Beckwith-Cohen Billie, Petersen-Jones Simon M
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, Michigan State University, East Lansing, MI, United States.
Front Vet Sci. 2024 Feb 20;11:1337062. doi: 10.3389/fvets.2024.1337062. eCollection 2024.
The fundus is unique in that it is the only part of the body that allows for a noninvasive and uninterrupted view of vasculature and nervous tissue. Utilization of this can be a powerful tool in uncovering salient incidental findings which point to underlying systemic diseases, and for monitoring response to therapy. Retinal venules and arterioles allow the clinician to assess changes in vascular color, diameter, outline, and tortuosity. The retina and optic nerve may exhibit changes associated with increased or decreased thickness, inflammatory infiltrates, hemorrhages, and detachments. While some retinal manifestations of systemic disease may be nonspecific, others are pathognomonic, and may be the presenting sign for a systemic illness. The examination of the fundus is an essential part of the comprehensive physical examination. Systemic diseases which may present with retinal abnormalities include a variety of disease classifications, as represented by the DAMNIT-V acronym, for Degenerative/Developmental, Anomalous, Metabolic, Neoplastic, Nutritional, Inflammatory (Infectious/Immune-mediated/ischemic), Toxic, Traumatic and Vascular. This review details systemic illnesses or syndromes that have been reported to manifest in the fundus of companion animals and discusses key aspects in differentiating their underlying cause. Normal variations in retinal anatomy and morphology are also considered.
眼底具有独特性,因为它是身体唯一能让人无创且不间断地观察血管和神经组织的部位。利用这一点可成为发现指向潜在全身性疾病的显著偶然发现以及监测治疗反应的有力工具。视网膜小静脉和小动脉使临床医生能够评估血管颜色、直径、轮廓和迂曲度的变化。视网膜和视神经可能会出现与厚度增加或减少、炎性浸润、出血和脱离相关的变化。虽然全身性疾病的一些视网膜表现可能不具有特异性,但其他表现则具有特征性,可能是全身性疾病的首发症状。眼底检查是全面体格检查的重要组成部分。可能出现视网膜异常的全身性疾病包括多种疾病分类,可用DAMNIT-V首字母缩写表示,即退行性/发育性、异常性、代谢性、肿瘤性、营养性、炎性(感染性/免疫介导性/缺血性)、中毒性、创伤性和血管性。本综述详细介绍了据报道在伴侣动物眼底出现的全身性疾病或综合征,并讨论了区分其潜在病因的关键方面。还考虑了视网膜解剖结构和形态的正常变异。