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Hung JH, Ford MM, Sanders MT, Stanley RG. Surgical management of unilateral restrictive strabismus in an 8-month-old dog. N Z Vet J 2024; 72:300-306. [PMID: 38885962 DOI: 10.1080/00480169.2024.2361619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/23/2024] [Indexed: 06/20/2024]
Abstract
CASE HISTORY An 8-month-old male, entire, mixed-breed dog was presented with a 1-month history of left exophthalmos and green mucopurulent ocular discharge. Subsequently, exophthalmos resolved but esotropia (medial strabismus) developed in the left eye, prompting referral to an ophthalmologist. CLINICAL FINDINGS At the initial referral consultation, enophthalmos and esotropia of the left eye were identified. The patient showed mild improvement after a 3-week tapering course of oral prednisolone and doxycycline. MRI was performed and showed left medial rectus muscle atrophy with increased contrast enhancement which was consistent with chronic extraocular muscle myositis (EOM). A forced duction test was performed to confirm the diagnosis of fibrosing esotropia, which is likely a sequela of chronic EOM. DIAGNOSIS Fibrosing esotropia presumably caused by untreated EOM. TREATMENT AND OUTCOME One month later, esotropia progressed to a marked ventro-medial strabismus resulting in visual deprivation. Surgical release of the ventral oblique, medial and ventral recti muscles was performed, resulting in immediate resolution of the enophthalmos. Despite a tapering post-operative course of oral prednisolone, mild esotropia was present 4 weeks later. In an effort to stabilise the globe position, the low dose of prednisolone was increased to a higher anti-inflammatory dose before slowly tapering over 2 months. The vision in the left eye was improved after surgery and has been maintained since without further treatment. CLINICAL RELEVANCE This is the first documented case of fibrosing esotropia in a young dog with prior signs of acute exophthalmos. Fibrosing esotropia has been documented in certain breeds or as a sequela to chronic EOM. In this patient, it was presumably caused by EOM, which was strongly supported by the case history, progression and MRI findings. Most historical reports of EOM described it as a bilateral condition that resolves with systemic corticosteroids at an anti-inflammatory dose. EOM has been shown to also present unilaterally and it can progress to strabismus if not promptly recognised and treated with systemic steroids. Surgical management can restore vision when severe strabismus results in visual deprivation.
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Affiliation(s)
- J H Hung
- Animal Eye Care, Melbourne, Australia
| | - M M Ford
- Animal Eye Care, Melbourne, Australia
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Bongers J, Gutierrez‐Quintana R, Stalin CE. External ophthalmoparesis as part of generalised myasthenia gravis in a dog: are there more similarities to the human counterpart than originally thought? VETERINARY RECORD CASE REPORTS 2021. [DOI: 10.1002/vrc2.48] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jos Bongers
- School of Veterinary Medicine University of Glasgow Glasgow UK
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Holly VL, Zwicker LA, Starrak G, Leis ML, Bauer BS, Osinchuk S, Sandmeyer LS, Grahn BH. Odontogenic parakeratinized cyst resulting in exophthalmos and palatine, maxillary, and zygomatic bone erosion in a dog. Vet Ophthalmol 2017; 21:539-543. [DOI: 10.1111/vop.12538] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Vanessa L. Holly
- Department Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; 52 Campus Drive Saskatoon SK S7N 5B4 Canada
| | - Lesley A. Zwicker
- Department Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; 52 Campus Drive Saskatoon SK S7N 5B4 Canada
| | - Gregory Starrak
- Department Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; 52 Campus Drive Saskatoon SK S7N 5B4 Canada
| | - Marina L. Leis
- Department Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; 52 Campus Drive Saskatoon SK S7N 5B4 Canada
| | - Bianca S. Bauer
- Department Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; 52 Campus Drive Saskatoon SK S7N 5B4 Canada
| | - Stephanie Osinchuk
- Department Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; 52 Campus Drive Saskatoon SK S7N 5B4 Canada
| | - Lynne S. Sandmeyer
- Department Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; 52 Campus Drive Saskatoon SK S7N 5B4 Canada
| | - Bruce H. Grahn
- Department Small Animal Clinical Sciences; Western College of Veterinary Medicine; University of Saskatchewan; 52 Campus Drive Saskatoon SK S7N 5B4 Canada
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Czerwinski SL, Plummer CE, Greenberg SM, Craft WF, Conway JA, Perez ML, Cooke KL, Winter MD. Dynamic exophthalmos and lateral strabismus in a dog caused by masticatory muscle myositis. Vet Ophthalmol 2015; 18:515-20. [PMID: 25728848 DOI: 10.1111/vop.12260] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
CASE DESCRIPTION A 5.5-year-old neutered male mixed-breed dog was presented for evaluation of a 5-month history of deviation of the right globe upon opening the mouth and a 1-month history of conjunctivitis in the same eye. Clinical findings, diagnostic imaging results, treatment and follow-up are described. CLINICAL FINDINGS When the mouth was opened, the right globe deviated rostrally and laterally. There was no pain or resistance to opening the mouth, or resistance to retropulsion of the globe. No other abnormalities were observed. Computed tomography was performed, revealing a contrast-enhancing region associated with the right masseter muscle impinging into the right orbit; this was more pronounced with the mouth open. Cytology revealed a small number of mildly to moderately atypical mesenchymal cells. Histopathology was consistent with polyphasic myositis, with a predominance of lymphocytes and plasma cells. No infectious agents were identified. Serum antibody titers for Toxoplasma gondii and Neospora caninum were negative. Serum titers for 2 M antibody were positive at 1:500, consistent with a diagnosis of masticatory muscle myositis. TREATMENT AND OUTCOME Therapy with prednisone was initiated. During a follow-up period of 5 months, there was no recurrence of clinical signs, and the dose of prednisone was reduced by 25%. CLINICAL SIGNIFICANCE To the authors' knowledge, this is the first reported case of masticatory muscle myositis causing dynamic exophthalmos and strabismus in a dog.
