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BSAVA OPHTHO BOOK > Uveal tract > Flashcards

Uveal tract Flashcards

1
Q

Embryology of uvea

A

Derived from mesenchyme (neural crest + mesoderm)
Iris musculature and epithelial layers are from neuroectoderm.
Stoma is from mesoderm.

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2
Q

Choroid layers

A

SUPRACHOROIDEA - pigmented, links to lamina fusca
LARGE VESSELS (vains)
MEDIUM VESSLES
TAPETUM
CHORIOCAPILLARIS
BRUCH’S MEMBRANE - joins with basement membrane of RPE

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3
Q

Difference of colour between two irides

A

Heterochromia iridis

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4
Q

Difference of the colour within the same iris

A

Heterochromia iridum

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5
Q

Merle ocular defects

A

Heterochromia irides, iris hypoplasia, correctional, dyscoria, ppm, colobomas.
Homozygous animals- retinal dysplasia, microphthalmos, ON hypoplasia, cataracts. Deafness.

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6
Q

Notch coloboma

A

At pupillary margin

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7
Q

Pseudopolycoria

A

Multiple colobomatous defects in iris

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8
Q

Anterior segment dysgenesis

A 
ASD. Faulty differetiation of mesenchyme of the anterior segment 
Goniodysgenesis 
PPMs 
Peter's anomaly 
Uveal cyst
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9
Q

Iris atrophy

A

Senile or following trauma, chronic uveitis, glaucoma

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10
Q

Sings of uveitis

A 
Pain-> lacrimation, photophobia, blepharospam
Visual impairment 
Miosis, decreased iop, flare
Swollen iris, loss of detail
Hyperaemia or ciliary injection
Vitreous opacities
Chorioretinitis
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11
Q

Sequelae of uveitis

A 
Chronic pain
Glaucoma>blindness
Corneal oedema/vasc 
Synechiae
Iris bombe 
Iris rest
Iris cyst 
Ectropion uvea
Iris neovasc, colour change,  atrophy
Dyscoria/ immobile pupil
Cataract / lens lux
Vitreous opacities/liquefaction/haemorrhage 
Retinal detachment 
Chorioretinal degeneration/pigment proliferation
Optic neuritis /atrophy
Endophthalmitis/panophthalmitis 
Hydrophthalmos/phthisis bulbi
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12
Q

CAV uveitis

A

1Mild/transient uveitis during acute phase of illness
2 severe keratouveitis 1-3 weeks after inj
Red iop, hypopyon, KPs common
ARThus reaction -> corneal odedema–> keratoglobus or conus or bullous keratopathy
Clears from limbus to the centre
Usually unilateral

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13
Q

Canine herpesvirus uveitis

A

Kerato-uveitis, chirioretinitis and panuveitis in puppies. Neonatal death

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14
Q

Rickestial uveitis

A

Ehrlichia canis (UK - monocytic ehrlichiosis /tropical canine pancytopaenia )
E. platys ( infectious cyclic thrombocytopaenia)
Rickettsia rickettsii (Rocky Mountain ⛰️ spotted 🤒)
VASCULITIS AND THROMBOCUTOPAENIA

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15
Q

Leptospirosis uveitis

A

Number of serovars of diphasic protozoan causing asculitis or endothelitis
Ophth signs : conj, scleratitis, keratitis, kerato-uveitis +u.
Decreases T cell , incr B- cell

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16
Q

Brucellosis

A

May present as low grade uveitis

Zoonotic . Not in UK.

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17
Q

Borreliosis

A

Lime disease
Possibly implicated in uveitis
Lymphadenopathy
Lameness

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18
Q

Fungal uveitis

A 
Imported animals 
Granulomatous or pyogranulomatous 
Blastomycosis 
Coccidio idomycosis 
Cryprococcosis 
Histoplasmosis
Aspergillosis 
Geotrichosis
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19
Q

Toxoplasma uveitis

A

Rare in dogs( concurrent disease present, sometimes chronic or subclinical infection)
Ant / post uveitis, eom, scleritis, ONitis.

