Scott Erin M, Schlesener Brittany N, Shaw Gillian C, Teixeira Leandro B C
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Texas A&M University, College Station, Texas.
Department of Pathological Sciences, School of Veterinary Medicine, University of Wisconsin-Madison, Madison, Wisconsin.
Vet Ophthalmol. 2019 Sep;22(5):666-673. doi: 10.1111/vop.12638. Epub 2019 Feb 4.
To describe the clinical and histopathologic features secondary to ocular and periocular snakebites in dogs requiring enucleation.
Retrospective review of patients with recorded snakebite envenomation from the archives of the Comparative Ocular Pathology Laboratory of Wisconsin (COPLOW) and Texas A&M Veterinary Medical Teaching Hospital (1997-2017). The cases included in this study required witnessed snakebites to the dog by the owner, clinical signs supportive of periocular or ocular envenomation, and/or histopathologic lesions compatible with snakebites. Two groups were established: ocular bites (OB) and periocular bites (PB).
Nineteen cases were included in the study (OB = 16/19; PB = 3/19). Dogs affected were typically older (median 8 years; range 1-18), and both sexes were equally represented. Left eyes (14/19) were more likely to sustain snake-induced trauma compared to right eyes (5/19). Fifteen breeds were identified, with terriers (9/19) commonly represented. Snakes bites occurred in six US states, with the majority of cases from Texas (7/19), California (5/19), and Arizona (4/19). Common clinical signs included facial edema, corneal ulceration, keratomalacia, uveitis, hyphema, and secondary glaucoma. All eyes demonstrated vision loss prior to enucleation. Histologically, the ocular and periocular tissues contained extensive necrosis associated with envenomation. Retinal detachment, lens capsule rupture, and intraocular hemorrhage/inflammation were commonly found.
Snakebite envenomation is a largely necrotizing disease process that can result in profound infiltrative and destructive ocular changes presumed to be related to the proteolytic factors and necrotoxins in venom. Ocular alterations secondary to snakebites may be irreversible regardless of supportive therapy instituted.
描述因眼部和眼周蛇咬伤而需要摘除眼球的犬的临床和组织病理学特征。
回顾性分析威斯康星比较眼病理学实验室（COPLOW）和德克萨斯A&M兽医医学教学医院存档的有蛇咬伤中毒记录的患者（1997 - 2017年）。本研究纳入的病例要求有主人目睹犬被蛇咬伤、支持眼周或眼部中毒的临床症状，和/或与蛇咬伤相符的组织病理学病变。分为两组：眼部咬伤（OB）和眼周咬伤（PB）。
本研究纳入19例（OB = 16/19；PB = 3/19）。受影响的犬通常年龄较大（中位年龄8岁；范围1 - 18岁），雌雄比例相当。与右眼（5/19）相比，左眼（14/19）更易遭受蛇咬伤所致创伤。共识别出15个品种，其中梗犬常见（9/19）。蛇咬伤发生在美国6个州，大多数病例来自德克萨斯州（7/19）、加利福尼亚州（5/19）和亚利桑那州（4/19）。常见临床症状包括面部水肿、角膜溃疡、角膜软化、葡萄膜炎、前房积血和继发性青光眼。所有眼睛在摘除眼球前均有视力丧失。组织学检查显示，眼组织和眼周组织存在与中毒相关联的广泛坏死。常见视网膜脱离、晶状体囊破裂和眼内出血/炎症。
蛇咬伤中毒主要是一种坏死性疾病过程，可导致严重的浸润性和破坏性眼部改变，推测与毒液中的蛋白水解因子和坏死毒素有关。无论采取何种支持治疗，蛇咬伤继发的眼部改变可能是不可逆的。
