OBJECTIVE:To evaluate the accuracy of the TONOVET Plus (TVP) and TONOVET Pro (TVPR) in measuring intraocular pressure (IOP) in ex vivo cynomolgus monkey eyes compared to manometry, and to determine the accuracy of Canine and Lapine calibration modes: ANIMALS STUDIED: Five enucleated eyes from three cynomolgus monkeys. PROCEDURES:The anterior chambers were cannulated to regulate IOP manometrically from 5 to 80 mmHg. Agreement between tonometric and manometric readings was analyzed using a linear mixed-effects model (LMM), Lin's concordance correlation coefficient (CCC), and repeated-measures Bland-Altman analysis. Data points at the 80 mmHg manometric setting were excluded to prevent artificial distortion from the devices' maximum display limits. RESULTS:Strong linear relationships were observed between manometric and tonometric IOPs for all modes. However, the Lapine mode demonstrated proportional overestimation with steeper regression slopes compared to the Canine mode. The Canine mode showed excellent agreement (CCC: 0.967 for TVP, 0.971 for TVPR) with minimal mean bias. In contrast, the Lapine mode exhibited significant positive bias and wider limits of agreement, particularly at higher pressures. CONCLUSIONS:Both TVP and TVPR provided accurate and reliable IOP measurements in cynomolgus monkeys when using the Canine calibration mode. Despite the central corneal thickness of cynomolgus monkeys being closer to that of rabbits, the Lapine mode resulted in significant overestimation and is not recommended. Among the tested settings, the Canine mode provided highly accurate IOP measurements with minimal bias, whereas the Lapine mode significantly overestimated IOP.
A four-year-old female white-bellied caique (Pionites leucogaster) was presented with lens opacification and blindness in the right eye (OD) following a history of head trauma. The left eye (OS) was normal. The bird underwent general anesthesia. Intracameral atracurium was administered to induce pupil dilation. Following corneal incision, ophthalmic viscoelastic devices (OVDs) were injected, and an anterior capsulotomy was performed. The lens material was removed using a manual aspiration and irrigation technique with balanced salt solution. Systemic enrofloxacin and meloxicam were prescribed, along with topical tobramycin. Vision returned postoperatively by Day 1, as indicated by a positive dazzle reflex and third eyelid incursion in response to an approaching stimulus. Transient intraocular hypertension was observed immediately after surgery, but responded well to topical hypotensive medication. At the two-year follow-up, vision remained, as evidenced by accurate landing and normal interaction with her owner and mate. To the best of the authors' knowledge, this is the only report describing successful cataract extraction in the smallest companion bird reported to date, using a manual irrigation and aspiration technique.
OBJECTIVE:This study aimed to identify factors associated with postoperative corneal clarity in dogs undergoing corneal transplantation for deep stromal or perforating corneal defects. ANIMALS STUDIED:A total of 76 dogs (78 eyes) treated surgically for deep stromal or perforating corneal defects were evaluated. METHODS:The medical records of dogs who underwent corneal reconstruction between January 2019 and August 2025, anonymized for review, were retrospectively reviewed. A total of 78 eyes were evaluated; surgical techniques included autologous corneal grafting (23 eyes), corneo-limbo-conjunctival transposition (CLCT; 13 eyes), and xenogeneic corneal grafting (42 eyes). The corneal clarity score (CCS) was used to grade postoperative corneal clarity. Associations between CCS and potential prognostic factors, including the graft type, brachycephalic conformation, corneal perforation, graft size, and bacterial infection, were assessed using the Mann-Whitney U test and logistic regression analysis. RESULTS:Corneal perforations were observed in 31 eyes, with a median graft size of 5 mm. Seven eyes required revision surgery, all of which had previously undergone xenogeneic corneal grafting. Corneal opacities were identified in 71 eyes. The graft type, brachycephalic conformation, graft size, and bacterial infection were not significantly associated with postoperative corneal clarity (p > 0.05). Conversely, corneal perforation was considerably associated with increased graft opacity (p = 0.04). However, no independent predictors of postoperative corneal clarity were identified in the multivariable logistic regression analysis. CONCLUSIONS:Postoperative corneal clarity in dogs is influenced more by disease severity, particularly corneal perforation, than by graft material.
