St. Louis, Mo: Saunders, 2006;131-144. Ames, Iowa: Blackwell Publishing, 2007;62-98. Dubey JP, Lappin MR. Toxoplasmosis and neosporosis. Coccidioidomycosis in 48 cats: a retrospective study (1984-1993). Andrew SE. View the eye perpendicular to the light source to evaluate the anterior chamber for flare, cellular accumulation, or changes of the iris face. Breakdown of the blood-aqueous barrier results in increased protein concentration of the aqueous humor, and the resultant turbidity (scattering of light) can be seen on oblique illumination of the anterior chamber. 20. Willis AM. In: Greene CE, ed. St. Louis, Mo: Saunders, 2006;88-102. Primary ocular neoplasms, iris melanoma being the most common,3 do not directly induce uveitis but instead mimic uveitis by producing such changes as tissue necrosis, hemorrhage, and glaucoma.8 Diffuse iridal melanoma is a progressive neoplasm (developing over months to years) that presents as increased pigmentation of the anterior iridal surface (Figure 7).11 Metastasis has been reported in as many as 63% of cases.11 Affected cats should be monitored for the degree of iris and iridocorneal angle involvement, changes in pupillary shape, and the development of increased intraocular pressure as enucleation may be required. Vet Pathol 2003;40(4):355-362. Care and Husbandry. Posterior uveitis is often accompanied by retinal inflammation because of the close anatomical position of the structures.2,3 The breakdown of the blood-ocular barrier located at the retinal blood vessels and the retinal pigment epithelium allows inflammatory cells to migrate to the area and results in chorioretinitis.3 Clinically, edema, exudation, and hemorrhage within the vitreous, retina, and subretinal space may be observed.2,3, Because of the location of the retina and subretinal space over the tapetum, tapetal reflectivity may be diminished or appear gray (Figure 6).2,3 Retinal detachments may also occur secondary to severe inflammation.2 Retinal detachments develop when the neurosensory retina separates from the underlying retinal pigmented epithelium. Toris CB, Pederson JE. For example lymphosarcoma in cats is often manifested as iritis, while uveitis associated with feline AIDS has been associated with pars planitis. Combined with local irritation, these factors often result in poor owner compliance. Brightman AH 2nd, Ogilvie GK, Tompkins M. Ocular disease in FeLV-positive cats: 11 cases (1981-1986). The ciliary body also contains the suspensory ligament and ciliary muscles which support the lens and control its shape and hence its ability to focus images. Uveitis is an inflammation of one or more of the structures making up the uvea. Â© 2020 MJH Life Sciences and DVM 360. Once a specialist has diagnosed your catâ¦ Treatment is initially aimed at reducing inflammation and providing pain relief primarily with topical eye medications such as corticosteroids (prednisolone, dexamethasone) or non-steroidal anti-inflammatory drugs, such as flurbiprofen (brand name Ocufen®). J Am Vet Med Assoc 1992;201(7):1010-1016. A slit lamp photo of a cat with FIP and anterior uveitis. Damage to the uveal tissue or vasculature2,3 causes the release of tissue factors and chemoattractants, resulting in vasodilation and changes in vascular permeability.3 These changes lead to a breakdown of the blood-aqueous barrier or the blood-retinal barrier, allowing protein and cellular accumulation.2. Thatâs why we â¦ Nonspecific therapy of uveitis is needed to minimize ocular inflammation, reduce pain, and prevent complications (see sidebar titled "Nonspecific therapy for uveitis). 40. Common abnormal serum chemistry profile findings include severely elevated serum globulin concentrations, elevated hepatic enzyme activity, and increased BUN and creatinine concentrations.25 Common clinical findings in addition to ocular lesions include ascites, thoracic or pericardial effusion, icterus, diarrhea, and neurologic signs.25 Although ocular lesions can be addressed with nonspecific therapy (see sidebar titled "Nonspecific therapy for uveitis"), systemic treatment is rarely successful but may include immunosuppressive and anti-inflammatory agents and feline interferon-omega.25, FHV-1. Invest Ophthalmol Vis Sci 1987;28(3):477-481. Vet Clin North Am Small Anim Pract 2008;38(2):323-346. 15. 27. Treatment with broad-spectrum oral antibiotics is recommended to reduce the risk of infectious endophthalmitis. Keratic precipitates are also present along the posterior aspect of the cornea inferiorly. Sellon RK, Hartmann K. Feline immunodeficiency virus infection. In the cat, uveitis can be caused by Feline Leukaemia Virus (FIV), Feline Infectious Peritonitis (FIP) with trauma such as cat scratches commonly reported. 