Department of Veterinary Clinical Sciences, College of Veterinary Medicine, Iowa State University, Ames, IA, USA.
Animal Eye Consultants of Iowa, Hiawatha, IA, USA.
Vet Ophthalmol. 2021 Mar;24(2):125-155. doi: 10.1111/vop.12853. Epub 2020 Dec 27.
To describe functional and structural features of presumed cancer-associated retinopathy (CAR) mimicking sudden acquired retinal degeneration syndrome (SARDS) in dogs and describe treatment outcomes.
Subjects were 17 dogs from 8 eight US states and Canada diagnosed with SARDS or immune-mediated retinitis (IMR) by 12 ophthalmologists. Nine eyes from seven deceased patients were used for microarray (MA), histology, or immunohistochemical (IHC) analysis.
Dogs underwent complete ophthalmic examination, including retinal photography, optical coherence tomography (OCT), chromatic pupil light reflex testing (cPLR), and electroretinography (ERG), in addition to complete systemic examination. Histology, microarray, and IHC analysis were performed in CAR retinas to evaluate histological and molecular changes in retinal tissue.
None of the patients evaluated satisfied previously established criteria for diagnosis of SARDS (flat ERG+ no red - good blue PLR), and all were diagnosed with IMR. All patients were diagnosed with a cancer: meningioma (24%), sarcoma (18%), pituitary tumor (12%), and squamous cell carcinoma (12%), other (34%). Median survival time was 6 months from diagnosis (range 1-36 months). Most frequent systemic abnormalities were as follows: proteinuria (78%); elevated liver enzymes (47%); and metabolic changes (PU/PD, polyphagia - 24%). Immunosuppressive therapy resulted in the reversal of blindness in 44% of treated patients, with 61% of all treated patients recovering and/or maintaining vision. Median time for preservation of vision was 5 months (range 1-35 months).
Observed changes are highly suggestive of immune-mediated damage in IMR-CAR eyes. A relatively high percentage of patients with CAR responded positively to immunosuppressive therapy.
描述疑似癌相关视网膜病变（CAR）的功能和结构特征，这些病变类似于犬的获得性突发性视网膜变性综合征（SARDS），并描述治疗结果。
本研究对象为 17 只来自美国 8 个州和加拿大的犬，由 12 位眼科医生诊断为 SARDS 或免疫介导性视网膜炎（IMR）。7 名已故患者的 9 只眼用于微阵列（MA）、组织学或免疫组织化学（IHC）分析。
除了进行全面的系统检查外，犬还接受了全面的眼科检查，包括视网膜摄影、光学相干断层扫描（OCT）、彩色瞳孔光反射测试（cPLR）和视网膜电图（ERG）。
评估的患者均未满足先前建立的 SARDS 诊断标准（平坦 ERG+无红色-良好的蓝色 PLR），且均被诊断为 IMR。所有患者均诊断出患有癌症：脑膜瘤（24%）、肉瘤（18%）、垂体肿瘤（12%）和鳞状细胞癌（12%）、其他（34%）。从诊断到死亡的中位生存时间为 6 个月（范围 1-36 个月）。最常见的全身异常如下：蛋白尿（78%）；肝酶升高（47%）；代谢变化（PU/PD，贪食-24%）。免疫抑制治疗使 44%的治疗患者视力恢复或部分恢复，所有接受治疗的患者中有 61%恢复和/或维持视力。保留视力的中位时间为 5 个月（范围 1-35 个月）。
观察到的变化高度提示 IMR-CAR 眼中存在免疫介导的损伤。CAR 患者中相对较高比例的患者对免疫抑制治疗有积极反应。
