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S&S > Disorders of the Anterior Uvea > Flashcards

Disorders of the Anterior Uvea Flashcards

1
Q

Iris Function

A

controls the amount of light entering the eye

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2
Q

Function of the blood-aqueous barrier

A

Communication between the eye & the rest of the body – how systemic disease manifests in the eye

COmposed of the posterior iris epithelium, iris vessels, and non-pigmented ciliary body epithelium

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3
Q

Identify the regions of the iris

A
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4
Q

Non-Inflammatory Conditions

What are Persistent Pupillary Membranes (PPM)?

A

Remnants of embryonic iris tissue/blood vessels which supplied nutrients to the developing lens before birth – normally, they are gone by 6 weeks of age

iris to iris, iris to lens, iris to cornea

typically inoccuous

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5
Q

Non-Inflammatory Conditions

Which PPM causes cataracts?

A

Iris to lens

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6
Q

Non-Inflammatory Conditions

Which PPM causes corneal opacities?

A

Iris to cornea

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7
Q

Non-Inflammatory Conditions

Iris Hypoplasia
- definition
- breed disposition

A
  • thinning of the iris tissue
  • Dalmatians (muscle-developmental defect -> pupil cannot constrict or dilate properly)

Differs from iris coloboma, in which the iris fails to develop

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8
Q

Non-Inflammatory Conditions

Iris Coloboma
- definition
- location

A
  • lack of iris tissue due to failure of the iris to develop completely
  • location: 6 o’clock (typical), any other location (atypical)
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9
Q

Non-Inflammatory Conditions

  • Identify
  • locations
  • breed disposition
A
  • Uveal cysts
  • posterior iris epithelium; inner ciliary body epithelium
  • Golden retreivers, labrador retrievers, boston terriers
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10
Q

Non-Inflammatory Conditions

How to differentiate uveal cysts from melanomas?

A

Uveal cysts transilluminate; melanomas will not

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11
Q

Non-Inflammatory Conditions

  • Identify
  • signs
A
  • Iris atrophy (senile issue)
  • age-related thinning of the iris tissue (stroma, pupillary margin)
  • signs: animal may exhibit squinting & sensitivity with bright light
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12
Q

Non-Inflammatory Conditions

  • Identify
  • species
  • ddx
A
  • iris nevus
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13
Q
  • Identify
  • types
  • location
A
  • ## Melanocytic Neoplasia
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14
Q

Uveal Melanoma - Dog
- malignancy
- sequelae?
- breeds?

A

Typically benign; locally invasive -> secondary uveitis & glaucoma
- labrador retrievers, german shepherds

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15
Q
  • Identify
  • Malignancy?
A

Uveal Melanoma - Cats

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16
Q

Signalment and malignancy of uveal melanomas in the horse

A
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17
Q

What are the 3 main treatments for melanocytic neoplasia?

A
  • Diode laser therapy
  • iridectomy
  • enucleation
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18
Q

What additional diagnostics are commonly performed for diagnosing uveal melanoma in cats, and why?

A
  • thoracic rads
  • abdominal u/s
  • FNA of lymph nodes

**b/c they are malignant in cats & can metastasize to the liver and lungs!!

19
Q
  • Identify
  • Malignancy and tx?
  • Signalment?
A

Iridociliary Epithelial Neoplasia
- pink, vascular mass (visible from behind the pupil)
- most common = ciliary body adenoma
- malignancy = locally aggressive -> enucleation
- signalement = middle-to-older-aged animals

20
Q

What is the most common tumor in metastatic neoplasia of the uvea?

A

Lymphoma

21
Q

Anterior uveitis

A

iris + ciliary body

22
Q

Posterior Uveitis

A

Choroid

23
Q

Ocular signs of inflammation

A

Episcleral injection - congestion of deep episcleral vessels (straight branches perpendicular to limbus).

uveitis, glaucoma, scleritis, episcleritis

24
Q

Ocular signs of inflammation

A

Ciliary Flush - dilation of deep conjunctival vessels occurring in a 360º pattern from the limbus (junction of corneal & conjunctival epithelium)

Uveitis, glaucoma

25
Q

Ocular signs of inflammation

What can cause corneal edema?