1. J Am Vet Med Assoc 1990;196(7):1116-1119. Uveitis can lead to secondary glaucoma because aqueous humor flow through the pupil or out of the iridocorneal angle becomes impaired. Performing a thorough ocular examination that includes systematic evaluation of all ophthalmic structures for possible abnormalities is critical (see DIAGNOSIS).Although no single patient has every potential clinical sign and finding associated with uveitis, the ability to recognize pertinent clues aids in accurate diâ¦ The larger-number diopter lenses make it easier to visualize the fundus when the pupil is small. Maggs DJ, Lappin MR, Nasisse MP. Fontenelle JP, Powell CC, Hill AE, et al. Gunn-Moore DA, Gruffydd-Jones TJ, Harbour DA. ANATOMY AND PATHOPHYSIOLOGY. Thus, this procedure is typically limited to patients that are blind or nearly blind.7 Procedures to acquire aqueous and vitreous humor can carry serious complications since structures within the eye may be inadvertently damaged. Detachments typically occur secondary to the accumulation of blood or exudates between these two layers. Pain is often associated with acute uveitis and is observed clinically as blepharospasm, photophobia, enophthalmos, third eyelid elevation, or epiphora.2,3, Aqueous flare, which is diagnostic of anterior uveitis (Figure 1), occurs secondary to the breakdown of the blood-aqueous barrier and increase in aqueous humor protein concentration.2,3 Purulent material or blood may also accumulate in the anterior chamber, resulting in hypopyon or hyphema, respectively (Figure 2).2, Figure 1. Peiffer RL Jr, Wilcock BP. Infectious diseases of the dog and cat. It is one of the most common parasitic diseases and infects nearly all warm-blooded animals, including pets and humans. The uvea, or vascular tunic of the eye, is composed of the iris and ciliary body anteriorly and the choroid posteriorly. In: Martin CL, ed. Beekhuis WH, McCarey BE. J Feline Med Surg 2008;10(1):41-46. Anterior uvea and anterior chamber. Powell CC, Lappin MR. Essentials of veterinary ophthalmology. Secondary glaucoma has been reported to occur in up to 50% of cats with uveitis secondary to systemic disease.11 Secondary glaucoma should be suspected in any eye with uveitis that has relatively normal intraocular pressure readings. English RV, Nelson P, Johnson CM, et al. ), Pupil dilation with tropicamide ophthalmic solution is required to evaluate the posterior segment. 11. The disease processes that can lead to uveitis, although discussed individually in this article, can occur concurrently in a patient. 29. As such, blood urea nitrogen and serum creatinine concentration monitoring is recommended.37. Cats â¦ Nasisse MP, Guy JS, Davidson MG, et al. Legendre AM. Special diagnostic procedures such as ultrasound may be used to examine the eye, and your veterinarian may recommend a referral to a veterinary ophthalmologist. It is one of the â¦ Blastomycosis in indoor cats: suburban Chicago, Illinois, USA. The image obtained by indirect ophthalmoscopy is less magnified than with direct ophthalmoscopy, but the larger field of view obtained makes it a better method of screening eyes for posterior segment involvement. AAFCO Pet Food â¦ Veterinary ophthalmology. J Am Vet Med Assoc 1991;198(6):1049-1051. A cat with uveitis â¦ Feline uveitis can be caused by numerous infectious agents in addition to neoplasia and less likely trauma. 21. Blouin P, Cello RM. Indirect ophthalmoscopy requires a focal light source (Finnoff transilluminator) and a hand-held lens. 34. Clinical aspects of natural infection with Blastomyces dermatitidis in cats: 8 cases (1991-2005). Morphologic features and development of granulomatous vasculitis in feline infectious peritonitis. An iridal color change is the result of rubeosis iridis, or neovascularization of the iridal surface. 22. Multifocal dark-gray (hyporeflective) lesions are seen scattered throughout the tapetal fundus indicating an active inflammatory process. Feline ophthalmology. A cat with uveitis caused by toxoplasmosis may be infectious to other cats or to people. A patient with lymphosarcoma presenting with hyphema, hypopyon, and dyscoria (an abnormally shaped pupil) in the left eye. Feline infectious peritonitis viruses arise by mutation from endemic feline enteric coronaviruses. Am J Vet Res 2008;69(2):289-293. 26. Hypopyon is also present in the anterior chamber (arrowhead). The uvea is a part of the feline eye and it is in charge with supplying blood to the retina. Horner's syndrome is a common neurological disorder of the eye and facial muscles and can occur suddenly. Note the diffuse, dark-brown color of the iris. Infectious diseases of the dog and cat. Uveitis in cats with FIV is often chronic and protracted in character. Basidiospores of Cryptococcus neoformans cause the disease; the mode of transmission is thought to be inhalation.37 Pigeon droppings serve as the principal reservoir for the yeast.37 Affected cats typically develop respiratory and cutaneous manifestations, but they may also exhibit neurologic signs secondary to direct extension of the organism through the cribriform plate.37 Ocular signs unrelated to neurologic disease are thought to occur secondary to hematogenous dissemination of the organism and include both anterior uveitis and chorioretinitis.37,38 Chorioretinal