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Affiliation(s)
- Sarah L Czerwinski
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - Caryn E Plummer
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA.,Department of Large Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - Shari M Greenberg
- New England Veterinary Center and Cancer Care, 955 Kennedy Road, Windsor, CT, 06095, USA
| | - William F Craft
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - Julia A Conway
- Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - Mayrim L Perez
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - Kirsten L Cooke
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
| | - Matthew D Winter
- Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Florida, 2015 SW 16th Avenue, Gainesville, FL, 32610, USA
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Azoulay T, Jongh O. [Extraocular myositis and comparative pathology: two case reports in the dog]. J Fr Ophtalmol 2011; 34:737.e1-5. [PMID: 21658791 DOI: 10.1016/j.jfo.2011.01.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2010] [Revised: 01/13/2011] [Accepted: 01/18/2011] [Indexed: 11/20/2022]
Abstract
Two cases of extraocular myositis in dogs are reported in a golden retriever and an Australian shepherd. This condition is characterized by sudden bilateral exophthalmos, the absence of pain and third eyelid protrusion, orbital sonography showing the enlargement of extraocular muscles, and a quick response to systemic steroids at an anti-inflammatory dose. The literature review reports a breed predisposition in the golden retriever, mainly in females. Histopathologic evaluations confirm the inflammation of one or several extraocular muscles. Chronic disease was also described. Canine extraocular myositis shows some resemblance to Graves ophthalmopathy but can better be compared to idiopathic orbital myositis. Both disorders are probably the consequence of an immune dysfunction that still has to be discovered.
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Affiliation(s)
- T Azoulay
- Service d'ophtalmologie, clinique vétérinaire des Halles, 28, rue du Faubourg-de-Saverne, 67000 Strasbourg, France.
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Barnes LD, Pearce JW, Berent LM, Fox DB, Giuliano EA. Surgical management of orbital nodular granulomatous episcleritis in a dog. Vet Ophthalmol 2010; 13:251-8. [PMID: 20618804 DOI: 10.1111/j.1463-5224.2010.00781.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
A 27 kg, 6-year-old, male castrated German shorthaired pointer presented to the University of Missouri, Veterinary Teaching Hospital with the complaint of progressive exophthalmia of 2 years duration optical density (OD). Lack of retropulsion OD was noted on physical examination. Anterior segment examination OU and fundic examination OS did not reveal any abnormalities. Examination of the fundus OD revealed focal scleral indentation of the inferior nasal globe. The indentation changed location with globe movement OD. MRI and CT scan revealed a well-circumscribed, approximately 2 cm in diameter mass located caudal and ventral to the affected globe that appeared to communicate with the nictitating membrane with absence of any bony involvement. A modified lateral orbitotomy was recommended and performed to remove the orbital mass and nictitating membrane en-bloc. Histopathology and immunohistochemistry of the mass confirmed a diagnosis of nodular granulomatous episcleritis (NGE). Postoperatively, the dog developed absolute keratoconjunctivitis sicca (KCS). Examples of primary episcleral inflammation in the dog include diffuse episcleritis, NGE, nodular fasciitis, fibrous histiocytoma, proliferative conjunctivitis/keratoconjunctivitis, pseudotumor, and Collie granuloma. The etiology of these episcleral inflammations is presumed to be immune mediated. To our knowledge, this is the first report of NGE affecting the orbital region of a dog. Development of absolute KCS resulting from excision of the nictitating membrane is also supported by this case.
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Affiliation(s)
- Laura D Barnes
- College of Veterinary Medicine, University of Missouri, Columbia, MO 65211, USA
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