接受免疫抑制药物治疗的犬类非感染性原因所致疑似视神经炎：28只犬（2000 - 2015年）
Presumed optic neuritis of non-infectious origin in dogs treated with immunosuppressive medication: 28 dogs (2000-2015).
作者信息
Bedos L, Tetas R, Crespo V, Shea A
机构信息
Animal Health Trust, Lanwades Park, Kentford, CB8 7UU, UK.
Comparative Ophthalmology Unit, Animal Health Trust, Lanwades Park, Kentford, CB8 7UU, UK.
出版信息
J Small Anim Pract. 2020 Nov;61(11):676-683. doi: 10.1111/jsap.13233. Epub 2020 Sep 28.
OBJECTIVE
To describe the clinical findings, magnetic resonance imaging features, management and outcome of canine cases with presumed optic neuritis of non-infectious origin that were presented to a UK referral centre from January 2000 to December 2015.
MATERIALS AND METHODS
The clinical database was searched for optic neuritis. Dogs with acute-onset vision impairment, systemic immunosuppressive treatment and follow-up of ≥6 months were included. Information collected included: age; gender; breed; clinical signs and duration; physical, ophthalmic and neurological examination findings; concurrent systemic disease; and results of electroretinogram, magnetic resonance imaging, cerebrospinal fluid analysis, polymerase chain reaction and serology testing for Toxoplasma gondii, Neospora caninum and canine distemper virus, haematology and serum biochemistry profiles, abdominal ultrasound, thoracic radiography, treatment and outcome.
RESULTS
Twenty-eight dogs were included, with a total of 48 affected optic nerves. Age at presentation ranged from 6 months to 10.5 years. Fundoscopic evidence of optic nerve disease was present in 34 of 48 (71%) optic nerves. Magnetic resonance imaging revealed enlargement of 32 of 48 (67%) nerves and contrast enhancement of 28 of 48 (58%) nerves. Cerebrospinal fluid analysis performed in 25 of 28 (89%) dogs revealed pleocytosis (>5 nucleated cells/uL) in 11 of 25 (44%) and increased protein (>0.35 g/L) in 11 of 25 (44%). Immunosuppressive prednisolone was administered to all dogs. Prednisolone was used alone in 9 of 28 (32%) dogs; the remaining 19 dogs received a combination of prednisolone with cytosine arabinoside, cyclosporine and/or azathioprine. Vision was recovered in 24 eyes (50%) of 18 affected dogs.
CLINICAL SIGNIFICANCE
A positive response to treatment was observed in 64% of dogs with presumptively diagnosed optic neuritis treated with immunosuppressive medication.
目的
描述2000年1月至2015年12月间转诊至英国一家转诊中心的疑似非感染性视神经炎犬病例的临床症状、磁共振成像特征、治疗及预后情况。
材料与方法
在临床数据库中检索视神经炎病例。纳入急性视力障碍、接受全身免疫抑制治疗且随访时间≥6个月的犬只。收集的信息包括：年龄；性别；品种；临床症状及持续时间；体格、眼科及神经学检查结果；并发的全身性疾病；以及弓形虫、新孢子虫和犬瘟热病毒的视网膜电图、磁共振成像、脑脊液分析、聚合酶链反应及血清学检测结果、血液学及血清生化指标、腹部超声、胸部X线检查、治疗及预后情况。
结果
共纳入28只犬，累及48条视神经。就诊时年龄范围为6个月至10.5岁。48条视神经中有34条（71%）存在眼底镜检查视神经病变的证据。磁共振成像显示48条神经中有32条（67%）增粗，48条神经中有28条（58%）有对比增强。28只犬中有25只（89%）进行了脑脊液分析，其中25只中有11只（44%）出现细胞增多（>5个有核细胞/微升），25只中有11只（44%）蛋白质升高（>0.35 g/L）。所有犬均给予免疫抑制性泼尼松龙治疗。28只犬中有9只（32%）单独使用泼尼松龙；其余19只犬接受泼尼松龙与阿糖胞苷、环孢素和/或硫唑嘌呤联合使用。18只患犬的24只眼睛（50%）视力恢复。
临床意义
在接受免疫抑制药物治疗的疑似视神经炎犬中，64%的犬对治疗有阳性反应。
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