A

abnormalities of the epithelium or endothelium that allow depositon of fluid into the stroma -> recall that cornea = “sandwich” – hydrophobic/lipophilic outside, hydrophilic inside
- Lack of epithelium (ulcers)
- Endothelial dystrophy / degeneration
- uveitis, glaucoma

26
Q

Ocular signs of inflammation

What causes pupillary constriction and spasming?

A

stimulation of sphincter muscles by inflammatory mediators (prostaglandin)

27
Q

Ocular signs of inflammation

What type of synechiae is most common in uveitis?

A

Posterior // “Iris Bombe” Iris adhesion to the anterior lens or anterior vitreous => prevents outflow of AH from posterior to anterior chambers => increases IOP -> glaucoma

Anterior synechiae = adherence of iris to the cornea

28
Q

Ocular signs of inflammation

Aqueous Flare versus Hypopyon

A

Aqueous Flare: blood-aqueous barrier breaks down => leaky vessels => protein (or lipids) deposit into normally clear aqueous medium of the anterior chamber

Hypopyon: similar to AF but instead the deposition of inflammatory cells into the anterior chamber

Hypopyon - purulent exudate appearance in ventral aspect of AC (that is well-demarcated in horizontal level due to gravity)

blood-aqueous barrier (BAB) is located in the anterior segment of the ciliary body

29
Q

Ocular signs of inflammation

A

Keratic precipitates (deposits of inflammatory cells on the corneal endothelium)

30
Q

Ocular signs of inflammation

Hyphema

A

hemorrhage // accumulation of blood within the eye => associated with vascular disease, severe blunt force trauma, uveitis, systemic hpertension, retinal detachemnt, neoplasia

31
Q

Ocular signs of inflammation

Rubeosis Iridis

A

Neovascularization in the anterior surface of the iris in response to inflammation

32
Q

What complication can chronic hypotony lead to?

A

Phthisis bulbi = shrinking of the eye due to chronic hypotony

33
Q

3 ways uveitis can cause secondary glaucoma:

A
  1. Obstruction of filtration angle by inflammatory debris (hypopyon, hyphema, etc.) => increased IOP => optic n. compression
  2. Pre-Iridal Fibrovascular Membrane forms from expansive neoplasia => occludes the trabecular meshwork @ filtration angle => AH builds up / increased IOP => optic n. compression
  3. Iris bombe + peripheral anterior synechiae => AH can’t outflow from posterior to anterior chamber => AH builds up / increased IOP => optic n. compression
34
Q

Common causes of canine uveitis

A
  1. Phacolytic or phacoclastic uveitis
  2. metabolic (hyperlipidemia)
  3. Infectious / mycoses
  4. idiopathic
  5. Reflex uveitis (Reflex uveitis is a common result of corneal ulceration or abscessation that stimulates corneal nerves, triggering an axonal reflex to release prostaglandins inside the eye)
  6. breed-specific diseases
35
Q

What is Reflex Uveitis?

A

Reflex uveitis is a common result of corneal ulceration or abscessation that stimulates corneal nerves, triggering an axonal reflex to release prostaglandins (=>INFLAMMATION) inside the eye.

36
Q
A

VKH Syndrome // Uveodermatologic Syndrome
- immune-mediated
- depigmentation of facial skin
- akitas, siberian huskies, samoyeds

37
Q

What dog breed is predisposed to pigmentary uveitis?

A

Golden Retrievers – “Golden Retriever Uveitis (GRU)”

38
Q

What two tumors metastasize to the globe?

A

Lymphoma & Carcinomas

39
Q

What causes immune-mediated uveitis in cats?

A

FIP (dry form)

40
Q

Pathogenesis and Sequela of Equine Recurrence Uveitis

A

“Moon Blindness”
- repeated bouts of anterior uveitis => cyclical / severity increases each time
- #1 CAUSE OF BLINDNESS IN HORSES!

3 classifications: classic (cyclical), insidious (ongoing low-grade), and posterior

41
Q

What equine breeds are most affected by Equine Recurrent Uveitis?

A

Appaloosas, Draft breeds, warmbloods, icelandic horses

42
Q

What intial serology tests should you do for cats and dogs with uveitis?

A

Dogs: fungal, tick titers, toxoplasmosis
Cats: fungal, FeLV, FIV, FIP, toxoplasmosis

43
Q

The #1 treatment goal of Uveitis?

A

Identify the underlying cause and treat if possible!

S&S (53 decks)

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