OBJECTIVE:Anions in tears may be related to the pathogenesis of ocular surface diseases. A comprehensive method that can detect small quantities of anions in human tears has been developed. However, the differences in individual anion concentrations between tears and plasma remain unclear. This study investigated anion concentrations in dog tears. METHODS:To compare anion concentrations between tear and plasma samples in canines, 12 eyes of six healthy purpose-bred research Beagles (unneutered males, 3 years old) were investigated. Additionally, the tears of canines with various diseases were examined. PROCEDURE:Anion concentrations were assessed using a commercially available ion chromatography system. For this, at least 10 μL of tears were collected in a glass capillary tube and diluted with 300 μL of distilled water; plasma was obtained by centrifuging collected blood samples, which were then diluted 100-fold before chromatography. RESULTS:Anion concentrations differed significantly between the tears and plasma of Beagles. The average concentrations (mg/L) of anions in tears of Beagles were as follows: Cl-, 5374.06 ± 157.06; Br-, 27.84 ± 1.43; NO3 -, 0.70 ± 0.65; HPO4 2-, 77.54 ± 14.36; and SO4 2-, 16.41 ± 8.17. In plasma, the values were as follows: Cl-, 4603.81 ± 542.52; Br-, 18.34 ± 2.78; NO3 -, 1.31 ± 0.87; HPO4 2-, 83.63 ± 21.04; and SO4 2-, 105.14 ± 21.86. No statistically significant differences in anion concentrations were observed between tears from diseased and non-diseased eyes of canines. CONCLUSIONS:Herein, we observed that certain anions, such as Br- and Cl-, were consistently elevated in tear fluid than in the plasma.
PURPOSE:To investigate risk factors for delayed healing, corneal sequestration, or corneal stromal vascularization in cases of spontaneous superficial feline ulcerative keratitis. METHODS:A retrospective review was performed of 71 corneal ulcers in 68 cats. Patient factors, medications, treatments and time until first recheck were each assessed to determine relationships with delayed ulcer healing (> 1 SD above mean healing time), corneal sequestration, or corneal stromal vascularization after ulcer healing. RESULTS:Delayed healing (8/71; 11.3%), corneal sequestration (20/71; 28.2%) and corneal stromal vascularization after ulcer healing (9/71; 12.7%) occurred commonly. Corneal ulcers were significantly more likely to experience delayed healing if chemosis was initially present (p = 0.04), or if therapy included oral lysine (p = 0.04), topical nonsteroidal anti-inflammatory drugs (NSAIDS; p = 0.03) or topical ethylenediaminetetraacetic acid (EDTA; p = 0.04). Ulcerated corneas were significantly more likely to undergo sequestration following cotton-tipped applicator (CTA) debridement (OR = 4.1, p = 0.03), or if faint corneal brunescence was initially present (OR = 5.0, p = 0.01). Corneal stromal vascularization after ulcer healing was significantly more likely in Persian cats (OR = 7.3, p = 0.02) or if corneal vascularization was initially present (OR = 8.6, p = 0.01). CONCLUSIONS:Delayed healing, corneal sequestration, and corneal stromal vascularization appear to be common sequelae of feline ulcerative keratitis. Clinicians should use caution when treating feline ulcers using oral lysine, topical NSAIDs, topical EDTA, or CTA debridement.
OBJECTIVE:To investigate the bacterial spectrum and antimicrobial susceptibility patterns of isolates obtained from canine corneal ulcers, assessing possible associations with breed, season, and multidrug resistance. METHODS:A retrospective review was conducted on corneal ulcers from 112 dogs between May 2021 and June 2024 at a specialized veterinary ophthalmology clinic in Berlin, Germany. Bacteriological cultures and antimicrobial susceptibility tests (ASTs) were analyzed according to the Clinical and Laboratory Standards Institute (CLSI). RESULTS:Brachycephalic breeds represented 79.5% of affected dogs. Positive bacterial growth was obtained in 79.5% (89/112) of samples, yielding 107 isolates. Gram-positive organisms predominated (72.2%), mainly Staphylococcus pseudintermedius (27.8%) and β-hemolytic Streptococcus (19.4%). Among 100 isolates tested, 59% were resistant to penicillins, while 71% were susceptible to aminoglycosides and fluoroquinolones, 73% to amoxicillin-clavulanate, and 78% to tetracyclines. Multidrug resistance (MDR) occurred in 27% of isolates. CONCLUSIONS:Staphylococcus pseudintermedius and β-hemolytic Streptococcus were the main bacterial agents associated with infected canine corneal ulcers. The relatively high frequency of MDR isolates emphasizes the need for culture-based therapy and ongoing regional surveillance to guide empirical antibiotic use.