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20
Q

Neosorosis

A

Mild uveitis
Ascending paralysis
V young dogs

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21
Q

Migrating heminth larvae

A

Toxocariasis (border collie)
Angiostrongylosis (mild-granul)
Filariasis( D immitis common in N America)

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22
Q

Endophthalmitis

A

Severe introcular inflammation which does not extend beyond the sclera.

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23
Q

Panophthalmitis

A

Severe intraocular inflammation which involves all ocular coats

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24
Q

Breeds predisposed to USD (6)

A 
Chow chow 
Sobering husky 
Samoyed 
Golden retriever 
Shetland 🐑 dog
Japanese Akita
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25
Q

USD

A 
Autoimmune reaction against melanocytes 
Signs: bilateral panuveotis 
Vitiligo (skin depigmentation) 
Poliosos (hair whitening) 
Mucocutaneous involvement

Additionally glaucoma., cataract , retinal detachment

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26
Q

Examination of ocular trauma

A

If eye too painful or intraocular contents lost - GA
Xray if bony damage is suspected
Check periocular region for brusing, contusion, laceration and penetrating injury.
Globe injury
Ultrasound I’d necessary

27
Q

Differentials for hyphaema

A 
Developmental (PHPV/PTVL/hyaloid vessels, RD, CEA) 
Aquired: 
Trauma (blunt, penetrating) 
Uveitis , vasculitis hypertension, hyperviscosity syndrome 
Neoplasia 
Coagulopathies 
Platelet disorders 
Retinal tear or detachment
Chronic glaucoma?
28
Q

Lipid aqueous values

A

Trigliceride rich lipid in ah >25nmol/l
Not associated with raised cholesterol
If chylomicrons are also raised - milky

29
Q

What cases - lipid aqueous

A

Primary chylomicronaemia in Min Schnauzers
Secondary chylomicronaemia
DM

30
Q

Primary Uveal neoplasia

A 
Melanoma 
Adenoma/adenocarcinoma 
Fibrosarcoma 
Leio myo sarcoma 
Haemangioma/haemangiosarcoma 
Medulloepithelioma
31
Q

Secondary uveal neoplasia

A 
Lymphoma, haemangiosarcoma 
Adenocarcinoma, fibrosarcoma, osteosarcoma 
Rhabdo myo sarcoma 
Seminoma/transmissible veneral tumour
Malignant melanoma
32
Q

FIP uveitis

A

Amongst non specific sings like lethargy, anorexis, pyrexia, wight loss and progressive neurological symptoms

AF, KPs, hypopyon, fibrin, vitritis, vasculitis, microhaemorrhages or hyphaema. Chorioretinitis and hyperviscisity syndrome.

33
Q

FeLV

A

Retrovirus
Ocular sings 1) haemorrhage related to anaemia or 2) neoplasia
Uveitis : Immune mediated or non specific to reaction to cellular infiltration

34
Q

Fiv

A

Ocular sings in late ( immunodeficient) stage if infection

Secondary infections and possible association with malignancy

35
Q

Feline mycotic infections

A 
Cryptococcus most common 
Coccidioidomycosis 
Blastomycosis 
Histoplasmosis 
Candidiasis
36
Q

Feline toxoplasmosis 🐈

A

Rare in primary disease but often in secondary chronic toxo
Anterior uveitis
Intermediate uvetitis or pars planitis
Multifocal or generalised chorioretinitis granulomatous or non-
Retinal detachment

37
Q

Origin of spindle cell sarcoma in a cat 🐈 😻 🐈‍⬛️

A

Release of lens epithelium by trauma

Ciliary body Epithelial cells can’t be excluded

38
Q

Feline 🐈 Idiopathic lymphocytic-plasmacytic uveitis

A

Thought to be an example of local immune-mediated disease

39
Q

When optic cup invaginates?

