目的:评价一例混种犬黄色肉芽肿性角膜炎的临床和组织病理学特征。
方法:混种犬。
■一只11岁的雌性混种狗因轻度眼睑痉挛而出现,角膜混浊,和增加结膜充血OD。眼科检查显示多灶性粉红色和奶油色合并角膜浸润性病变和广泛性新生血管形成,怀疑诊断为基质脓肿。经过1个月的医疗管理没有改善,所以做了角膜切除术,并送角膜组织进行组织病理学评估。
结果:非溃疡性角膜炎对包括局部和全身抗生素在内的药物治疗无效,局部抗真菌药,全身抗炎,所以进行了角膜切除术.黄色肉芽肿性角膜炎的组织病理学诊断为术后1周。患者服用了0.05%二氟泼尼酯眼用乳剂和0.2%他克莫司眼用软膏(最初q8h,OD)。二氟泼尼酯逐渐变细,2个月后停药,但他克莫司仍在继续(q12h,OD)。术后1年无病灶复发记录。
结论:关于犬黄色肉芽肿的报道很少,尤其是在兽医眼科。据报道,眼内和眼表发现了眼部黄色肉芽肿。组织学上,它们的特征是轮廓清晰的结节,含有组织细胞和丰富的脂质巨噬细胞。该临床病例的治疗是手术切除,然后进行局部免疫抑制/抗炎治疗,术后1年无复发。当检查发现非溃疡性角膜炎时,黄色肉芽肿性角膜炎应作为额外的鉴别诊断。特别是在合并的情况下,角膜浸润和轻微的疼痛。
OBJECTIVE: To evaluate the clinical and histopathological features of a case of xanthogranulomatous keratitis in a mixed-breed dog.
METHODS: Mixed-breed dog.
UNASSIGNED: An 11-year-old spayed female mixed-breed dog was presented for mild blepharospasm, corneal cloudiness, and increasing conjunctival hyperemia OD. Ophthalmic examination revealed multifocal pink and cream-colored consolidated corneal infiltrative lesions and generalized neovascularization with suspected diagnosis of stromal abscessation. There was no improvement after 1 month of medical management, so a
keratectomy was performed, and corneal tissue was sent for histopathological evaluation.
RESULTS: The nonulcerative keratitis was refractive to medical management including topical and systemic antibiotics, topical antifungal, and systemic anti-inflammatory, so
keratectomy was performed. Histopathologic diagnosis of xanthogranulomatous keratitis was made 1 week postoperatively. The patient was prescribed 0.05% difluprednate ophthalmic emulsion and 0.2% tacrolimus ophthalmic ointment (initially q 8 h, OD). The difluprednate was tapered and discontinued after 2 months, but the tacrolimus was continued (q 12 h, OD). No lesion recurrence had been documented 1 year postoperatively.
CONCLUSIONS: There has been little published on canine xanthogranulomas, especially in veterinary ophthalmology. Ocular xanthogranulomas have been reportedly found intraocularly and at the ocular surface. Histologically, they are characterized by well-delineated nodules that contain histiocytes and abundant lipid-laden macrophages. The treatment in this clinical case was surgical excision followed with topical immunosuppression/anti-inflammatory therapy with no recurrence 1 year postoperatively. Xanthogranulomatous keratitis should be an added differential diagnosis when nonulcerative keratitis is found on examination, specifically with consolidated, corneal infiltrate and minimal pain.