OBJECTIVE:To describe the clinical presentation, diagnostic findings, and surgical management of zygomatic sialadenitis associated with retrobulbar disease in a dog following extensive dental extractions. ANIMALS STUDIED:A 10-year-old spayed female Cavalier King Charles Spaniel. PROCEDURES:The dog was evaluated for acute-onset right-sided exophthalmos that developed after a recent dental procedure involving 15 extractions. Ophthalmic examination identified marked exophthalmos, pain on opening of the mouth, lagophthalmos, and a superficial corneal ulcer. Computed tomography (CT) of the head was performed and revealed a tubular fluid-filled structure likely consistent with a retrobulbar abscess and right-sided zygomatic sialadenitis. Samples for cytology and culture were obtained. Initial medical management included intravenous fluids, broad-spectrum systemic antibiotics, analgesics, topical antibiotics, and ocular antihypertensive medications. RESULTS:Cytology revealed septic suppurative inflammation. Microbial culture identified Bacteroides pyogenes , an anaerobic organism not typically associated with antimicrobial resistance. Histopathology confirmed subacute zygomatic sialadenitis with associated cellulitis. Due to progressive clinical deterioration and vision loss, transpalpebral exenteration with zygomatic sialoadenectomy was performed. Postoperative recovery was uneventful, with complete resolution of periocular swelling and pain on follow-up examination. CONCLUSIONS:Zygomatic sialadenitis should be considered a differential diagnosis for retrobulbar disease in dogs, particularly when cases are refractory to medical management. In this case, persistent salivary secretions likely contributed to ongoing inflammation and clinical signs. Advanced imaging facilitated accurate diagnosis, and surgical removal of the affected gland was necessary for definitive resolution.
OBJECTIVE:To characterize the signalment and clinical presentation of glaucoma in pet rabbits. ANIMAL STUDIED:Client-owned pet rabbits (n = 222) referred to an exotic specialty animal hospital for ophthalmic examination between 2007 and 2023. PROCEDURE:Medical records were retrospectively reviewed for rabbits diagnosed with glaucoma, to evaluate clinical findings and treatments. In addition to routine ophthalmic examination, gonioscopy and Encephalitozoon cuniculi serologic testing were performed when indicated. RESULTS:Of 222 rabbits examined, 63 (28.4%) were diagnosed with glaucoma of which 33/63 (52.4%) were categorized as primary glaucoma and 27/63 (42.9%) as secondary glaucoma. Three other rabbits (4.8%) presented with unilateral secondary glaucoma with primary glaucoma risk in the fellow eye (mixed-risk glaucoma). The mean age at diagnosis was 4.4 ± 2.8 years for primary and 10.0 ± 5.3 years for secondary glaucomas. Gonioscopy was performed in 23/33 (69.7%) of rabbits in the primary glaucoma group revealing a closed iridocorneal angle in 16/23 (69.6%). Median follow-up was 707 days [IQR 126-1299] for primary and 59 days [IQR 1-1623] for secondary glaucomas. Medical management involved various topical antiglaucoma medications, with treatment regimens adjusted and often progressing to multi-drug therapy. Bilateral glaucoma was ultimately documented in 75.8% (25/33) of primary and 29.6% (8/27) of secondary glaucomas. The most common underlying ocular condition associated with secondary glaucoma was suspected to be E. cuniculi infection. CONCLUSIONS:Both primary and secondary glaucomas are prevalent among pet rabbits in the Japanese population. Further studies are needed into the possible genetic factors underlying the development of glaucoma in rabbits.
OBJECTIVES:To report the clinical outcomes of photodynamic therapy (PDT), alone and in combination with electrochemotherapy (ECT), in the conservative treatment of bilateral palpebral squamous cell carcinoma (SCC) in a cat, involving the right and left eyelids, with functional preservation and local tumor control. METHODS:A domestic shorthair cat with histologically confirmed squamous cell carcinoma affecting both eyelid margins underwent different therapeutic protocols. The left eye received a single PDT session with topical a lipophilic methyl ester derivative of 5-aminolevulinic acid (160 mg/g) and red LED light, while the right eye received two sessions, followed by adjuvant ECT with intravenous bleomycin. RESULTS:The lesion in the left eye presented with pallor associated with mild inflammation after the PDT session, with complete resolution in the following days and recovery of its normal clinical appearance. In the right eye, the first two PDT sessions resulted in significant regression of the neoplastic lesions. However, a lesion in the medial canthus showed partial response, requiring adjuvant treatment with ECT, which led to complete clinical resolution, despite the presence of mild eyelid deformity. CONCLUSIONS:In this single case report, PDT was associated with clinical regression of superficial lesions, while adjuvant ECT was followed by complete clinical resolution of the residual lesion. The combination of these modalities represents a viable conservative alternative to extensive surgical excision, enabling the tumor remission while preserving the aesthetic appearance and functional integrity of the eyelid.