lesions vary in appearance from single to multifocal and pinpoint opacities to large circular lesions.37, Blastomycosis. Contributors: Ryan Llera, BSc, DVM; Cheryl Yuill, DVM, MSc, CVH, infections; including viral, including feline leukemia (FeLV), feline immunodeficiency virus (FIV), feline infectious peritonitis (FIP), bacterial, parasitic (toxoplasmosis, migrating larvae), or fungal (cryptococcosis, blastomycosis), toxins (typically chemicals or irritants getting onto the eye), immune mediated; particularly autoimmune disease where the cat produces antibodies against its own tissues, lens damage resulting in the leakage of lens protein. Treat secondary glaucoma with carbonic anhydrase inhibitors and beta-blockers to decrease aqueous humor production. Posterior lens luxation secondary to chronic anterior uveitis. Fontenelle JP, Powell CC, Veir JK, et al. A thorough ophthalmic examination is required to diagnose uveitis. On physical examination, rectal temperature and mucous membrane color should be evaluated, and the cat should be examined for ectoparasites, ocular or nasal discharge, and lymphadenopathy in addition to undergoing a thorough thoracic auscultation and abdominal palpation. Infectious Diseases, Medical Conditions, Pet Services. Causes of uveitis in cats include: Feline Leukemia Virus (FeLV), which cannot be spread to people Feline immunodeficiency virus (FIV, also known as feline AIDS), which cannot be spread to â¦ Uveitis is a painful condition, and some cats with uveitis will paw at the sore eye while others will avoid any touch. 45. Four viral diseases in cats have been associated with uveitisâfeline leukemia virus (FeLV) infection, feline immunodeficiency virus (FIV) infection, feline infectious peritonitis (FIP), and feline herpesvirus-1 (FHV-1) infection. Bartonella infection in domestic cats and wild felids. Chomel BB, Kasten RW, Henn JB, et al. Uveitis is a common and painful ocular disease in cats that can e ventually lead to blindness. Comparison of the hypotensive and other ocular effects of prostaglandins E2 and F2 alpha on cat and rhesus monkey eyes. Ocular manifestations of feline herpesvirus. Blondin N, Baumgardner DJ, Moore GE, et al. In: Greene CE, ed. Diffuse iridal melanoma was diagnosed on histologic examination. 3rd ed. Complications are more common after very severe or recurrent cases of uveitis. St. Louis, Mo: Saunders, 2006;575. Feline coronavirus infections. Uveitis is a common and painful ocular disease in cats that can eventually lead to blindness. Current systemic therapy is centered on good husbandry and supportive care, but antiviral chemotherapy and immune modulatory therapy are under investigation.21, FIP. FeLV and lymphosarcoma. In order to assess the initial response to treatment, your veterinarian will need to examine your cat frequently, sometimes daily. Feline intraocular tumors may arise from transformation of lens epithelium. ), Intraocular pressure is often decreased in patients with uveitis because of prostaglandin-mediated inflammation5 and edema of the ciliary body resulting in impaired aqueous humor formation or increased aqueous humor outflow through the uveoscleral route.6, Figure 3. (Photo courtesy of the University of Wisconsin-Madison. Further diagnostic tests may be required if a diagnosis is not made with routine testing. Enucleation or exenteration is the treatment of choice for feline ocular neoplasms, and evaluation for metastasis should occur not only at the time of diagnosis but in the years after enucleation or exenteration.11, Despite a complete ophthalmic examination and systemic work-up, the cause of a patient's uveitis may not be identified. Uveitis is a general term that does not denote any specific underlying etiology.3 The causes of uveitis are numerous and, in part, depend on the catâs geographic location, travel history, â¦ Sometimes there is blepharospasm and increased lacrimation but this is less frequently encountered than in dogs, mainly because uveitis in cats â¦ Feline respiratory disease. Mycopathologia 2007;163(2):59-66. 14. In some cases, histologic evaluation has demonstrated uveal lymphocytic-plasmacytic cellular infiltrates. Bartonella spp infection as a possible cause of uveitis in a cat. If the eye is very cloudy or if hemorrhage has occurred, this may take a few more days to clear. Vet Clin North Am Small Anim Pract 2000;30(5):971-986. Â© 2020 MJH Life Sciencesâ¢ and DVM 360. Powell CC, Lappin MR. The most common neoplastic disease secondary to FeLV infection is lymphosarcoma,17 which is a significant cause of uveitis in cats.19 Clinically, lymphosarcoma manifests as iridal thickening with associated flesh-colored lesions (Figure 8).17 These lesions are most commonly nodular but may be diffuse, with diffuse lesions appearing similar to uveitis secondary to other causes.20 Other ocular findings may include pink vascular corneal masses, hyphema, orbital disease,17 retinal degeneration, and hemorrhage.17,18, Figure 8.
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