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猫的高血压性眼病:眼底病变指南以促进早期诊断。

Hypertensive ocular disease in cats: A guide to fundic lesions to facilitate early diagnosis.

作者信息

Carter Jenny

机构信息

Auckland, New Zealand.

出版信息

J Feline Med Surg. 2019 Jan;21(1):35-45. doi: 10.1177/1098612X18818668.

DOI:10.1177/1098612X18818668
PMID:30763152
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10814178/
Abstract

PRACTICAL RELEVANCE

Systemic hypertension is common in older cats and can result in damage to organs with a rich arteriolar supply such as the eyes, kidneys, myocardium and brain. Hypertensive disease in these organs is known as target organ damage (TOD). Disease in the eye resulting from hypertension is the most easily identifiable form of TOD and can often be the reason the cat is presented to the veterinarian. Routine blood pressure measurement and fundic examination allows cats with hypertensive ocular lesions to be detected early in the course of the disease, when the lesions have the best chance of responding to treatment.

CLINICAL CHALLENGES

Detecting early evidence of TOD in the fundus requires a veterinarian to be competent in recognising lesions associated with mild hypertensive disease, as well as the more easily recognised advanced lesions that frequently result in impaired vision and blindness.

AUDIENCE

This review is written for all veterinarians who treat cats. It provides information and images to facilitate and guide veterinarians performing fundoscopy in cats, in particular in those over 7 years of age, with the aim of diagnosing hypertensive ocular lesions when they are present.

EQUIPMENT

The clinical manifestations of hypertensive ocular disease can be detected non-invasively with inexpensive equipment. A summary of the equipment available for general practitioners to perform fundoscopy is provided.

EVIDENCE BASE

This is a comprehensive review of the literature on hypertensive ocular disease in cats. The author has also included images of hypertensive ocular lesions taken in general practice to highlight the variety of lesions that can be detected.

摘要

实际意义

全身性高血压在老年猫中很常见,可导致对具有丰富小动脉供应的器官造成损害,如眼睛、肾脏、心肌和大脑。这些器官中的高血压疾病被称为靶器官损害(TOD)。由高血压引起的眼部疾病是最容易识别的TOD形式,通常也是猫被带到兽医处就诊的原因。常规血压测量和眼底检查可使患有高血压性眼部病变的猫在疾病早期被检测出来,此时病变对治疗反应的机会最大。

临床挑战

要在眼底检测到TOD的早期迹象,需要兽医有能力识别与轻度高血压疾病相关的病变,以及更容易识别的晚期病变,这些晚期病变常常导致视力受损和失明。

受众

本综述是为所有治疗猫的兽医撰写的。它提供信息和图像,以方便和指导兽医对猫进行眼底镜检查,特别是对7岁以上的猫,目的是在出现高血压性眼部病变时进行诊断。

设备

高血压性眼病的临床表现可以用廉价设备进行无创检测。提供了可供全科医生进行眼底镜检查的设备总结。

证据基础

这是对猫高血压性眼病文献的全面综述。作者还纳入了在全科医疗中拍摄的高血压性眼部病变图像,以突出可检测到的各种病变。

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ACVIM consensus statement: Guidelines for the identification, evaluation, and management of systemic hypertension in dogs and cats.美国兽医内科学会共识声明:犬猫系统性高血压的识别、评估及管理指南
J Vet Intern Med. 2018 Nov;32(6):1803-1822. doi: 10.1111/jvim.15331. Epub 2018 Oct 24.
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ISFM Consensus Guidelines on the Diagnosis and Management of Hypertension in Cats.国际猫科医学协会(ISFM)关于猫高血压诊断与管理的共识指南
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