OBJECTIVE:To evaluate the outcome and describe complications associated with use of Ahmed valve gonioimplants in the treatment of glaucoma in rabbits. ANIMALS:Six client-owned rabbits with glaucoma. PROCEDURES:Medical records of rabbits that underwent Ahmed valve gonioimplantation between 2022 and 2025 were reviewed. All eyes received intracameral tissue plasminogen activator immediately postoperatively. RESULTS:Gonioimplantation was performed in eight eyes. The Holland Lop breed was overrepresented. Median age was 5 years and median pre-operative IOP was 32 mmHg (26-43 mmHg). 6/8 eyes were suspected to have primary glaucoma. Three eyes had developed presumed secondary glaucoma after phacoemulsification. Clinical signs at presentation included slow and incomplete pupillary light reflex (one eye), blepharospasm (three eyes), conjunctival hyperemia (one eye), periocular swelling (two eyes), corneal edema (one eye), ulcerative keratitis (two eyes), retinal vascular attenuation (one eye), and optic nerve cupping (five eyes). Three rabbits died of unrelated causes at 6, 10 and 22 months post-operatively. After gonioimplantation, median IOP was 17 mmHg (10-25 mmHg). Vision was retained in all eyes for a mean period of 11.6 months (2-22 months). Mean antiglaucoma medication use decreased from 1.75 to 1.38 post-operatively. Mean administration frequency reduced from 4 to 3.37 times daily. Post-operative complications included shallow anterior chamber (two eyes), Haab's striae (one eye), iridal and periocular hemorrhage (one eye). One rabbit experienced hypokalemia related to topical therapy. CONCLUSIONS:In rabbits with medically refractory glaucoma, gonioimplantation is effective in IOP control and maintaining vision in sighted rabbit eyes.
OBJECTIVE:This study aimed to characterize the relationship between intraocular pressure (IOP) measurements obtained using two rebound tonometers (TonoVet and TonoVet Plus) in Labrador retrievers and to evaluate a regression-based approximation for supporting longitudinal interpretation following device replacement. ANIMALS STUDIED:Fifty-three clinically normal Labrador retrievers (106 eyes), including guide dog candidates and breeding dogs undergoing routine health screening in Japan, were included. PROCEDURES:IOP was measured sequentially using the TonoVet and TonoVet Plus, both set to dog mode. The first of three readings per eye per device was used for analysis. Measurement order effects were assessed in a separate cohort. Statistical analyses included paired t-tests, Pearson's correlation coefficient, and Bland-Altman analysis. Deming regression was used to derive a regression-based approximation accounting for measurement error in both devices. RESULTS:Measurement order did not significantly influence IOP values. The TonoVet Plus yielded significantly higher IOP values than the TonoVet (p < 0.0001), and a moderate positive correlation was observed between the two devices (r = 0.69). Bland-Altman analysis demonstrated a systematic bias (mean difference + 4.5 mmHg; 95% limits of agreement, 1.3 to 7.7 mmHg). Deming regression yielded a slope of 1.05 and an intercept of 3.52. Age-related effects on IOP were small and not statistically significant. CONCLUSIONS:The TonoVet Plus systematically measures higher IOP values than the TonoVet in Labrador retrievers. The derived breed-specific approximation may support longitudinal interpretation rather than precise individual-level prediction in comparable clinical settings; however, external validation in independent Labrador retriever populations is warranted.
