Ali Khaled M, Mostafa Ayman A
Department of Small Animal Surgery and Ophthalmology, Faculty of Veterinary Medicine, Cairo University, Cairo, Egypt.
Open Vet J. 2019 Oct;9(3):222-229. doi: 10.4314/ovj.v9i3.6. Epub 2019 Aug 4.
Proptosis is a serious traumatic disease commonly affecting small breed dogs and possibly causing loss of vision, with globe replacement surgery (GRS) being essential in most of the cases after stabilizing the patient's condition.
To determine the common dog breeds and clinical findings associated with traumatic proptosis and demonstrate the short-term complications following GRS.
The study was performed on 15 client-owned small-breed dogs presented with unilateral traumatic proptosis. Dogs were examined at initial presentation to determine the concurrent abnormalities associated with globe prolapse. The globe was replaced within the orbit and avulsed extraocular muscles were identified and sutured. Endoscopic examination of the ocular fundus was achieved 1 and 3 weeks after GRS in one Pekingese diagnosed with glaucoma. Complications following GRS were recorded.
Pekingese (53.3%) and Griffon (26.7%) were the most affected dogs with proptosis in Egypt. Bruised, hyperemic and swollen conjunctiva and periorbital tissue, lateral globe retraction, cloudy cornea, and miosis were common clinical findings associated with proptosis. Exposure keratitis, keratoconjunctivitis sicca, and exotropia were identified in all 15 patients at presentation. Complications following GRS included phthisis bulbi (53.3%), strabismus (26.7%), and lateral exotropia (20%). Intraocular pressure was reduced to 22 mmHg 3 weeks after GRS in the only patient diagnosed with glaucoma, and endoscopic evidence of optic nerve cupping was identified.
Clinical findings associated with proptosis at initial presentation may have influenced the outcome of GRS. Favorable prognosis may be given to patients with relatively high potential for vision at initial presentation and ≤2 extraocular muscle avulsions. Immediate surgical intervention following the occurrence of proptosis should be advised to achieve favorable disease prognosis.
眼球突出是一种严重的创伤性疾病,常见于小型犬种,可能导致失明,在大多数情况下,在稳定患者病情后,眼球置换手术(GRS)至关重要。
确定与创伤性眼球突出相关的常见犬种和临床发现,并展示GRS后的短期并发症。
对15只患有单侧创伤性眼球突出的客户拥有的小型犬进行了研究。在初次就诊时对犬进行检查,以确定与眼球脱垂相关的并发异常。将眼球放回眼眶内,识别并缝合撕脱的眼外肌。对一只被诊断为青光眼的北京犬在GRS后1周和3周进行了眼底内镜检查。记录GRS后的并发症。
在北京犬(53.3%)和格里芬犬(26.7%)是埃及受眼球突出影响最严重的犬种。结膜和眶周组织瘀伤、充血和肿胀、眼球外侧回缩、角膜混浊和瞳孔缩小是与眼球突出相关的常见临床发现。所有15例患者在就诊时均发现暴露性角膜炎、干眼症和外斜视。GRS后的并发症包括眼球痨(53.3%)、斜视(26.7%)和外斜视(20%)。在唯一被诊断为青光眼的患者中,GRS后3周眼压降至22 mmHg,并发现了视神经杯状凹陷的内镜证据。
初次就诊时与眼球突出相关的临床发现可能影响了GRS的结果。对于初次就诊时视力恢复潜力相对较高且眼外肌撕脱≤2处的患者,可给予良好的预后。建议在眼球突出发生后立即进行手术干预,以获得良好的疾病预后。