- Immunohistochemical evaluation of lymphocyte populations in the nictitans glands of normal dogs and dogs with keratoconjunctivitis sicca. [Journal Article]
- OVOpen Vet J 2018; 8(1):47-52
- Idiopathic canine keratoconjunctivitis sicca (iKCS) is a common condition of the canine eye involving a deficiency in aqueous tear production which is commonly held to have an immune-mediated, as mos...
Idiopathic canine keratoconjunctivitis sicca (iKCS) is a common condition of the canine eye involving a deficiency in aqueous tear production which is commonly held to have an immune-mediated, as most probably an autoimmune aetiopathogenesis. Yet to date no direct evaluation has been made of the inflammatory cell populations in the lacrimal tissue of dogs with iKCS. Here we sought to quantify T and B lymphocyte populations in the lacrimal tissue of the nictitans glands of dogs with iKCS those with neurological KCS (nKCS)and also in dogs with tear production within the recognized normal levels and no ocular surface signs of KCS. Nictitans glands were obtained from 10 healthy dogs with no signs or history consistent with KCS at post-mortem or after enucleation. Nictitans glands were also obtained at parotid duct transposition surgery from ten dogs with idiopathic KCS and three with neurogenic KCS. Histological sections form the lacrimal tissue were processed immunohistochemically with primary monoclonal antibodies recognizing the T lymphocyte CD3 antigen and the B lymphocyte CD79a antigen. Cell numbers were counted in 10 randomly sampled representative high-power fields in five sections. Statistical significance of differences in cell numbers was determined using analysis of variance with significance achieved at p=0.05.Nictitans glands from dogs with iKCS showed elevated numbers of T and B lymphocytes compared with those from dogs with normal tear production. The increase in the T cell population was highly statistically significant (p=0.0025) while the increase in B cells, while statistically significant was less pronouncedly so (p=0.049). T and B lymphocyte numbers were not significantly elevated in nictitans glands from dogs with neurogenic KCS compared with those in dogs with normal tear production. The elevation in the T cell population seen in dogs with idiopathic KCS strongly supports the widely held assumption that this disease is an immune-mediated and probably autoimmune. The lack of increase in T cell populations in dogs with nKCS strongly suggests that the changes in iKCS are causing the tear deficiency and not resulting from it.
- Topical ocular 0.1% cyclosporine A cationic emulsion in dry eye disease patients with severe keratitis: experience through the French early-access program. [Journal Article]
- COClin Ophthalmol 2018; 12:289-299
- CONCLUSIONS: The French ATU cohort provides supportive data on the clinical benefit of CsA CE in improving/stabilizing symptoms and corneal damage in DED patients with severe keratitis in real-world clinical practice.
- Coping with dry eyes: a qualitative approach. [Journal Article]
- BOBMC Ophthalmol 2018 Jan 16; 18(1):8
- CONCLUSIONS: Holistic coping strategies were found to be prominent in dry eye sufferers from these focus groups, and people tend to find personalised ways of coping with the impact of dry eye on daily living.
- Optimising tear replacement rheology in canine keratoconjunctivitis sicca. [Journal Article]
- EEye (Lond) 2018; 32(2):195-199
- Dry eye is a substantial problem in a large number of human and canine patients. Numerous laboratory models for tear deficiency exist using genetically predisposed rodent models, animals treated with...
Dry eye is a substantial problem in a large number of human and canine patients. Numerous laboratory models for tear deficiency exist using genetically predisposed rodent models, animals treated with topical anti-muscarinics, or those kept in environments with increased air flow to produce the ocular surface changes seen in human patients. Canine keratoconjunctivitis sicca, seen in many thousands of dogs kept as companion animals, can provide a valuable spontaneous model for testing tear replacement medications that might better model disease in human patients, existing as it does in an outbred population that live in the same environments as their owners. Here the development of a crosslinked hyaluronic acid topical drop is described together with the results of trials on dogs with spontaneous keratoconjunctivitis sicca. Although hyaluronic acid in its native form in tear replacement drops shows a Newtonian rheology, the crosslinked product described here behaves in a non-Newtonian manner, with the same shear thinning shown by the tear film itself. The crosslinked product thus shows itself as a potentially valuable tear replacement medication for the human dry eye population as well as for dogs with the same condition.
- Epidemiology of ocular disorders presumed to be inherited in three small Italian dog breeds in Italy. [Journal Article]
- VOVet Ophthalmol 2017 Dec 28
- CONCLUSIONS: Clinicians should be aware of KP-HED that commonly affect three small Italian dog breeds. Breed standards should be reconsidered, and breeding programs should be directed at limiting such disorders.
- Noninvasive Electrical Stimulation for the Treatment of Chronic Ocular Pain and Photophobia. [Journal Article]
- NNeuromodulation 2017 Dec 28
- CONCLUSIONS: Our data indicate that TENS may similarly provide analgesia in patients with dry eye symptoms as it does for many other chronic pain conditions. Furthermore, the noted effect on symptoms of photophobia and dryness suggest that all may be linked by similar trigeminal-thalamic-cortical pathways. Prospective studies with electrical stimulation of dry eye are needed to further elucidate its benefit and mechanism of action.
- Use of clinical vignette questionnaires to investigate the variation in management of keratoconjunctivitis sicca and acute glaucoma in dogs. [Journal Article]
- VRVet Rec 2018 Jan 06; 182(1):21
- There is little peer-reviewed research assessing therapeutic effectiveness in canine eye disease. Current treatments used in first opinion and ophthalmology referral practices are also somewhat poorl...