OBJECTIVE:To characterize the trace element composition of feline corneal sequestra (FCS) and provide insights into their pathophysiology. METHODS:FCS samples were collected from 11 eyes of 9 cats following keratectomy and compared with corneal samples from four clinically normal control cats euthanized for reasons unrelated to the study. Excised corneal tissues were immediately frozen at -80°C and analyzed using particle-induced X-ray emission (PIXE) with a 1.7 MV Pelletron accelerator to determine relative elemental abundance. Trace element levels between groups were compared using Mann-Whitney tests, and results were expressed as peak area units. RESULTS:Affected cats were predominantly brachycephalic or predisposed breeds, including Sphynx, Persian, and British Shorthair. Lesions measured 1-8 mm in diameter and involved approximately 20%-70% stromal depth. Across all samples, sulfur demonstrated the highest elemental signal, followed by phosphorus, potassium, chloride, sodium, calcium, magnesium, zinc, iron, and bromine. Iron (median ± SEM: 751 ± 336 vs. 0 ± 0; p = 0.047) and bromine (110 ± 50 vs. 0 ± 0; p = 0.004) were consistently detected in sequestral tissue but were absent in control corneas. No statistically significant differences were observed between groups for sodium, potassium, chloride, magnesium, phosphorus, calcium, sulfur, or zinc. CONCLUSION:Feline corneal sequestra exhibited a distinct elemental profile characterized by the detection of iron and bromine, which were not detected in the normal corneal samples analyzed. These findings demonstrate measurable differences in trace element composition between sequestral and healthy corneas and provide novel insights into the biochemical characteristics of this disease.
OBJECTIVE:The goal of this retrospective study is to evaluate the complications following nictitating membrane resection in horses with the aim of providing valuable information on the risks of this surgical procedure. ANIMALS:83 horses (92 eyes). PROCEDURES:Medical records for 83 horses that underwent nictitating membrane resection in 92 eyes between February 2015 and June 2024 were reviewed. Horses were included if they had at least 1 month of follow-up data available. Owners were contacted via telephone or email questionnaire to obtain follow-up information. Complications were recorded only when present in the surgical eye and not in the contralateral eye. Owner-reported findings were included only when they were persistent at the time of follow-up or noted beyond the immediate postoperative period (> 1 week). RESULTS:The overall owner reported complication rate was 28.2% (26/92). Complications that occurred within 1 week of surgery were fat prolapse (n = 4; 4.3%) and hemorrhage (n = 1; 1.1%). Long-term complications noted by owners included epiphora (n = 21; 22.8%) and conjunctivitis (n = 9; 9.8%). The incidence of fat prolapse was low, with no cases reported when sutures were placed (p = 0.80). There were follow-up examinations performed for 39 horses and 23.1% had complications. These included epiphora (n = 4; 10.3%), conjunctival adhesion (n = 1; 2.6%), fat prolapse (n = 2; 5.1%), and enophthalmos (n = 2; 5.1%). CLINICAL RELEVANCE:Overall complications reported by owners and found on examination were minor and easily managed. Chronic mild epiphora is the most common complication that persists after the nictitating membrane resection procedure and should be reviewed with owners.
PURPOSE:To determine the effects of 0.002% omidenepag isopropyl (OMDI) ophthalmic solution on intraocular pressure (IOP) and pupil diameter (PD) in clinically normal dogs. METHODS:Five healthy dogs (10 eyes) were included in this prospective randomized, observer-masked, placebo-controlled study. An initial pilot study was conducted to evaluate IOP and ocular irritation up to 48 h after a single instillation of OMDI. For the subsequent main study, each dog received one drop of 0.002% OMDI in one randomly selected eye and placebo in the contralateral eye once daily. IOP, PD, and conjunctival hyperemia scores were measured five times daily during the baseline (3 days), treatment (5 days), and recovery (3 days) periods. RESULTS:A single instillation of topical OMDI significantly lowered IOP by a maximal IOP reduction of 7.2 mmHg (60%). In the repeated-dose study, once-daily administration of topical OMDI significantly reduced average daily IOP ± SD by 4.8 ± 0.68 mmHg (38.6%) and 6.1 ± 0.75 mmHg (44.3%), relative to baseline and contralateral controls, respectively. No clinically relevant miosis was observed in OMDI-treated eyes. Adverse events were limited to mild-to-moderate conjunctival hyperemia in OMDI-treated eyes. CONCLUSIONS:Once-daily administration of 0.002% OMDI resulted in a robust reduction in IOP without inducing miosis and was well-tolerated in normal dogs. Further studies are warranted to assess its therapeutic potential and long-term safety in dogs with glaucoma.
