目的:描述33只接受眼球摘除和眼部组织病理学检查的无菌肉芽肿性全葡萄膜炎综合征的临床和组织病理学特征。
方法:回顾33例患者的病历和眼部组织病理学报告。纳入标准是摘除术结合特征性临床和组织病理学特征。
结果:代表了13个品种(包括杂交品种)。葡萄膜炎是急性和暴发性的,继发性青光眼是常见的(n=27)。从初次就诊到摘除的间隔为99天(中位数为33天,5-605天)。眼球摘除的平均年龄为6.7岁。眼部体征最初为单侧(n=18)或双侧(n=15)。在最初接受单侧摘除的18/25例病例中,该疾病变为双侧疾病,导致9/18的摘除或安乐死(平均间隔168天)。59只眼中的7只眼在局部抗炎和全身免疫抑制治疗后具有良好的结果。从就诊到随访,没有一条狗有旅行史或相关的全身体征(平均619天,范围16-3012天)。组织病理学显示组织细胞和淋巴浆细胞性葡萄膜炎伴色素分散,在光学显微镜上没有发现感染因子。
结论:据作者所知,这是英国首次报道犬的无菌肉芽肿性葡萄膜炎综合征.临床症状很严重,随着快速发展,并可能导致受影响的狗的双侧摘除或安乐死。似乎没有年龄或品种倾向,然而,在这方面需要进一步的研究。早期和积极的干预,局部和全身免疫抑制治疗,建议减少失明的风险,摘除,和安乐死。
OBJECTIVE: To describe the clinical and histopathological features of a sterile
granulomatous panuveitis syndrome in 33 dogs that underwent enucleation and ocular histopathology.
METHODS: Retrospective
review of the medical records and ocular histopathology reports of 33 cases. Inclusion criteria were enucleation in conjunction with characteristic clinical and histopathological features.
RESULTS: Thirteen breeds were represented (including crossbreeds). Panuveitis was acute and fulminating, and secondary glaucoma was common (n = 27). Interval from initial presentation to enucleation was 99 days (median 33 days, range 5-605 days). The mean age at enucleation was 6.7 years. Ocular signs were initially unilateral (n = 18) or bilateral (n = 15). The disease became bilateral in 18/25 cases that initially underwent unilateral enucleation, resulting in enucleation or euthanasia in 9/18 (mean interval of 168 days). Seven out of 59 eyes had a good outcome following topical anti-inflammatory and systemic immunosuppressive therapy. None of the dogs had travel history nor relevant systemic signs from presentation to follow-up (mean 619 days, range 16-3012 days). Histopathology revealed histiocytic and lymphoplasmacytic panuveitis with pigment dispersion, and no infectious agents were identified on light microscopy.
CONCLUSIONS: To the authors\' knowledge, this is the first report of a sterile
granulomatous panuveitis syndrome in dogs in the UK. The clinical signs are severe, with rapid progression, and can result in bilateral enucleation or euthanasia in affected dogs. There does not appear to be an age or breed predisposition, however further research is necessary in this regard. Early and aggressive intervention, with both topical and systemic immunosuppressive therapy, is recommended to reduce the risk of blindness, enucleation, and euthanasia.