A

Day 19
Forms bilayer medullary epithelium
Inner layer (inner pig iris epith, non-pigmented CB epith, neutosensory retina) and
outer layer ( outer pig. iris epith, pigmented CB epith, RPE)

40
Q

Developmental abnormalities of uvea in dogs 🐕

A

Incomplete development (coloboma)
Maldevelopment ( asd)
Incomplete regression of embriological tissue (PPMs)

41
Q

Cea - choroidal hypoplasia always bilateral, ON coloboma?

A

Not always

42
Q

Ppm most common in ?

A

Cocker spaniel

43
Q

Iris anatomy

A

Pupillary zone , iris collarbone. Ciliary zone.
Iris attaches to sclera by pectinate fibres making up pectinate ligament
Ant border layer
Stroma (dilat/sp)
Epithelium

44
Q

CB anatomy

A

Made up from smooth muscle (para) ct, bv, n. Bilayered epith
Pars plicata/plana
Lens zones from tips and valleys
Uveal part of ICDA

45
Q

Functions of CB

A

Production and drainage of ah. Accommodation

46
Q

Stability of BAB

A

Primate>dog>rabbit

47
Q

BRB

A

Non fenestrated etinal vascular endothelium

Tight junctions between RPE

48
Q

Acaid

A

Anterior chamber associated immune deviation

System trying to supress inflammation

49
Q

When bob breaks down

A

Increased blood flow
Increased permeability
WBC migration

50
Q

Heterochromia iris

A

In the same iris

Associated with Merle gene

51
Q

Merle ocular dysgenesis

A

Excessively white coat with MOD
Often in rough and smooth collies, Australian shepherd, great dane. Old English Sheepdog
Often deaf
Iris hypoplsia/coloboma, dyscoria cataract, microphth RD, retinal detachment)

52
Q

Aniridia gene

53
Q

Mydriasis causes

A

Drug
Oculoplegia
Iris atrophy - pg analogue if not sure
glaucoma

54
Q

Golden retriever uveitis

A 
More common in USA 
Dark iris, rest, multiple cysts. 
46% of eyes get glaucoma 
Poorly understood 
Great Danes sometimes
55
Q

Signs of anterior uveitis

A

Flare, fibrin, KPs, hyphaema, hypopyon(sterile, inf, neo)
Iris colour change (rubeosis iridis cats, darkening dogs)
Miosis
Reduced iop
Corneal oedema

56
Q

How to differentiate low grade uveitis from Horner’s?

A

Phenylephrine test, in uveitis won’t dilate as well , in H will
Conjunctival vessels blanch , deeper vessels won’t

57
Q

Miosis causes

A

Drug pilocarpine, pg analogues
Uveitis
Horner

58
Q

Posterior uveitis

A 
Reduced vision
Choroidal effusion 
Optic neuritis 
Retinal detachment (usually flat) 
Retinal haemorrhage 
Vitreous opacity
59
Q

Sequelae to uveitis

A 
Posterior synachiae 
Ectropion uveae
Iris 💣 
Glaucoma 
Cataracts 🐈 >🐕 
Lens lux  🐈‍⬛️ 
Phthisis bulbi
60
Q

Uveitis causes

A 
Traumatic 
Immune-mediated (LIU, USD)
Infectious  (v, r, b, p, p, f, a)  
Neoplastic (prim, multicen,met, paran) 
Idiopathic 
Breed-related (goldens) 
Ulcerative keratitis 
Drug induced
61
Q

Septic implantation syndrome

A

Lens capsule rupture –> intralenticular organisms>lenticular abscess> Endophthalmitis (10d-1y)

62
Q

Phacolytic LIU

A

Lens protein leak though intact lens capsule > stimulate inflammation
Wose in rapidly forming cataracts

63
Q

Phacoclastic LIU

A

Breach of lens capsule (penetrating trauma/ spontaneous)

64
Q

Wjat bread spontaneous lens capsule rupture in DM?

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