OBJECTIVE:To characterize the tear film pharmacokinetics of parenterally administered cefovecin (Convenia) and compare tear concentrations with the minimum inhibitory concentrations (MICs) of common ocular pathogens. ANIMALS STUDIED:Six healthy research-bred Beagles. PROCEDURES:Dogs received a single subcutaneous injection of cefovecin (8 mg/kg) after inducing blood-tear barrier disruption through histamine-mediated conjunctivitis. Tear fluid was collected using Schirmer strips at multiple time points up to 336 h and analyzed via liquid chromatography-mass spectrometry. Tear concentrations from both eyes were averaged for analysis. MIC values were determined for Staphylococcus pseudintermedius, Streptococcus canis, and Pseudomonas aeruginosa (n = 10 isolates per species). RESULTS:In a pilot experiment (n = 1 dog), tear cefovecin concentrations were 1.5 to 430-fold higher in the conjunctivitis eye than in the control eye at all but one time point. Across all dogs, tear concentrations ranged from 68 to 73 035 ng/mL and remained detectable throughout the 336-h study. Mean ± SD pharmacokinetic parameters were: Cmax 27.23 ± 27.74 μg/mL, Tmax 61 ± 83 h, AUC 2734 ± 2563 μg/mL·h, and t1/2 64 ± 46 h. Tear concentrations exceeded the MIC90 for Streptococcus (0.64 μg/mL) for 336 h and exceeded the MIC90 for some Staphylococcus (10.2 μg/mL) between 48 and 120 h, but remained below the MIC90 for Pseudomonas. CONCLUSIONS:Parenteral cefovecin achieved sustained tear concentrations sufficient to inhibit some susceptible Streptococcus and Staphylococcus isolates in vitro for clinically relevant time windows. While these findings support further investigation of cefovecin as an adjunctive therapy in selected cases, they do not justify empiric systemic antimicrobial use. Larger pharmacokinetic and clinical studies are warranted to validate these findings.
OBJECTIVE:To describe pectinate ligament dysplasia (PLD) and primary glaucoma in a litter of adult Lop rabbits. ANIMALS STUDIED:A litter of six adult Lop rabbits, three males and three females. PROCEDURES:The animals were surrendered to the shelter. One male appeared functionally blind with bilateral severe corneal edema, and a second male showed severe corneal edema in one eye. Based on these observations, detailed ophthalmic examinations were performed on all six animals. Digital gonioscopy and fundoscopy were performed on three females. Because the two affected males were euthanized for humane reasons, and one female arrested during general anesthesia for ovariohysterectomy, six eyes of three animals were examined by routine histopathology. RESULTS:Clinical examination revealed that the three eyes with diffuse corneal edema were affected by chronic glaucoma with intraocular pressure (IOP) elevation, buphthalmos, and severe secondary keratitis. Gonioscopy performed in the normal-appearing, normotensive female rabbits showed partial or complete closure of the iridocorneal angle (ICA). Histopathologic evaluation revealed PLD in the glaucomatous and clinically normal eyes. In the glaucomatous eyes, uvea-like tissue crossed the ICA with an indistinct to absent ciliary cleft, pectinate ligament, and scleral venous plexus. Inner-to full-thickness retinal atrophy was consistent with chronic glaucoma. In the non-glaucomatous eyes, multiple segments of uveal tissue crossed the ICA, with the trabecular meshwork partially collapsed. CONCLUSIONS:This is the first formal description of PLD and primary glaucoma in a litter of Lop rabbits.
OBJECTIVE:Aqueous deficient dry eye disease (ADDE) results from a quantitative reduction in aqueous tears. We sought to determine the clinical effect of autologous mesenchymal stromal cell (MSC) injections into the region of the lacrimal gland and the gland of the third eyelid in immunomodulatory-dependent ADDE-affected dogs. METHODS:Dogs (n = 4) were enrolled that met the inclusion criteria for ADDE (consistent clinical signs combined with Schirmer tear test I [STT-I] value < 15 mm/min, responsive to topical immunomodulatory therapy, and documented drop in STT-I after cessation of therapy). By applying these stringent criteria, there was a high failure rate for inclusion. Autologous MSCs were harvested, expanded, and unilaterally injected after cessation of immunomodulatory therapy. Examinations, ophthalmic diagnostics, clinical scoring, and owner surveys were performed at regular intervals post-injection. RESULTS:No adverse ocular events were associated with the MSC injections. There were variable responses between dogs, with one dog exhibiting an immediate increase in STT-I that remained elevated (5.5-fold increase); two dogs had a smaller and temporary increase in STT-I over baseline (0.6-0.7-fold increases), and one dog had no increases detected over the initial 6 months. Repeated injections did not improve clinical or diagnostic values. CONCLUSIONS:Autologous MSC injections were well-tolerated in dogs with ADDE. Results were variable in this small sample size. Despite initial improvement in 3 of 4 dogs, the positive response was variable in magnitude of response and duration of effect. Repeated injections did not sustain this response. Future studies using conditioned MSCs and/or exosomal therapy are warranted.
