canis - Articles
Uveitis
Synonym(s): Panuveitis, iritis, iridocyclitis, cyclitis, choroiditis, anterior uveitis
Introduction
- Inflammation of the uveal tract (iris, ciliary body and choroid).
- Cause: infection (eg viral, bacterial, parasitic, fungal), trauma, lens damage, immune-mediated.
- Signs: severe pain, hyphemia, miosis, cloudy cornea, conjunctival hyperemia.
- Treatment: medical - many approaches.
- Prognosis: serious consequences if disease is uncontrolled.
Presenting signs
- Ocular pain.
- Red eye (episcleral congestion).
- Lacrimation.
- Corneal edema.
- Cloudy eye.
- Iris color change.
Geographic incidence
- Common, although true incidence is unknown.
- Fungal and rickettsia diseases vary with location.
Cost considerations
- If surgery or specialist referral required.
- Medical treatment only is usually sufficient.
Pathogenesis
Etiology
- Often undetermined.
- Reflex uveitis Reflex uveitis.
- Systemic viral disease, eg infectious canine hepatitis Canine adenovirus type 1 disease with corneal opacity, very common.
- Systemic bacterial disease, eg leptospirosis Leptospirosis , brucellosis Brucellosis , Lyme disease Arthritis: borrelial , tuberculosis Pulmonary tuberculosis.
- Local bacterial disease, eg pasteurellosis, staphyloccocal infection (toxins).
- Septic bacterial focus, eg pyometra Pyometra.
- Parasitic, eg toxoplasmosis Toxoplasmosis , leishmaniasis Canine leishmaniosis (imported animals?).
- Mycotic infection, eg cryptococcosis , blastomycosis, histoplasmosis. Rare in temperate climate/country.
- Neoplasia - primary or secondary. Lymphoma is most common.
- Trauma, eg blunt or sharp injury or foreign bodies.
- Primary lens damage to expose lens proteins to aqueous.
- Diabetes.
- Lens-induced uveitis from cataract formation.
- Systemic hypertension.
- Auto-immune, eg uveodermatological syndrome. VKH syndrome.
- Rickettsial diseases, eg Ehlichiosis Ehrlichiosis , Rocky Mountain spotted fever.
- Immune-mediated.
- Hypermature cataracts cause lens proteins to elicit inflammation.
Pathophysiology
- Inflammation of uveal tract may involve iris (iritis), ciliary body (cyclitis), or choroid (choroiditis).
- More commonly involves all 3 (panuveitis).
- Breakdown of the blood-aqueous barrier causes anterior uveal tissue destruction.
- Increased vascular permeability is mediated by histamine, serotonin, prostaglandins and leukotrines, and causes extravasation of plasma proteins, cells and fluid.
- Iridal congestion, aqueous flare, hypopyon, keratitic precipitates and corneal edema develop along with cellular infiltration.
- Inflammation causes muscular spasm giving miosis and pain.
Timecourse
- Anterior uveitis therapy should last at least 2 months as the blood-aqueous barrier remains disrupted for about 8 weeks after insult.
Diagnosis
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Treatment
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Prevention
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Outcomes
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Further Reading
Publications
Refereed papers
- Recent references from PubMed and VetMedResource.
- Michau T M, Breitschwerdt E B, Gilger B C et al (2003) Bartonella vinsonii subspecies berkhoffi as a possible cause of anterior uveitis and choroiditis in a dog. Vet Ophthalmol 6 (4), 299-304 PubMed.
- Sansom J (2000) Diseases involving the anterior chamber of the dog and cat. In Practice 22 (2), 58-70 VetMedResource.
- Huss B T, Collier L L, Collins B K et al (1994) Polyarthropathy and chonoretinitis with retinal detachment in a dog with systemic histoplasmosis. JAAHA 30 (3), 217-224 VetMedResource.
- Håkanson N & Forrester S D (1990) Uveitis in the dog and cat. Vet Clin North Am Small Anim Pract 20 (3), 715-35 PubMed.
- Crispin S M (1988) Uveitis in the dog and cat. JSAP 29 (7), 429-447 PubMed.