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12只患有内眼肌麻痹/眼肌麻痹的猫的临床体征、影像学表现及预后

Clinical signs, imaging findings, and outcome in twelve cats with internal ophthalmoparesis/ophthalmoplegia.

作者信息

Hamzianpour Negar, Lam Richard, Tetas Roser, Beltran Elsa

机构信息

Department of Clinical Science and Services, Royal Veterinary College, University of London, Hawkshead Lane, North Mymms, AL9 7TA, Hatfield, UK.

出版信息

Vet Ophthalmol. 2018 Jul;21(4):382-390. doi: 10.1111/vop.12523. Epub 2017 Dec 28.

Abstract

OBJECTIVE

To retrospectively evaluate the clinical signs, imaging findings, and outcome of feline internal ophthalmoparesis/ophthalmoplegia.

PROCEDURE

Medical records were reviewed from 2008 to 2015. Inclusion criteria included cats that presented with internal ophthalmoparesis/ophthalmoplegia, underwent diagnostic imaging, and had follow-up information available.

RESULTS

Twelve cases of feline internal ophthalmoparesis/ophthalmoplegia were identified. Nine cats were unilaterally affected, and three cats were bilaterally affected. Affected cats had a median age of 10.54 years (range 5.75 to 13.17), and both sexes of varying breeds were affected (nine males; three females). Clinical signs including abnormal mental status (n = 9; 75%) and additional neurologic abnormalities (n = 10; 83%) were observed. Magnetic resonance imaging and/or computed tomography (MRI/CT) of the head were performed in ten cats, revealing a mass lesion in all cases with varying locations. Multicentric lymphoma was diagnosed in two cats via abdominal ultrasound and cytology. All twelve cats were euthanized due to deterioration of clinical signs and/or quality-of-life concerns. Median time from diagnosis to euthanasia was 3.5 days (range 0 to 80 days).

CONCLUSIONS

Feline internal ophthalmoparesis/ophthalmoplegia rarely presents as the sole clinical sign in a referral hospital. Advanced imaging (MRI/CT) may be necessary to reach a definitive diagnosis in these cases. However, abdominal ultrasound would be advocated in cats with systemic clinical signs as a less expensive and less invasive diagnostic test to further investigate the possible etiology of internal ophthalmoparesis/ophthalmoplegia prior to advanced imaging. Feline cases with internal ophthalmoparesis/ophthalmoplegia associated with other intracranial signs and/or systemic clinical signs have a poor prognosis.

摘要

目的

回顾性评估猫内眼肌麻痹/眼肌麻痹的临床体征、影像学表现及预后。

过程

回顾2008年至2015年的病历。纳入标准包括出现内眼肌麻痹/眼肌麻痹、接受诊断性影像学检查且有随访信息的猫。

结果

共确定12例猫内眼肌麻痹/眼肌麻痹病例。9只猫为单侧受累,3只猫为双侧受累。受累猫的中位年龄为10.54岁(范围5.75至13.17岁),不同品种的雌雄猫均有受累(9只雄性;3只雌性)。观察到的临床体征包括精神状态异常(n = 9;75%)和其他神经学异常(n = 10;83%)。10只猫进行了头部磁共振成像和/或计算机断层扫描(MRI/CT),所有病例均显示有占位性病变,位置各不相同。通过腹部超声和细胞学检查,2只猫被诊断为多中心淋巴瘤。由于临床体征恶化和/或生活质量问题,所有12只猫均被安乐死。从诊断到安乐死的中位时间为3.5天(范围0至80天)。

结论

在转诊医院,猫内眼肌麻痹/眼肌麻痹很少作为唯一的临床体征出现。在这些病例中,可能需要先进的影像学检查(MRI/CT)才能做出明确诊断。然而,对于有全身临床体征的猫,建议进行腹部超声检查,作为一种成本较低且侵入性较小的诊断测试,以便在进行先进影像学检查之前进一步调查内眼肌麻痹/眼肌麻痹的可能病因。伴有其他颅内体征和/或全身临床体征的猫内眼肌麻痹/眼肌麻痹病例预后不良。

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