There is little peer-reviewed research assessing therapeutic effectiveness in canine eye disease. Current treatments used in first opinion and ophthalmology referral practices are also somewhat poorly documented. The aim of this study was to investigate the current management of canine keratoconjunctivitis sicca (KCS) and acute primary angle-closure glaucoma (PACG) by veterinary surgeons. Questionnaires using clinical vignettes were administered to a cross section of general practitioners ('GPs') and veterinarians engaged in or training for postgraduate ophthalmology practice ('PGs'). Similar treatment recommendations for KCS (topical cyclosporine, lubricant, antibiotic) were given by both groups of veterinarians with the single exception of increased topical antibiotic use by GPs. Treatment of acute glaucoma diverged between groups: PGs were much more likely to recommend topical prostaglandin analogues and a wider array of both topical and systemic treatments were recommended by both groups. Systemic ocular hypotensive agents were suggested infrequently. Our results suggest that treatments may vary substantially in ocular conditions, particularly in conditions for which neither guidelines nor high-quality evidence exists. This study highlights the need for novel strategies to address evidence gaps in veterinary medicine, as well as for better evaluation and dissemination of current treatment experience.
- StatPearls [BOOK]
- BOOKStatPearls Publishing: Treasure Island (FL)
- Dry eyes, also known as dry eye disease, dry eye syndrome, and keratoconjunctivitis sicca (KCS) is one of the most common reasons for a visit to an eye doctor. The tears have three layers. The innerm...
Dry eyes, also known as dry eye disease, dry eye syndrome, and keratoconjunctivitis sicca (KCS) is one of the most common reasons for a visit to an eye doctor. The tears have three layers. The innermost layer is the mucin layer. The middle layer is the thickest and is the aqueous layer. The outermost layer is the lipid layer.
- Systemic lupus erythematosus and ocular involvement: an overview. [Review]
- CEClin Exp Med 2017 Dec 14
- Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease of undefined etiology and with remarkably heterogeneous clinical features. Virtually any organ system can be affected, including...
Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease of undefined etiology and with remarkably heterogeneous clinical features. Virtually any organ system can be affected, including the eye. SLE-related eye involvement can be diagnosed in approximately one-third of the patients and is usually indicative of disease activity. An early diagnosis and the adoption of suitable therapeutic measures are necessary to prevent sight-threatening consequences, especially in patients with juvenile SLE. Periocular lesions, such as eyelid involvement and orbital inflammation, are relatively rare and, in case of orbital masses, may require a biopsy control. Keratoconjunctivitis sicca or secondary Sjögren's syndrome is the most frequent ophthalmic manifestation of SLE. According to its variable severity, lubricating tear drops may be sufficient in mild cases, whereas cyclosporine-A ophthalmic solution, glucocorticoids (GCs), methotrexate, and/or other immunosuppressive drugs may be required in the more severe cases. Partial occlusion of the lacrimal punctum by thermal cautery is rarely applied. Although uncommon, episcleritis and scleritis can sometimes be detected as an initial finding of SLE and reveal themselves as moderate to intense ocular pain, redness, blurred vision, and lacrimation. Unilateral or more often bilateral retinopathy is responsible for visual loss of variable severity and is ascribed to vasculitis of the retinal capillaries and arterioles. In addition to the combined treatment suitable for all patients with active SLE, intravitreal bevacizumab should be considered in cases of severe vaso-occlusive retinopathy and laser photocoagulation in cases of neovascularization. Purtscher-like retinopathy is likely ascribable to the formation of microemboli that results in retinal vascular occlusion and microvascular infarcts. Choroidal disease is characterized by monolateral or bilateral blurred vision. Because of the choroidal effusion, retinal detachment and secondary angle-closure glaucoma may occur. Ischemic optic neuropathy is characterized by acute-onset and progressive binocular visual impairment as a consequence of occlusion of the small vessels of the optic nerves due to immune complex vasculitis. Intravenous GC boluses followed by oral GCs and/or, in case of recurrence, intravenous cyclophosphamide and/or rituximab are commonly employed. Neovascularization can be treated by intravitreal bevacizumab and progression of retinal ischemic areas by retinal laser photocoagulation. Ocular adverse events (AE) have been described following the long-term administration of one or more of the drugs presently used for the treatment of SLE patients. Posterior subcapsular cataracts and secondary open-angle glaucoma are common AE of the prolonged GC administration. The long-term administration of hydroxychloroquine (HCQ) sulfate is well known to be associated with AE, such as vortex keratopathy and in particular the often irreversible and sight-threatening maculopathy. Length of administration > 5 years, > 1000 g total HCQ consumption, > 6.5 mg/kg daily dosing, coexistence of renal disease, and preexisting maculopathy are all considered risk factors for HCQ-induced retinopathy. Ocular AE of additional immunosuppressive and biological agents are still poorly known, given the worldwide more limited experience with their long-term use. A thorough ophthalmological control is strongly recommended at closer intervals for all SLE patients, in step with the total length of exposure to the drugs and the cumulative dose administered.
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- Are Serum Vitamin D Levels Associated With Dry Eye Disease? Results From the Study Group for Environmental Eye Disease. [Journal Article]
- JPJ Prev Med Public Health 2017; 50(6):369-376
- CONCLUSIONS: The findings of the present study support previous reports that serum vitamin D levels are not associated with DED.