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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?

21
Q

Anterior uveitis

A

iris + ciliary body

22
Q

Posterior Uveitis

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
# Ocular signs of inflammation What can cause corneal edema?
**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
# Ocular signs of inflammation What causes pupillary constriction and spasming?
stimulation of sphincter muscles by inflammatory mediators (prostaglandin)
27
# Ocular signs of inflammation What type of synechiae is most common in uveitis?
**Posterior** // "**Iris Bombe**" Iris adhesion to the anterior lens or anterior vitreous => prevents outflow of AH from posterior to anterior chambers => increases IOP -> glaucoma ## Footnote Anterior synechiae = adherence of iris to the cornea
28
# Ocular signs of inflammation Aqueous Flare versus Hypopyon
**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 ## Footnote **blood-aqueous barrier (*BAB*) is located in the *anterior segment* of the *ciliary body***
29
# Ocular signs of inflammation
**Keratic precipitates** (deposits of inflammatory cells on the corneal *endothelium*)
30
# Ocular signs of inflammation Hyphema
hemorrhage // accumulation of **blood** within the eye => associated with vascular disease, severe blunt force trauma, uveitis, systemic hpertension, retinal detachemnt, neoplasia
31
# Ocular signs of inflammation Rubeosis Iridis
**Neovascularization** in the anterior surface of the iris **in response to inflammation**
32
What complication can chronic **hypotony** lead to?
**Phthisis bulbi** = shrinking of the eye due to chronic hypotony
33
3 ways uveitis can cause **secondary glaucoma**:
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
Common causes of canine uveitis
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
What is Reflex Uveitis?
**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
VKH Syndrome // **Uveodermatologic Syndrome** - immune-mediated - depigmentation of facial skin - akitas, siberian huskies, samoyeds
37
What dog breed is predisposed to **pigmentary uveitis**?
**Golden Retrievers** -- "Golden Retriever Uveitis (GRU)"
38
What two tumors **metastasize** to the globe?
Lymphoma & Carcinomas
39
What causes immune-mediated uveitis in cats?
FIP (dry form)
40
Pathogenesis and Sequela of Equine Recurrence Uveitis
"Moon Blindness" - repeated bouts of **anterior uveitis** => **cyclical / severity increases each time** - #1 CAUSE OF BLINDNESS IN HORSES! ## Footnote 3 classifications: classic (cyclical), insidious (ongoing low-grade), and posterior
41
What equine breeds are most affected by Equine Recurrent Uveitis?
Appaloosas, Draft breeds, warmbloods, icelandic horses
42
What intial serology tests should you do for cats and dogs with uveitis?
Dogs: fungal, tick titers, toxoplasmosis Cats: fungal, FeLV, FIV, FIP, toxoplasmosis
43
The #1 treatment goal of Uveitis?
Identify the underlying cause and treat if possible!

S&S (53 decks)

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