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BSAVA OPHTHO BOOK > Uveal tract > Flashcards

Uveal tract Flashcards

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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
USD
``` Autoimmune reaction against melanocytes Signs: bilateral panuveotis Vitiligo (skin depigmentation) Poliosos (hair whitening) Mucocutaneous involvement ``` Additionally glaucoma., cataract , retinal detachment
26
Examination of ocular trauma
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
Differentials for hyphaema
``` 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
Lipid aqueous values
Trigliceride rich lipid in ah >25nmol/l Not associated with raised cholesterol If chylomicrons are also raised - milky
29
What cases - lipid aqueous
Primary chylomicronaemia in Min Schnauzers Secondary chylomicronaemia DM
30
Primary Uveal neoplasia
``` Melanoma Adenoma/adenocarcinoma Fibrosarcoma Leio myo sarcoma Haemangioma/haemangiosarcoma Medulloepithelioma ```
31
Secondary uveal neoplasia
``` Lymphoma, haemangiosarcoma Adenocarcinoma, fibrosarcoma, osteosarcoma Rhabdo myo sarcoma Seminoma/transmissible veneral tumour Malignant melanoma ```
32
FIP uveitis
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
FeLV
Retrovirus Ocular sings 1) haemorrhage related to anaemia or 2) neoplasia Uveitis : Immune mediated or non specific to reaction to cellular infiltration
34
Fiv
Ocular sings in late ( immunodeficient) stage if infection | Secondary infections and possible association with malignancy
35
Feline mycotic infections
``` Cryptococcus most common Coccidioidomycosis Blastomycosis Histoplasmosis Candidiasis ```
36
Feline toxoplasmosis 🐈
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
Origin of spindle cell sarcoma in a cat 🐈 😻 🐈‍⬛️
Release of lens epithelium by trauma | Ciliary body Epithelial cells can't be excluded
38
Feline 🐈 Idiopathic lymphocytic-plasmacytic uveitis
Thought to be an example of local immune-mediated disease
39
When optic cup invaginates?
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
Developmental abnormalities of uvea in dogs 🐕
Incomplete development (coloboma) Maldevelopment ( asd) Incomplete regression of embriological tissue (PPMs)
41
Cea - choroidal hypoplasia always bilateral, ON coloboma?
Not always
42
Ppm most common in ?
Cocker spaniel
43
Iris anatomy
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
CB anatomy
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
Functions of CB
Production and drainage of ah. Accommodation
46
Stability of BAB
Primate>dog>rabbit
47
BRB
Non fenestrated etinal vascular endothelium | Tight junctions between RPE
48
Acaid
Anterior chamber associated immune deviation | System trying to supress inflammation
49
When bob breaks down
Increased blood flow Increased permeability WBC migration
50
Heterochromia iris
In the same iris | Associated with Merle gene
51
Merle ocular dysgenesis
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
Aniridia gene
Pax6
53
Mydriasis causes
Drug Oculoplegia Iris atrophy - pg analogue if not sure glaucoma
54
Golden retriever uveitis
``` More common in USA Dark iris, rest, multiple cysts. 46% of eyes get glaucoma Poorly understood Great Danes sometimes ```
55
Signs of anterior uveitis
Flare, fibrin, KPs, hyphaema, hypopyon(sterile, inf, neo) Iris colour change (rubeosis iridis cats, darkening dogs) Miosis Reduced iop Corneal oedema
56
How to differentiate low grade uveitis from Horner's?
Phenylephrine test, in uveitis won't dilate as well , in H will Conjunctival vessels blanch , deeper vessels won't
57
Miosis causes
Drug pilocarpine, pg analogues Uveitis Horner
58
Posterior uveitis
``` Reduced vision Choroidal effusion Optic neuritis Retinal detachment (usually flat) Retinal haemorrhage Vitreous opacity ```
59
Sequelae to uveitis
``` Posterior synachiae Ectropion uveae Iris 💣 Glaucoma Cataracts 🐈 >🐕 Lens lux 🐈‍⬛️ Phthisis bulbi ```
60
Uveitis causes
``` 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
Septic implantation syndrome
Lens capsule rupture --> intralenticular organisms>lenticular abscess> Endophthalmitis (10d-1y)
62
Phacolytic LIU
Lens protein leak though intact lens capsule > stimulate inflammation Wose in rapidly forming cataracts
63
Phacoclastic LIU
Breach of lens capsule (penetrating trauma/ spontaneous)
64
Wjat bread spontaneous lens capsule rupture in DM?
Lab

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