OBJECTIVE:Cohen's kappa is widely used to measure rater agreement on binary outcomes and performs well when outcome prevalence is relatively balanced. This paper aims to explain the challenges encountered with Cohen's kappa, and to provide guidance to veterinary ophthalmologists on the usage and interpretation of kappa values. ANIMALS STUDIED:Article based on an existing dataset in which two examiners graded iridocorneal angle abnormalities in 60 client-owned dogs during pre-breeding examinations. PROCEDURE:Following the 2022 ECVO-HED (European College of Veterinary Ophthalmology-Hereditary Eye Diseases) gonioscopy grading scheme and its general recommendations, eyes were classified into two categories-"breeding-YES" (not affected, mildly or moderately affected) or "breeding-NO" (severely affected). Inter-examiner agreement was separately assessed for real (60 left and 58 right eyes) and simulated data (manually balanced left eye dataset with unchanged agreement between examiners). RESULTS:While the two examiners classified 52/60 left and 51/58 right eyes into the "breeding-YES" category, they disagreed on 7/60 left and 1/58 right eyes, with resulting kappa values of 0.18 and 0.91 for the left and right eyes, respectively. After balancing the data, with both examiners classifying 27/60 left eyes into the "breeding-yes" category, but still disagreeing on 7/60 eyes, the kappa value increased to 0.77. CONCLUSIONS:Readers should be cautious when comparing kappa values across studies with different underlying prevalence and bias. Under non-ideal data distribution, additional statistical indices like prevalence- and bias index, prevalence-and-bias-adjusted kappa (PABAK), and maxKappa, do not replace Cohen's kappa, but assist in interpreting it.
This case report describes the clinical presentation and successful surgical management of a combined dorsal entropion-ectropion macroblepharon with an elongated and folded nictitating membrane in a 2-year-old male giant rabbit. The rabbit initially presented with bilateral chronic, recurrent corneal erosions secondary to abnormal eyelid and third eyelid conformation. Surgical correction was performed via wedge excision of the upper eyelid and shortening of the third eyelid cartilage. Following the procedure, the corneal erosions resolved completely and did not recur during a 1-year follow-up period. In this case, surgical intervention resulted in resolution of chronic, recurrent keratitis related to adnexal abnormalities, supporting the potential usefulness of this technique in managing erosive corneal disease in rabbits.
PURPOSE:To compare the estimation of corneal stromal ulcer depth (UD) by slit-lamp biomicroscopy (SLB) and ultrasound biomicroscopy (UBM) images, to identify factors influencing surgical decision-making, and to evaluate whether decisions based on SLB images change after reviewing UBM depth measurements. METHODS:Fifty dogs with corneal stromal ulceration were included. SLB and UBM images of the deepest part of each ulcer were obtained. Three masked external examiners estimated UD percentage using the SLB images. Clinical records were reviewed, and a questionnaire evaluated whether surgery was recommended and which factors influenced that decision. Finally, UBM images with depth measurements were provided, and examiners were asked whether this information altered their initial surgical recommendation. RESULTS:Median UD estimated by the evaluators was 63.3% (interquartile range [IQR]: 40.0-78.7), which was significantly higher than the UD measured by UBM (42.1%; IQR: 30.2-55.9; p < 0.001). The mean absolute percentage difference in UD% between SLB estimates and UBM measurements (relative to UBM) was 38.7%. This difference was evident in both anterior and medium stromal ulcers (p < 0.001). The factors most frequently influencing surgical decision-making were UD (84.0%-92.0%) and ulcer width (36.0%-52.0%). After reviewing the UBM images, evaluators modified their initial medical versus surgical recommendation in 10.0%-14.0% of cases, most commonly changing from surgery to medical management. CONCLUSION:The SLB tended to provide higher UD% estimates than UBM, with a mean absolute percentage difference of 38.7% (relative to UBM), particularly in anterior and medium stromal ulcers. UD and ulcer width drive surgical decisions. UBM provides the necessary precision that may help refine surgical indication and avoid unnecessary corneal surgery.
