% of case series in Boxer dogs• Poor epithelial attachment with superficial stromal
acellular zone• Basement membrane is lost but laminin is
overexpressed on the surface• Very commonly seen in enucleated globes as a
secondary phenomenon– Possibly bullous edema
![Page 23: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/23.jpg)
Indolent Ulcer/Recurrent Erosion
![Page 24: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/24.jpg)
Canine Indolent Ulcer
![Page 25: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/25.jpg)
Laminin Immunohistochemistry
![Page 26: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/26.jpg)
Indolent UlcerSequestrum
![Page 27: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/27.jpg)
Canine Indolent Ulcer
![Page 28: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/28.jpg)
The Doubling Phenomenon of Descemet’s Membrane
from Blunt Trauma or Surgical Trauma
Kafarnik C, Murphy CJ, Dubielzig RR (2009) Canine Duplication of Descemet's Membrane. Vet Pathol. 46:464-73
![Page 29: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/29.jpg)
“eye hit with a bottle rocket2 years ago”
25x, H&E
200x, Alcian blue PAS
![Page 30: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/30.jpg)
Electron microscopic findings
![Page 31: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/31.jpg)
Descemetization
600x, Cytokeratin
Cytokeratin
![Page 32: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/32.jpg)
Mechanical Damage to Endothelium
![Page 33: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/33.jpg)
Corneal Squamous Cell Carcinoma in Dogs with a history of
Superficial Chronic Keratitisthat were treated with
Cyclosporin or Tacrolimus•117 cases of canine SCC in the COPLOW collection out of
6984 ocular tumors in dogs•29 cases of corneal SCC in the COPLOW Collection
•9 Pugs and 4 Bulldogs•Only 8 from non-brachyocephalic breeds
•All have pre-existing chronic keratitis•All have been treated with cyclosporin and/or tacrolimus
Dubielzig RR, Schobert CS, Dreyfus J. (2008) Corneal squamous cell carcinoma in dogs with a history of chronic keratitis. ACVO, Boston
![Page 34: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/34.jpg)
Corneal Squamous Cell Carcinomas diagnosed at COPLOW
1 1 1 1 1 10
1
68
7*
0.00%
0.10%0.20%
0.30%0.40%
0.50%
0.60%0.70%
0.80%0.90%
1.00%
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
10
![Page 35: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/35.jpg)
Clinical Appearance of Corneal SCC
![Page 36: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/36.jpg)
Risk Factors
• 21 of 21 had superficial chronic corneal inflammatory disease most often diagnosed as keratoconjunctivitis sicca
• Treatment information– Cyclosporin alone … 10 cases– Tacrolimus alone … 4 cases– Combination of both drugs … 6 cases– Other drugs or unknown … 5 cases
![Page 37: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/37.jpg)
Morphology
Superficial central corneal malignant transformation
![Page 38: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/38.jpg)
Morphology
Superficial keratectomy is adequate treatmentin most cases
![Page 39: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/39.jpg)
Morphology
![Page 40: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/40.jpg)
Follow-up (n = 23)
• Follow-up interval 5 days to 31 months• Only one dog had recurrent disease because
of dirty deep margins
![Page 41: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/41.jpg)
ConclusionsCanine Corneal Squamous Cell Carcinoma
• The number of submissions is increasing• Previous superficial inflammation is a
strong risk factor• The Pug and Bulldog are over-represented• Relationship to cyclosporin &/or tacrolimus• The disease remains superficial and is
treatable with keratectomy
![Page 42: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/42.jpg)
Corneal Protozoal Keratoconjunctivitisin Dogs Treated with
Cyclosporin or Tacrolimus
![Page 43: Selected Diseases of the Cornea Dick Dubielzig July 20 , 2009 · 2019-11-27 · Selected Diseases of the Cornea Dick Dubielzig July 20th, 2009. Canine Collagenolytic Keratitis. Canine](https://reader034.fdocuments.in/reader034/viewer/2022042420/5f38687bee92f516ac3d6d07/html5/thumbnails/43.jpg)
Corneal Protozoal Keratoconjunctivitisin Dogs Treated with
Cyclosporin or Tacrolimus